Nursing Elites

1. Gio told his nurse that the FBI is monitoring and recording his every movement and that microphones have been placed in the unit walls. Which action would be the most therapeutic response?

• A. Confront the delusional material directly by telling Gio that this simply is not so.
• B. Tell Gio that this must seem frightening to him but that you believe he is safe here.
• C. Tell Gio to wait and talk about these beliefs in his one-on-one counseling sessions.
• D. Isolate Gio when he begins to talk about these beliefs.

Correct answer: B

Rationale: The most therapeutic response in this situation is to acknowledge Gio's feelings of fear and validate his experience by expressing empathy ('this must seem frightening to him'). By reassuring Gio that he is safe in the current environment, the nurse can help reduce his anxiety and build trust. Choice A is not recommended as directly confronting delusional beliefs may lead to increased distress and resistance. Choice C delays addressing Gio's concerns and may not provide immediate support. Choice D of isolating Gio can worsen his feelings of paranoia and distrust in the treatment setting.

2. Which of the following is an example of effective time management?

• A. Always agreeing to others' requests for help
• B. Arranging long meetings to discuss important data
• C. Using multiple forms of technology to communicate or educate others
• D. Working in a secluded area to minimize interruptions

Correct answer: D

Rationale: Effective time management involves strategies that help individuals focus and complete tasks efficiently. Working in a secluded area to minimize interruptions is an example of effective time management as it allows for concentration and productivity without distractions. Choices A, B, and C are not examples of effective time management. Always agreeing to others' requests for help can lead to overcommitment and time mismanagement. Arranging long meetings can be counterproductive as they consume time that could be used for actual work. Using multiple forms of technology, though helpful, can lead to information overload and inefficiency if not managed properly. Therefore, the most effective choice for optimal time management in this scenario is working in a secluded area to minimize interruptions.

3. A nurse is assisting a pregnant client who is having an amniocentesis. Which of the following statements by the nurse indicates the correct teaching for this procedure?

• A. I'm going to help you lie lat on your back for this."
• B. Don't worry, I'm sure everything will be all right."
• C. I will need to help you remove your shirt for this procedure."
• D. Now that the procedure is inished, I will put a small bandage over the puncture site."

Correct answer: D

Rationale: An amniocentesis is performed to draw amniotic luid from the sac around the fetus during pregnancy. It may be analyzed for certain disorders or complications associated with pregnancy. Following the procedure, the nurse should wash the client's abdomen and place a small bandage over the puncture site

4. According to HIPAA, which of the following is considered an individual right for privacy of a client's protected health information?

• A. The right to receive a copy of the organization's privacy practices
• B. The right to receive medical bills for care received
• C. The right to change personal health information
• D. An understanding that protected health information will only be used in regards to client treatments

Correct answer: A

Rationale: According to HIPAA, individuals receiving care at healthcare facilities have rights surrounding their protected health information. One of these rights is to receive a copy of the organization's privacy practices, which outlines how their health information will be used and protected. This ensures transparency and allows individuals to understand how their information is handled. The other choices are incorrect because while individuals have the right to access their health information, receive explanations of how it is used, and ensure its confidentiality, receiving medical bills or changing personal health information are not specifically outlined as rights related to the privacy of protected health information.

5. A 23-year-old patient in the 27th week of pregnancy has been hospitalized on complete bed rest for 6 days. She experiences sudden shortness of breath, accompanied by chest pain. Which of the following conditions is the most likely cause of her symptoms?

• A. Myocardial infarction due to a history of atherosclerosis.
• B. Pulmonary embolism due to deep vein thrombosis (DVT).
• C. Anxiety attacks due to worries about her baby's health.
• D. Congestive heart failure due to fluid overload.

Correct answer: B

Rationale: In a hospitalized patient on prolonged bed rest, the most likely cause of sudden onset shortness of breath and chest pain is pulmonary embolism. Pregnancy and prolonged inactivity both increase the risk of clot formation in the deep veins of the legs, known as deep vein thrombosis (DVT). These clots can dislodge and travel to the lungs, causing a pulmonary embolism. Myocardial infarction (Choice A) is less likely in a young patient without a significant history of atherosclerosis. Anxiety attacks (Choice C) may present with similar symptoms but are less likely in this context. Congestive heart failure (Choice D) is less probable given the acute onset of symptoms and absence of typical signs like peripheral edema in this case.

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