Nokea
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? Which statement indicates a need for HIPAA teaching?
- A. A patient's address would be an example of personally identifiable information.
- B. HIPAA is a federal law, not a state law.
- C. HIPAA established regulations of individually identifiable health information in verbal, electronic, or written form.
- D. Information about a client can be disclosed to family members at any time.
Correct Answer: D
Rationale: The correct answer is D because HIPAA protects the confidentiality of a patient's health information and restricts disclosure to family members without the patient's consent. This ensures privacy and security. Choice A is correct as a patient's address is considered personally identifiable information. Choice B is correct as HIPAA is indeed a federal law. Choice C is correct as HIPAA covers health information in various forms. Choices E, F, and G are not relevant to the question.
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A nurse is caring for a patient who is 9 days postoperative following a total laryngectomy. The nurse removes the patient's NG tube and initiates oral feedings. Which of the following statements should the nurse make? Which statement should the nurse make post-laryngectomy?
- A. You should have no trouble swallowing fluids.
- B. It is no longer possible for you to choke on or aspirate food.
- C. I will add a thickener to your liquids to prevent aspiration.
- D. Tuck your chin when you swallow so you won't choke.
Correct Answer: D
Rationale: The correct answer is D: "Tuck your chin when you swallow so you won't choke." After a laryngectomy, patients have altered anatomy that can affect swallowing. Tucking the chin helps close off the airway during swallowing, reducing the risk of choking. This technique directs the food towards the esophagus instead of the trachea, minimizing the risk of aspiration. Choices A, B, and C are incorrect because they do not address the specific swallowing precautions needed post-laryngectomy. Choice A assumes normal swallowing function, which may not be the case. Choice B is inaccurate as aspiration can still occur post-laryngectomy. Choice C is not specific to the patient's individual needs and may not be necessary.
A nurse is caring for a patient who has a new prescription for amitriptyline. Which of the following adverse effects should the nurse monitor for? Which adverse effect should the nurse monitor for amitriptyline?
- A. Constipation
- B. Hypertension
- C. Fever
- D. Tachypnea
Correct Answer: A
Rationale: The correct answer is A: Constipation. Amitriptyline, a tricyclic antidepressant, can cause anticholinergic effects leading to constipation. The rationale is that amitriptyline blocks the action of acetylcholine in the gut, slowing down bowel movements and causing constipation. Monitoring for constipation is important to prevent complications such as fecal impaction. Choices B, C, and D are incorrect as hypertension, fever, and tachypnea are not commonly associated with amitriptyline use.
A nurse is attending to a patient with a wound infection. What should the nurse do when collecting a wound-drainage specimen for culture? What should the nurse do for wound culture collection?
- A. Swab an area of skin away from the wound to identify the usual flora.
- B. Irrigate the wound with an antiseptic prior to obtaining the specimen.
- C. Cleanse the wound with 0.9% sodium chloride saline irrigation before obtaining the specimen.
- D. Include intact skin at the wound edges in the culture.
Correct Answer: C
Rationale: The correct answer is C: Cleanse the wound with 0.9% sodium chloride saline irrigation before obtaining the specimen. This step is essential to ensure that the sample collected is not contaminated with external bacteria, which could lead to inaccurate results. By cleansing the wound with a sterile solution like saline, the nurse can remove debris and bacteria from the wound surface, increasing the likelihood of obtaining an accurate culture. Swabbing an area away from the wound (choice A) would not provide an accurate representation of the bacteria present in the wound. Irrigating the wound with an antiseptic (choice B) could potentially interfere with the culture results by killing the bacteria being tested for. Including intact skin at the wound edges in the culture (choice D) is unnecessary and could introduce contaminants. Overall, choice C is the most appropriate step to ensure a reliable wound culture.
A nurse is caring for a patient who is postoperative following a cesarean section. Which of the following findings should the nurse report to the provider? Which finding post-cesarean should the nurse report?
- A. Lochia serosa
- B. Fundus firm at the umbilicus
- C. Mild cramping
- D. Foul-smelling vaginal discharge
Correct Answer: D
Rationale: The correct answer is D: Foul-smelling vaginal discharge. This finding indicates a possible infection, which is crucial to report to the provider for prompt intervention. Foul odor may indicate endometritis or other postoperative complications.
A: Lochia serosa is a normal finding post-cesarean.
B: Fundus firm at the umbilicus is a normal finding post-cesarean, indicating proper involution.
C: Mild cramping is common post-cesarean due to uterine contractions as it returns to its pre-pregnancy size.
A nurse is educating a patient with benign prostatic hypertrophy who has been newly prescribed finasteride. What should the nurse include in the teaching? What should the nurse include in finasteride teaching?
- A. Decreased libido is an adverse effect of the medication.
- B. Avoid drinking grapefruit juice when taking this medication.
- C. PSA levels will increase while taking this medication.
- D. Expect to see a response from the medication within one week.
Correct Answer: A
Rationale: The correct answer is A: Decreased libido is an adverse effect of the medication. Finasteride is a 5-alpha reductase inhibitor commonly used to treat benign prostatic hypertrophy. One of the common side effects of finasteride is a decrease in libido due to its mechanism of action on hormone levels. This information is crucial for the patient to be aware of to monitor and report any changes in sexual function. Choice B is incorrect because grapefruit juice does not interact with finasteride. Choice C is incorrect as PSA levels typically decrease with finasteride treatment. Choice D is incorrect as it may take several months to see a response from the medication due to its mechanism of action on prostate size.