Nursing Elites

1. When teaching a Vietnamese patient who has been treated for pneumonia and needs to complete her antibiotic regimen at home, what is an important cultural component to consider?

• A. Cupping will help to pull toxins from the body
• B. Coining will help to release the wind or bad energy from the body
• C. Once symptoms disappear there is no longer an illness
• D. Most households consist of at least 3 generations

Correct answer: C

Rationale: The correct answer is 'Once symptoms disappear there is no longer an illness'. In Vietnamese culture, there is a belief that once symptoms go away, the illness is no longer present and does not require further treatment. This is crucial to understand when educating Vietnamese patients about completing their antibiotic regimen. Choices A and B (cupping and coining) are traditional Vietnamese healing practices that are not directly related to completing antibiotic therapy. Choice D, about households consisting of multiple generations, is not directly relevant to the completion of antibiotic treatment for pneumonia in this context.

2. How do technological advances relate to HIPAA?

• A. Technology can expose us to HIPAA violations.
• B. Computers facilitate information sharing.
• C. Computer screens should be visible only to authorized personnel.
• D. Technology enhances HIPAA confidentiality.

Correct answer: A

Rationale: Technology can expose us to HIPAA violations. For instance, leaving a computer screen unattended and visible to unauthorized individuals can result in breaches of patient confidentiality, leading to HIPAA violations. While computers can indeed aid in sharing information, this is not directly related to HIPAA compliance. Ensuring that computer screens are only visible to authorized personnel is a good practice, but it does not address the broader risks and challenges posed by technological advancements in maintaining HIPAA compliance. Therefore, the correct answer is that technology can expose us to HIPAA violations.

3. A client has a right-sided chest tube with 50 cc of serosanguinous fluid in the collection chamber and air bubbles are collecting in the water seal chamber. What is the most appropriate action for the nurse to take at this time?

• A. Do nothing; this is a normal response
• B. Strip the tubing to remove any clots
• C. Place a clamp on the tube near the client's chest
• D. Remove the collection chamber and connect the tubing to a new device

Correct answer: C

Rationale: The water seal of a chest tube acts as a one-way valve. Air bubbles in the water seal indicate a leak between the client and the chamber. The nurse should briefly clamp the tube near the client's chest to locate the source of the leak. Once identified, the nurse should unclamp the tubing and notify the physician immediately. Choice A is incorrect because air bubbles in the water seal chamber are not a normal finding and indicate a leak. Choice B is incorrect as stripping the tubing could aggravate the issue and is not the initial appropriate action. Choice D is incorrect as it does not address the immediate need to locate and address the leak.

4. Which of the following clients have barriers to accessing healthcare?

• A. A 36-year-old client who must use a wheelchair for mobility
• B. A 44-year-old client who is visiting the United States on a visa from India
• C. An 81-year-old client who is unable to drive
• D. All of the above

Correct answer: D

Rationale: All of the provided clients have barriers to accessing healthcare. Clients with physical limitations, such as the 36-year-old client using a wheelchair, may face challenges in mobility and accessing healthcare facilities. The 44-year-old client from India visiting the United States on a visa may encounter barriers related to language, cultural differences, or insurance coverage. The 81-year-old client who is unable to drive may struggle with transportation to healthcare appointments. Therefore, all three clients face different barriers to accessing healthcare, making 'All of the above' the correct answer.

5. A nurse is caring for a client who is post-op day #1 after a total hip replacement. Although the client was alert with a normal affect in the morning, by lunchtime, the nurse notes the client is confused, has slurred speech, and is having trouble with her balance. Her blood glucose level is 48 mg/dl. What is the next action of the nurse?

• A. Contact the physician immediately
• B. Administer a bolus of 50 cc of D20W through the IV
• C. Administer 10 units of regular insulin
• D. Give the client 6 oz. of orange juice

Correct answer: D

Rationale: A client with a blood glucose level of 48 mg/dl is experiencing significant hypoglycemia, as manifested by confusion, balance difficulties, and slurred speech. The nurse should work to correct this situation as rapidly as possible. The first measure that can be performed quickly and will have fast results is to give the client something to eat or drink that contains glucose, such as 6 oz. of orange juice. Administering a bolus of D20W through the IV (Choice B) would be too aggressive and could lead to complications in this scenario. Administering regular insulin (Choice C) would further lower the blood glucose level, worsening the client's symptoms. Contacting the physician (Choice A) is important, but immediate intervention to raise the blood glucose level is crucial to address the client's hypoglycemia.

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