Nursing Elites

1. Which cultural group has the highest incidence of inflammatory bowel disease (IBD)?

• A. Asians
• B. Caucasians
• C. Hispanics
• D. African Americans

Correct answer: B

Rationale: The correct answer is Caucasians. Studies have shown that Caucasians have the highest incidence of inflammatory bowel disease (IBD) compared to other cultural groups. While IBD can affect individuals from various backgrounds, the prevalence is notably higher in Caucasians. Asians, Hispanics, and African Americans have a lower incidence of IBD compared to Caucasians, making them incorrect choices in this context.

2. The client asks the nurse not to tell anyone outside of the care team about his positive HIV diagnosis. What response is most appropriate?

• A. "I have to inform all clients on the unit of your diagnosis as it is transmissible."?
• B. "I will not communicate your diagnosis to anyone without your permission."?
• C. "Because this is a communicable disease, it may need to be reported to the CDC."?
• D. "You should not be concerned with who I share your diagnosis with."?

Correct answer: C

Rationale: The most appropriate response is C: "Because this is a communicable disease, it may need to be reported to the CDC."? It is important to uphold patient confidentiality, but in the case of certain communicable diseases like HIV, there are legal requirements for mandatory reporting to public health authorities such as the CDC. Option A is incorrect because it violates patient confidentiality and does not consider legal obligations. Option B, while respecting the client's wishes, may not align with the legal requirement for reporting certain communicable diseases. Option D is inappropriate as it dismisses the client's concerns and rights regarding their health information.

3. What is a true statement about post-discharge follow-up?

• A. The nurse should ensure the client is educated on their discharge instructions.
• B. If the client seems stable, they likely do not need a follow-up visit.
• C. The physician is responsible for ensuring the client has their prescriptions upon discharge.
• D. If the client has questions, the nurse should address them before discharge.

Correct answer: A

Rationale: The correct statement is that the nurse should ensure the client is educated on their discharge instructions. This is crucial to promote continuity of care and prevent adverse events. The responsibility of educating the client falls on the nurse, not assuming stability without a follow-up visit. While the physician may prescribe medications, it is the nurse's responsibility to ensure the client has them before discharge. Instructing the client to bring up questions at a follow-up appointment is not ideal; all questions should be addressed before discharge to ensure the client's understanding and compliance.

4. As part of the teaching plan for a client with type I diabetes mellitus, the nurse should include that carbohydrate needs might increase when:

• A. an infection is present.
• B. there is an emotional upset.
• C. a large meal is eaten.
• D. active exercise is performed.

Correct answer: D

Rationale: During active exercise, insulin sensitivity increases, leading to lower blood glucose levels. To balance the effect of increased insulin sensitivity, additional carbohydrates might be needed. The other choices are incorrect because: A) an infection typically raises blood glucose levels rather than increasing the need for carbohydrates; B) emotional upset can impact blood glucose but does not directly affect carbohydrate needs; C) while a large meal can raise blood glucose levels, it does not necessarily mean an increase in carbohydrate needs.

5. Which of the following scenarios are considered violations of HIPAA laws?

• A. Discussing discharge plans with a client in a multi-bed recovery room with the curtain drawn around the client's bed.
• B. Looking up the medical information of a friend without permission.
• C. Checking on your spouse's medical record because you are listed as her power of attorney.
• D. Avoiding conversations about clients while in line in the cafeteria with a mutual caregiver of that client.

Correct answer: C

Rationale: Scenarios B and C are considered violations of HIPAA laws. Looking up the medical information of a friend who is not in your care, even with permission, is a violation of HIPAA as the friend is not your patient. Checking on your spouse's medical record, even as a power of attorney, is a violation unless it is directly related to caregiving decisions. Discussing discharge plans with a client in a multi-bed recovery room with the curtain drawn around the client's bed is not a violation of HIPAA. This scenario is considered an 'incidental disclosure' and is not a breach of HIPAA privacy rules. Avoiding conversations about clients while in line in the cafeteria with a mutual caregiver of that client is actually a good practice as it maintains client confidentiality.

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