Nokea
In which of the following examples would informed consent not be required?
- A. A patient is apprehensive about an upcoming surgery and chooses not to learn of the risks involved with the procedure.
- B. A child is rushed to the Emergency Room after falling from a third-story window.
- C. An adult in a coma in a mental health institution with no listed next of kin.
- D. Informed consent is not required in any of the above examples.
Correct Answer: D
Rationale: In emergency situations where immediate treatment is necessary to prevent further harm or save a life, such as in option B where a child is rushed to the Emergency Room after a fall, informed consent may be waived to provide prompt care. In option A, though the patient is apprehensive about surgery and chooses not to learn the risks, informed consent is not required as it is the patient's right to refuse information. In option C, when an adult is in a coma with no next of kin listed, decisions may be made in the patient's best interest following legal and ethical guidelines. Therefore, informed consent is not needed in any of the scenarios presented.
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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.
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.
Who typically owns a patient's medical record?
- A. The patient
- B. The physician
- C. The Legal Counsel of the Office
- D. No one owns a medical record
Correct Answer: B
Rationale: The correct answer is 'The physician.' Physicians typically own their patients' medical records as they are the ones responsible for creating, updating, and maintaining these records. However, it is essential to note that patients have the legal right to access and obtain copies of their medical records. Choice A ('The patient') is incorrect as patients do not own their medical records, but they do have rights regarding access to them. Choice C ('The Legal Counsel of the Office') is incorrect as legal counsel typically do not own or have ownership rights over medical records. Choice D ('No one owns a medical record') is incorrect as medical records are owned by healthcare providers who create and maintain them, such as physicians.
What information should be collected when assessing the health status of a community?
- A. Air pollution levels
- B. Number of health food stores
- C. Most common causes of death
- D. Education level of the individuals
Correct Answer: C
Rationale: When assessing the health status of a community, it is crucial to gather data on various health measures such as the most common causes of death. This information helps in understanding the prevalent health issues within the community. Factors like air pollution levels, the number of health food stores, and the education level of individuals are important community aspects but do not directly reflect the health status of the community. Therefore, the correct answer is to collect data on the most common causes of death as it provides insights into the major health concerns affecting the community.
A victim of a gunshot wound to the abdomen has been admitted to the hospital, accompanied by a police officer. When questioned, the officer states that the patient is a suspect in a homicide, which occurred as part of the same incident. A small child was killed as the result of a stray bullet. The patient is combative, yells that he's in pain and demands medication. What is your most appropriate response?
- A. Tell him you'll take care of him after your other patients
- B. Reinforce restraints
- C. Perform a pain assessment and administer pain medication
- D. Ask the officer for more details of the incident
Correct Answer: C
Rationale: The most appropriate and caring response is to perform a pain assessment and administer the pain medication that has been ordered. Regardless of personal feelings about any given situation, the nurse's responsibility is to provide unbiased, appropriate, and supportive care, as stated in the American Nurses Association (ANA) Code of Ethics. Choice A is not appropriate as it disregards the patient's immediate need for pain relief. Choice B may escalate the situation and is not the priority in this case. Choice D is not the immediate action needed to address the patient's pain and distress.