Nursing Elites

1. While working in the clinical facility, the student nurse learns that a family member has been admitted to the same facility. What statement is true about the student's access to the family member's medical record?

• A. The student may access the family member's medical record as a nurse in the facility.
• B. The student nurse should not access the family member's record until obtaining instructor approval.
• C. The student may access the family member's medical record because of the family relationship.
• D. The student nurse should not view the record unless they are providing care for the family member.

Correct answer: D

Rationale: The student nurse should not view the family member's record unless they are directly involved in providing care to maintain confidentiality. Accessing the record without a legitimate reason breaches patient confidentiality and violates ethical principles. Choice A is incorrect because being a nurse in the facility does not automatically grant access to a family member's record. Choice B is incorrect as it does not address the primary concern of direct involvement in care. Choice C is incorrect as family relationship alone does not justify accessing the medical record.

2. A patient is admitted with pneumonia. My case manager refers to a plan of care that specifically identifies dates when supplemental oxygen should be discontinued, positive pressure ventilation with bronchodilators should be changed to self-administer inhalers, and antibiotics should be changed from intravenous to oral treatment, based on assessment findings. This plan of care is referred to by what term?

• A. patient classification system
• B. patient-centered plan of care
• C. diagnosis-related group
• D. clinical pathway

Correct answer: D

Rationale: A clinical pathway is a structured, evidence-based plan that outlines the expected course of treatment and interventions for a specific diagnosis or procedure, in this case, pneumonia. It includes guidelines on the timing of interventions and transitions in care based on assessment findings, promoting standardized care and improved outcomes for patients. The other choices are incorrect: A) patient classification system categorizes patients based on similar characteristics; B) patient-centered plan of care focuses on individual patient needs and preferences; C) diagnosis-related group is a classification system used for billing purposes.

3. 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.

4. The nurse overhears a physician yelling at a newly hired graduate nurse in the hall. What is the nurse's best caring response?

• A. Yell at the physician for yelling at a new graduate and report the incident to the supervisor.
• B. Wait until the situation ends and comfort the graduate privately.
• C. Suggest that the physician take a quieter and more private approach to the problem.
• D. Ignore the situation to avoid embarrassing the graduate further.

Correct answer: C

Rationale: Suggesting a quieter and more private approach to the problem is the best caring response as it addresses the issue respectfully. This response shows empathy towards the graduate nurse and also aims to improve the situation without escalating it further. Choice A is not ideal as responding to yelling with yelling can exacerbate the situation and create more tension. Choice B, while offering comfort, does not directly address the inappropriate behavior of the physician. Choice D is not recommended as ignoring the situation may not help the graduate nurse and can lead to the continuation of inappropriate behavior without intervention.

5. Which action directly resulted from the contribution made by Linda Richards?

• A. Using an antiseptic before administering an injection
• B. Exploring the psychosocial needs of the patient
• C. Documenting patient care in the medical record
• D. Listening to a patient describe his or her symptoms

Correct answer: C

Rationale: The correct answer is C: Documenting patient care in the medical record. Linda Richards' contribution was developing a system for recording patient details and care, leading to modern medical records. This innovation directly resulted in the practice of documenting patient care in medical records, ensuring accurate and organized patient information for effective healthcare delivery. Choices A, B, and D are incorrect because they do not directly stem from Richards' specific contribution related to medical records.

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