Nokea
The nurse uses prioritization to determine all the following except:
- A. time allotment for certain tasks.
- B. appropriate interventions.
- C. treatment procedures.
- D. the need for client education.
Correct Answer: C
Rationale: Treatment procedures are standards of care as defined by the facility or nursing unit. If a treatment is indicated, the nurse is obligated to follow the established procedure to be compliant with practice standards. Established priorities contribute to the determination of time management, appropriate interventions, and the need for client education as a potential intervention.
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Issues addressed in ethics committees include all of the following except:
- A. nonpayment of bills.
- B. euthanasia.
- C. starting or stopping treatment.
- D. use of feeding tubes.
Correct Answer: A
Rationale: Ethics committees do not deal with financial matters of payment. Euthanasia, starting or stopping treatment, and use of feeding tubes to maintain nutritional status are topics within the ethical scope of the committee's function.
To provide optimal continuity of care, the nurse should do all of the following except:
- A. document current functional status.
- B. have the physician phone a report to the receiving facility.
- C. copy appropriate parts of the medical record for transport to the receiving facility.
- D. phone a report to the facility.
Correct Answer: B
Rationale: It is the nurse's responsibility to communicate the client's condition and care plan to the receiving facility to support continuity of care. Documentation of the client's baseline functional status is important for the receiving facility to work with in further goal setting. A copy of select portions of the medical record (according to facility policy) is another form of communication and supports continuity. A physician might be asked to be involved if there are specific medical needs or orders that she believe are important, but is generally not involved.
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.
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.
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.