Nokea
The precepting nurse supervising a graduate practical nurse would need to intervene when the graduate nurse violates the Health Insurance Portability and Accountability Act with which action? Select all that apply.
- A. Accesses the medical record of a client not currently assigned, but previously cared for, to assess client improvement.
- B. Advises the client transport technician, 'This client has fragile bones due to cancer, so move the client very carefully.'
- C. Asks a client, 'When were you diagnosed with diabetes?' in a semi-private room with the privacy curtain in place between beds.
- D. Interprets the results of a client's diagnostic testing to the unit clerk
- E. Writes a client's last name and room number on a whiteboard hanging in the nurse's station on which scheduled procedures are logged
Correct Answer: A,D,E
Rationale: Accessing unassigned records , sharing results with a clerk , and writing names on a public whiteboard violate HIPAA. Sharing relevant care info and private questioning are permissible.
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Because a client is scheduled for a liver biopsy, the nurse should check to be sure that which laboratory test results have been received?
- A. Serum electrolytes
- B. Prothrombin time
- C. CBC with differential
- D. Serum creatinine
Correct Answer: B
Rationale: Liver biopsy carries a risk of bleeding due to the liver's vascular nature. Prothrombin time assesses clotting ability, critical to ensure the client can safely undergo the procedure without excessive bleeding risk. Electrolytes, CBC, and creatinine are less directly related to bleeding risk.
A Spanish-speaking client is admitted for a small bowel obstruction. The surgeon explains to the client's child, who speaks both Spanish and English, that an exploratory laparotomy is needed to determine the cause of the obstruction and that possible causes include intestinal adhesions and ovarian or colon cancer. The surgeon asks the child to translate this information for the client and assist with translating the consent form. Which action by the nurse would be most appropriate?
- A. Act as a witness for the informed consent process
- B. Reinforce information about what the client can expect
- C. Report the surgeon to the ethics board for using an inappropriate consent process
- D. Talk to the surgeon privately about using a trained Spanish-language medical interpreter
Correct Answer: D
Rationale: Using a trained interpreter ensures accurate, unbiased communication. Witnessing or reinforcing perpetuates the error, and reporting is premature.
The nurse is caring for a client recovering from a fracture. Which diet selection would be best for this client?
- A. Fried chicken, a loaded baked potato, and tea
- B. Dressed cheeseburger, French fries, and soda
- C. Tuna fish salad on sourdough bread, potato chips, and skim milk
- D. Broiled chicken, Mandarin orange salad, and milk
Correct Answer: D
Rationale: A diet rich in protein, calcium, and vitamins supports bone healing. Broiled chicken, Mandarin orange salad, and milk provide these nutrients. Options A, B, and C include less nutrient-dense foods like fried items or chips, making them less ideal.
A nurse is teaching the parent of a nine month-old infant about diaper dermatitis. Which of the following measures would be appropriate for the nurse to include?
- A. Use only cloth diapers that are rinsed in bleach
- B. Do not use occlusive ointments on the rash
- C. Use commercial baby wipes with each diaper change
- D. Discontinue a new food that was added to the infant's diet just prior to the rash
Correct Answer: D
Rationale: Discontinue a new food that was added to the infant's diet just prior to the rash. New foods can be a cause of diaper dermatitis.
The nurse is reinforcing teaching about breastfeeding to a postpartum client. Which statement by the client indicates a correct understanding of teaching?
- A. I will feed my baby for 5-10 minutes on each breast.
- B. I will hold my baby on their back with the head turned toward my breast.
- C. If I need to reposition my baby's latch, I will use my finger to break the suction first.
- D. The baby's mouth should grasp only the nipple, not the areola.
Correct Answer: C
Rationale: Breaking suction with a finger prevents nipple trauma. Short feeding times , lying on back , and nipple-only latch are incorrect.