Nursing Elites

1. Which of the following reasons would be legal when considering a patient's medical record?

• A. Allowing a patient's brother to view her chart to find out her birthdate and address so that he can mail her a card
• B. Not allowing a patient to view her own chart because the physician feels this information would be detrimental to her wellbeing
• C. Not allowing a patient to view her chart because she is behind on her payments
• D. All of the above are legal

Correct answer: B

Rationale: The correct answer is not allowing a patient to view her own chart because the physician feels this information would be detrimental to her wellbeing. Physicians have a duty to withhold certain health information from patients if disclosing it could potentially harm the patient. In situations where revealing certain information may have a significantly negative impact on the patient's mental or physical health, healthcare providers have the legal right to withhold that information. Allowing a patient's brother to view her chart for non-medical reasons like sending a card is not a valid legal reason for disclosing patient information. Similarly, refusing access based on financial reasons is not a legal ground for restricting access to a patient's medical record as patient care should not be influenced by financial matters.

2. Is it true that Hepatitis C virus (HCV) can be spread through hugging, sneezing, coughing, sharing eating utensils, and other forms of casual contact?

• A. True
• B. False
• C.
• D.

Correct answer: B

Rationale: False. HCV is not spread through casual contact such as hugging, sneezing, or sharing eating utensils. The correct modes of transmission for HCV include direct contact with human blood through blood transfusions, improperly sterilized needles and syringes, needle sharing, or occasionally through sexual contact. Therefore, the statement is false, making 'False' the correct answer. Choices A, C, and D are incorrect as they do not accurately reflect the mode of transmission of HCV.

3. Which of the following situations might warrant a laboratory magnesium level?

• A. Hyperthyroidism
• B. Arthritis
• C. Ulcerative colitis
• D. Depression

Correct answer: C

Rationale: Ulcerative colitis can lead to symptoms such as abdominal pain, fever, diarrhea, and weight loss. This condition may impact the absorption of certain nutrients, including magnesium. Therefore, patients with chronic gastrointestinal conditions like ulcerative colitis should be screened for electrolyte imbalances related to impaired digestion. Hyperthyroidism, arthritis, and depression do not typically directly affect magnesium levels in the same way as gastrointestinal conditions like ulcerative colitis.

4. At the beginning of her shift in a long-term care facility, which of the following clients should a nurse check on first?

• A. A 91-year-old man who needs help eating breakfast
• B. An 86-year-old man who has been incontinent in his bed
• C. An 82-year-old woman who needs IV antibiotics
• D. A 75-year-old man who is recovering from an injury and needs an ice pack

Correct answer: C

Rationale: When prioritizing care in a long-term care facility, the nurse must consider tasks that require their immediate attention and cannot be delegated. Administering IV antibiotics is a critical nursing task that only the nurse can perform, ensuring the timely and correct delivery of medication to the patient. While assisting with breakfast, managing incontinence, and providing an ice pack are important, these tasks can be delegated to other healthcare team members, allowing the nurse to address the client needing IV antibiotics first to ensure effective treatment and patient safety.

5. What preparation is necessary for a colposcopy procedure?

• A. NPO for 8-12 hours before the procedure.
• B. D/C all hypertension medications for two days prior to the procedure.
• C. Take three Dulcolax tablets and two containers of Miralax the day before to clear out the lower GI system.
• D. None of the above prep is necessary for this type of procedure.

Correct answer: D

Rationale: A colposcopy procedure is performed to examine the vagina and cervix. The only preparation required is washing the external genitals with soap and water on the morning of the procedure. Choices A, B, and C suggest unnecessary preparations that are not relevant to a colposcopy. NPO for 8-12 hours, discontinuing hypertension medications, and using laxatives are not part of the standard preparation for a colposcopy.

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