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As a type of quality indicator, an example of a structure standard is:
- A. a written philosophy.
- B. a procedure for a straight catheterization.
- C. a protocol for treatment of a client with chest pain.
- D. the diagnostic work-up for a client with abdominal pain.
Correct Answer: A
Rationale: Structure standards define all the conditions needed to operate, direct, and control a system. They do not address client care but rather describe structure with regard to purpose, such as philosophy, objectives, goals, hours of operation, and management responsibility.
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The nurse is admitting a client to the unit who says they would feel more reassured with an extra oxygen tank in their room because of a past incident when they were short of breath. Which of the following statements is the best response?
- A. I will make sure there is always an extra oxygen tank in your room.'
- B. I will ask the previous nurse if the extra tank was needed.'
- C. I will need to check if your insurance benefits would cover an additional oxygen tank.'
- D. The first priority is ensuring there are enough oxygen tanks for everyone who needs them. I am not sure we will be able to provide an extra on standby.'
Correct Answer: D
Rationale: The nurse should recognize the appropriate need for materials and equipment. The client's preference for extra equipment that other clients may need is not appropriate.
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 not in your care but who gave you 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.
- E. Looking up only the address of a co-worker who delivered a baby so you can surprise her with a gift.
Correct Answer: D
Rationale: Reviewing or obtaining any information regarding clients not in your care or discussing sensitive client information in non-secure environments are violations of HIPAA. Discussing discharge plans in a multi-bed recovery room is considered an 'incidental disclosure' and is not considered a HIPAA violation.
Which of the following is not one of the four categories related to client care plans?
- A. privacy
- B. evaluation
- C. diagnosis
- D. outcome
Correct Answer: A
Rationale: The four categories of client care plans are diagnosis, intervention, outcome, and evaluation.
The LPN needs to delegate a task to the nurse aide who is new to the unit. Which of these is the best option for the nurse to choose in proceeding?
- A. Delegate the task to the nurse aide, confirm understanding, and follow up to ensure the task was safely/correctly done.
- B. Delegate the task to the nurse aide, watch them perform the task without them seeing you, and follow up to ensure the task was done safely/accurately.
- C. Delegate the task to the nurse aide, supervise if needed and check in after the task to see if help is needed.
- D. Delegate the task to the nurse aide, ensure understanding of the task, and supervise task being performed.
Correct Answer: A
Rationale: Delegation is transferring responsibility for a task but sharing its accountability. It is the delegator's responsibility to make sure the delegatee understands the task prior and to follow up after to make sure it was done correctly and safely.
While performing a physical assessment on a 6-month-old infant, the nurse observes head lag. Which of the following nursing actions should the nurse perform first?
- A. Ask the parents to allow the infant to lay on her stomach to promote muscle development
- B. Notify the physician because a developmental or neurological evaluation is indicated
- C. Document the findings as normal in the nurse's notes
- D. Explain to the parents that their child is likely to be mentally retarded
Correct Answer: B
Rationale: Persistent head lag at 6 months suggests developmental or neurological issues, warranting immediate physician referral for evaluation.