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A nurse is reviewing information about the Health Insurance Portability and Accountability Act (HIPAA) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching?
- A. Information about a client can be disclosed to family members at any time.
- B. HIPAA established regulations of individually identifiable health information in verbal, electronic, or written form.
- C. HIPAA is a federal law, not a state law.
- D. A client's address would be an example of personally identifiable information.
- G. A
Correct Answer: HIPAA restricts sharing client information with family without consent, except in specific care-related situations. The other statements are correct: HIPAA regulates identifiable health information, is a federal law, and includes addresses as protected information.
Rationale:
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A nurse is working with a woman who has been diagnosed with severe fibrocystic breast disease. After describing the medications that can be used as treatment, the nurse determines that additional teaching is needed when the client identifies which drug as being used?
- A. Danazol
- B. Penicillin
- C. Bromocriptine
- D. Tamoxifen
- G. B
Correct Answer: Penicillin, an antibiotic, has no role in treating fibrocystic breast disease, which involves hormonal changes. Danazol, bromocriptine, and tamoxifen are used to manage symptoms by altering hormone levels.
Rationale:
To assist the woman in regaining control of the urinary sphincter after bladder surgery, the nurse should teach the client to perform which action?
- A. Limit the intake of fluid.
- B. Void every hour while awake.
- C. Perform Kegel exercises daily.
- D. Take a laxative every night.
- G. C
Correct Answer: Kegel exercises strengthen pelvic floor muscles, improving urinary sphincter control. Limiting fluids risks dehydration, frequent voiding may irritate the bladder, and laxatives address constipation, not sphincter control.
Rationale:
A postmenopausal woman with uterine prolapse is being fitted with a pessary. The nurse would be most alert for which side effect?
- A. Increased vaginal discharge
- B. Urinary tract infection
- C. Vaginitis
- D. Vaginal ulceration
- G. D
Correct Answer: Vaginal ulceration is a serious side effect of pessary use due to potential pressure necrosis and mucosal erosion. Increased vaginal discharge is normal, and UTIs and vaginitis are less common with proper hygiene and care.
Rationale:
A nurse is caring for a client who is 4 days postoperative following a right radical mastectomy. Which of the following activities should the nurse anticipate being the most difficult for this client to perform with her right hand?
- A. Brushing her teeth
- B. Buttoning her blouse
- C. Eating her breakfast
- D. Combing her hair
- G. D
Correct Answer: Combing hair requires lifting the arm above the shoulder, which can be painful and difficult due to impaired lymphatic drainage and nerve damage post-mastectomy. Brushing teeth, buttoning a blouse, and eating are less challenging as they require minimal arm elevation or strength.
Rationale:
A nurse is preparing a class discussion on the clinical manifestations of a heart attack observed in women. Which symptoms would the nurse include as key assessment data? Select all that apply.
- A. Sleep disturbances
- B. Syncope
- C. Unusual fatigue
- D. Extreme hunger
- E. Arm pain
- G. A,C,E
Correct Answer: Women may experience sleep disturbances (48%), unusual fatigue (70%), and arm pain (42%) before a heart attack, indicating reduced cardiac function. Syncope (12%) and extreme hunger (4%) are less common.
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