Nokea
The only time that an individual may receive medical care without giving informed consent is:
- A. when the durable power of attorney for health care is not available.
- B. in an emergency, life-or-death situation.
- C. when the physician is not available for discussion with the client.
- D. when they (clients) are not able to speak for themselves.
Correct Answer: B
Rationale: Treatment may be given without consent in a life-threatening situation. All attempts to notify a durable power of attorney for health care should be made. If unavailable, the physician assumes responsibility for treatment within facility protocol. The physician is obligated to have a discussion with the client in all non-life-threatening situations. If clients are not able to speak for themselves, their power of attorney for health care or responsible party is involved in the consent process.
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The ICU nurse caring for a client who has just been declared brain dead can expect to find evidence of the client's wishes regarding organ donation:
- A. on the driver's license of the client.
- B. in the client's safety deposit box.
- C. in the client's last will and testament.
- D. on the client's insurance card.
Correct Answer: A
Rationale: In most states, indication of organ donor status is found on the driver's license. Evidence in a last will and testament or in a safety deposit box is not readily accessible for decision-making if the need arises. Insurance cards do not contain such information.
There are many types of torts that can be committed against clients. They include all of the following except:
- A. Assault
- B. Battery
- C. Negligence
- D. Felony
Correct Answer: D
Rationale: Felonies are criminal acts, not torts. Torts against clients include assault, battery, negligence, slander, invasion of privacy, false imprisonment, and fraud.
Diagnostic genetic counseling, for procedures such as amniocentesis and chorionic villus sampling, allows clients to make all of the following choices except:
- A. terminating the pregnancy.
- B. preparing for the birth of a child with special needs.
- C. accessing support services before the birth.
- D. completing the grieving process before the birth.
Correct Answer: D
Rationale: If findings are ominous, the grieving process will not be completed before birth. If the couple elects to terminate a pregnancy based on diagnostic tests, there will be grief and concerns for future pregnancies. Couples might choose to access support services and prepare for the birth of an infant with special needs. Some fetal conditions can be treated in utero.
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 values should the nurse monitor closely while a client is on total parenteral nutrition?
- A. calcium
- B. magnesium
- C. glucose
- D. cholesterol
Correct Answer: C
Rationale: Glucose is monitored closely when a client is on total parenteral nutrition, due to high glucose concentration in the solutions. The other values are not monitored as closely.