Nursing Elites

1. The increasing use of licensed practical nurses (LPNs) in management positions, especially in long-term care facilities, is an example of what?

• A. Assertive management
• B. A shifting paradigm
• C. Critical thinking
• D. Smarter LPN graduates

Correct answer: B

Rationale: The correct answer is B: A shifting paradigm. The increasing use of LPNs in management positions, particularly in long-term care facilities, represents a changing paradigm in healthcare management. This shift indicates a move towards assigning leadership responsibilities to LPNs, signaling a departure from traditional industry roles. Choices A, C, and D are incorrect because the situation described does not primarily demonstrate assertive management, critical thinking, or the intelligence of LPN graduates. The focus is on the evolving role of LPNs in management, suggesting a broader change in healthcare practices.

2. What may the patient's statement, 'I cannot read until I get my glasses,' indicate?

• A. The patient is embarrassed about needing glasses
• B. The patient has visual impairment
• C. The patient may be illiterate
• D. The patient is being uncooperative

Correct answer: C

Rationale: The patient stating they cannot read until they get their glasses suggests a potential issue with literacy rather than visual impairment or unwillingness to cooperate. This statement should prompt further assessment to determine the patient's reading abilities and potential literacy needs. Choice A is incorrect as the statement does not directly imply embarrassment. Choice B is incorrect as the statement does not necessarily indicate a visual impairment. Choice D is incorrect as there is no clear evidence of the patient being uncooperative based on the provided statement.

3. A healthcare professional walks into the nurse's station and sees several staff members looking at the electronic medical record for a celebrity client on another unit. Which of the following actions should the healthcare professional take first?

• A. remind the staff members that this is a breach of confidentiality
• B. discuss the issue with the unit manager
• C. request that an administrative restriction be placed on the client's medical access
• D. prepare a report for the facility ethics committee

Correct answer: A

Rationale: The correct action for the healthcare professional to take first is to remind the staff members that accessing the electronic medical record of a celebrity client from another unit is a breach of confidentiality. This immediate action addresses the ethical and legal issue at hand, emphasizing the importance of patient confidentiality and privacy. Discussing the issue with the unit manager, requesting administrative restrictions, or preparing a report for the facility ethics committee can be considered after addressing the initial breach and reminding staff members of their obligations.

4. Nurses and community officials are working together to ensure that churches and schools have needed supplies to provide shelter for a large number of individuals in the event of a natural or man-made disaster. These activities represent which phase of a disaster continuum?

• A. Crisis Intervention
• B. Preparedness
• C. Recovery
• D. Relief Response

Correct answer: B

Rationale: The scenario described in the question, where nurses and community officials are preparing churches and schools with supplies for potential disaster situations, falls under the Preparedness phase of a disaster continuum. Preparedness involves planning, organizing, and equipping to handle potential disasters before they occur. This phase aims to enhance the readiness of individuals, organizations, and systems to respond effectively when a disaster strikes. Choices A, C, and D are incorrect because they do not align with the activities of preparing for a disaster before it happens; Crisis Intervention deals with immediate response during or after a disaster, Recovery focuses on rebuilding and restoring after a disaster, and Relief Response involves providing immediate assistance in the aftermath of a disaster.

5. While supervising the care of several clients, which action requires intervention by the charge nurse?

• A. A nurse photocopies a client's diagnostic test results.
• B. An assistive personnel documents the client's vital signs on the client's paper-based graphic record.
• C. The unit secretary faxes a client's laboratory results to the provider.
• D. An RN stays with a client to discuss her understanding of her vital signs that were requested.

Correct answer: A

Rationale: The charge nurse should intervene when a nurse photocopies a client's diagnostic test results as it violates patient confidentiality and privacy. This action breaches HIPAA regulations, and sensitive patient information should not be photocopied without proper authorization. The other actions are within the scope of practice and do not raise concerns regarding patient privacy or confidentiality.

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