Nokea
In order to safeguard patient information when using a computer, the nurse should:
- A. only use the computer located in the nurse's station.
- B. wait until the end of the shift and document all information at one time.
- C. use personal code words and abbreviations to disguise information.
- D. change the computer password frequently. Computerized patient information requires extra vigilance by the nurse to safeguard confidentiality. Changing personal passwords frequently helps safeguard information. When using the computer at a health care facility, the nurse must remember not to leave a computer screen open when he or she is finished. The nurse should always log out so that someone else cannot access information using his or her password and must not share his or her password with others. Computers in the nurse's station are not as convenient as those at the bedside or in the hall. Personal codes and abbreviations are not useful.
Correct Answer: D
Rationale: The correct answer is D: change the computer password frequently. This is essential to safeguard patient information on a computer. Changing passwords regularly enhances security by reducing the risk of unauthorized access. By doing so, the nurse ensures that even if someone gains access to their password, it will soon be outdated. This practice aligns with best practices for maintaining confidentiality and data security.
Now, let's analyze the other choices:
A: Using only the computer at the nurse's station limits flexibility and convenience for accessing patient information.
B: Waiting until the end of the shift to document information increases the risk of errors and delays in updating patient records.
C: Using personal code words and abbreviations may lead to misinterpretation of information and compromise patient confidentiality.
In summary, changing the computer password frequently is the most effective measure to safeguard patient information on a computer, while the other options do not provide the same level of security and confidentiality.
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A patient states, "I'm so worried that I might have cancer." The nurse responds, "It is time for you to eat breakfast." The nurse's response is an example of:
- A. using clichés.
- B. judgmental response.
- C. changing the subject.
- D. giving false reassurance. Changing the subject is a block to effective communication in which the patient is deprived of the chance to verbalize concerns.
Correct Answer: C
Rationale: The correct answer is C: changing the subject. The nurse's response shifts the conversation away from the patient's expression of worry about having cancer to a completely unrelated topic - eating breakfast. This technique blocks effective communication as it disregards the patient's concerns and prevents further exploration of the underlying issue. By redirecting the conversation, the nurse fails to address the patient's emotional needs and misses an opportunity to provide support and reassurance. Choices A, B, and D are incorrect as they do not accurately reflect the nurse's response in this scenario.
The nurse is reviewing Mr. N's (non-Hodgkin lymphoma) medication administration record and sees that the combination therapy aprepitant, dexamethasone, and ondansetron was administered during the last shift. What is the nurse most likely to ask to determine efficacy of the therapy?
- A. "On a scale of 1 to 10, with 1 being the least and 10 being the worst, what number is your pain? Where is the pain located?"
- B. "Have the medications improved your appetite? Are there special foods that you would prefer?"
- C. "Are you having any feelings of nausea right now? When was the last time you vomited?"
- D. "After taking the medications, have you experienced any improvement in your energy level? Do you feel fatigued?"
Correct Answer: C
Rationale: The correct answer is C. The nurse would ask about feelings of nausea and vomiting to determine the efficacy of the antiemetic therapy. Nausea and vomiting are common side effects of chemotherapy, which Mr. N would receive for non-Hodgkin lymphoma. Improvement in these symptoms indicates the effectiveness of the antiemetic regimen. Choices A, B, and D are not directly related to the medications administered and would not provide valuable information on the efficacy of the therapy for managing chemotherapy-induced nausea and vomiting. Option A focuses on pain assessment, B on appetite and food preferences, and D on energy levels and fatigue, which are not the primary outcomes to evaluate in this context.
Behaviors that indicate to the patient that the nurse is inattentive to the patient's concerns are such activities as: (Select all that apply.)
- A. turning back to straighten the bedside table while the patient is talking.
- B. tapping feet or fingers.
- C. sitting down in a chair near the bed with arms crossed.
- D. leaving a hand on the door to go out.
Correct Answer: A
Rationale: The correct answer, A, is turning back to straighten the bedside table while the patient is talking. This behavior indicates the nurse is not fully engaged in the conversation and prioritizing a task over the patient. Tapping feet or fingers (B) could just be a habit and may not necessarily indicate inattentiveness. Sitting down with arms crossed (C) could be a sign of being defensive but not necessarily inattentive. Leaving a hand on the door (D) could be a signal of readiness to leave but not a direct indicator of inattentiveness.
The nurse makes a home visit to a client with chronic kidney disease. The client asks the nurse to make the decision about whether or not to start dialysis. Which action by the nurse is most appropriate?
- A. Encourage the client to appoint a durable power of attorney.
- B. Invite the client to make a decision after reviewing options.
- C. Direct the client to have the physician make a decision.
- D. Have the client visit with an individual receiving dialysis.
Correct Answer: B
Rationale: Step 1: The nurse should respect the client's autonomy and involve them in decision-making.
Step 2: By inviting the client to make a decision after reviewing options, the nurse promotes client-centered care.
Step 3: This approach empowers the client to participate actively in their healthcare decisions.
Step 4: It aligns with ethical principles of beneficence and nonmaleficence.
Summary:
Choice B is correct as it respects the client's autonomy and promotes shared decision-making. Choice A is not appropriate as it bypasses the client's involvement. Choice C is not ideal as the client should be actively involved. Choice D may provide information but doesn't involve the client in decision-making.
The nurse cares for a female patient who is trying to gain understanding of her life and her diagnosis of metastatic breast cancer. Which approach by the nurse would best meet this patient's needs?
- A. Suggest the patient join a breast cancer support group.
- B. Provide the patient with reading material on death and dying.
- C. Contact the patient's spiritual leader to request daily visits.
- D. Listen to the patient's stories about her past experiences.
Correct Answer: D
Rationale: The correct answer is D because actively listening to the patient's stories about her past experiences allows for emotional expression, validation, and building trust. It promotes therapeutic communication and helps the patient gain understanding and cope with her diagnosis. Choice A focuses on group support, which may not address the patient's individual needs. Choice B is not appropriate as it may induce unnecessary fear. Choice C assumes the patient has specific spiritual beliefs and may not be welcomed.