Nursing Elites

1. An RN cared for a state senator during the day shift. Later that day he was having dinner with friends when the news mentioned the senator had been hospitalized. The RN’s friends asked if he knew what was wrong with the senator. Which ethical principle should the RN consider when replying?

• A. Fidelity
• B. Confidentiality
• C. Veracity
• D. Accountability

Correct answer: B

Rationale: The RN should consider the ethical principle of confidentiality when replying.

2. What is the main purpose of a healthcare proxy?

• A. To manage financial affairs
• B. To make medical decisions on behalf of the patient
• C. To provide legal representation
• D. To oversee patient discharge planning

Correct answer: B

Rationale: The main purpose of a healthcare proxy is to make medical decisions on behalf of the patient when they are unable to do so. Choice A is incorrect as managing financial affairs is typically handled by a power of attorney for finances. Choice C is incorrect as a healthcare proxy is not meant to provide legal representation. Choice D is incorrect as overseeing patient discharge planning is a responsibility of healthcare providers, not a healthcare proxy.

3. An RN is writing reminders for good documentation for the nurses on her staff. The purpose is to ensure nursing documentation is legally credible. Which of the following is a recommendation she should include in the reminders?

• A. Use shortcuts in documentation.
• B. Only use approved abbreviations.
• C. Documentation should be subjective.
• D. Document after care is provided.

Correct answer: B

Rationale: The correct recommendation the RN should include in the reminders is to 'Only use approved abbreviations.' Using shortcuts in documentation (choice A) may lead to errors or omissions, affecting the credibility of documentation. Documentation should be objective (choice C) rather than subjective to ensure accuracy and legal credibility. It is essential to document care promptly after providing it (choice D) to maintain the accuracy and completeness of patient records, but using approved abbreviations is a more specific recommendation to enhance legal credibility.

4. An active 28-year-old male with type 1 diabetes is being seen in the endocrine clinic. Which finding may indicate the need for a change in therapy?

• A. Hemoglobin A1C level 6.2%
• B. Blood pressure 146/88 mmHg
• C. Heart rate at rest 58 beats/minute
• D. High-density lipoprotein (HDL) level 65 mg/dL

Correct answer: B

Rationale: The correct answer is B. In a young adult with type 1 diabetes, a blood pressure of 146/88 mmHg may indicate the need for a change in therapy as it is above the recommended target levels. High blood pressure can increase the risk of cardiovascular complications in diabetic patients. Choices A, C, and D are within normal ranges and do not necessarily indicate the need for an immediate change in therapy. A Hemoglobin A1C level of 6.2% is generally considered good control for a diabetic patient, a resting heart rate of 58 beats/minute is normal for an active individual, and an HDL level of 65 mg/dL is considered to be in the desirable range for heart health.

5. From a unit perspective, disruptive and violent patient behavior may be distracting to patients and staff. As the nurse manager, you are concerned about: (EXCEPT)

• A. Patient and staff safety.
• B. Team tension.
• C. Fear of disappointment.
• D. Stress levels.

Correct answer: C

Rationale: Disruptive and violent patient behavior can indeed pose challenges on a unit. Concerns as a nurse manager would revolve around patient and staff safety (Choice A) due to the risk of harm, team tension (Choice B) arising from managing such situations, and stress levels (Choice D) of both patients and staff. Fear of disappointment (Choice C) is not a typical concern in this scenario and does not directly relate to the immediate impact of disruptive and violent patient behavior.

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