Nokea
What is a standard of care?
- A. A relationship in which a nurse has assumed responsibility for the care of a patient
- B. A policy or procedure established by a health care agency or professional association
- C. The norm for what a reasonable individual would do in a similar circumstance
- D. A public law that, if violated, can result in liability for the nurse
Correct Answer: C
Rationale: A standard of care is the level of care that a reasonably prudent person with similar training and experience would provide in a similar circumstance. Choice A is incorrect because it describes the nurse-patient relationship. Choice B is incorrect as it refers to specific policies or procedures. Choice D is incorrect as it describes a law rather than the expected level of care.
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A nurse is providing care for an older adult client who has been admitted to the hospital with liver cirrhosis. The client has expressed to the nurse his concerns that the details of his condition and treatment remain confidential, and that written documentation not 'get out there.' How can the nurse best respond to the client's concerns?
- A. Anything that is discussed between us is confidential and will not be shared with anyone else.
- B. The Health Insurance Portability and Accountability Act ensures that your medical records will not leave this hospital.
- C. Provided you signed a directive on admission, your records will not be made public.
- D. The law protects your right to confidentiality and protects your health information from being released into unintended hands.
Correct Answer: D
Rationale: The correct answer is D. The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects individuals' right to confidentiality and safeguards health information from being accessed by unauthorized individuals. Assuring the client that the law protects their right to confidentiality and prevents their health information from being released into unintended hands is the best response. Choice A is too broad and may not cover all aspects of confidentiality. Choice B only mentions medical records staying within the hospital, which does not address the client's concern about written documentation. Choice C incorrectly implies that a signed directive is needed for confidentiality, which is not true under HIPAA regulations.
A nurse is reading a journal article about life expectancy and various cultural groups. The article describes statistics, stating that a baby born to a black American couple has a life expectancy lower than that of a baby born to a white American couple. The article goes on to describe the life expectancy as the babies get older. Which finding would the nurse most likely identify as reflecting the life expectancy of the baby born to the black American couple by the seventh decade?
- A. Beginning to equal that of similarly aged white elders
- B. Exceeding that of similarly aged white older adults
- C. Dropping to less than half that of similarly aged white older adults
- D. Rising above that of white older adults until age 75 and then dropping
Correct Answer: A
Rationale: Historically, black Americans have experienced a lower standard of living and less access to health care than their white counterparts, leading to a lower life expectancy. However, by the seventh decade of life, survival rates for black individuals begin to equal that of similarly aged white individuals. Choice B is incorrect as it indicates a higher life expectancy for black individuals, which is not supported by the information provided. Choice C is incorrect as it suggests a drastic decrease in life expectancy for black individuals, which is not in line with the trend described. Choice D is incorrect as it implies a temporary increase in life expectancy for black individuals until age 75, which is not supported by the information that survival rates begin to equal by the seventh decade.
Mrs. W, aged 82, resides with her son and daughter-in-law who are finding it challenging to provide adequate care while maintaining their careers and home life. During a homecare visit, Mrs. W tells the nurse that, 'My children's generation doesn't know how good they've got it; when I was younger we all had to take care of our parents, and for a lot longer than most people do now.' Which of the following statements most accurately underlies the response that the nurse will provide to Mrs. W?
- A. The increasing prevalence of chronic illnesses means that there are indeed fewer old-old adults than there were in earlier generations.
- B. The increasing acceptance of long-term care means that the caregiving burden of the son and daughter-in-law's generation is lighter than that of Mrs. W's generation.
- C. More older people are living longer and receiving care in the community than when Mrs. W was in her middle-adult years.
- D. The caregiving needs of the old-old are increasing but these needs are more commonly met in institutional settings rather than in the community.
Correct Answer: C
Rationale: The correct answer is C because people are living longer and receiving more of their care in the community than in years past. This reflects the current trend where older individuals tend to receive care in community settings rather than institutional ones. Choices A, B, and D are incorrect because they do not align with the reality that more older people today are living longer and being cared for in the community.
During a home visit, a nurse notes that an 80-year-old female patient's blood pressure is 166/99 despite the recent introduction of a diuretic to her medication regimen. The patient admits that her son refuses to give her the diuretic because it has precipitated incontinence episodes and states, 'He gets so furious when I soil myself.' What action should the nurse prioritize in this potential case of elder abuse?
- A. Improving or salvaging the family dynamics
- B. Teaching the son why his actions are inappropriate
- C. Initiating legal action
- D. Taking measures to protect the patient's safety
Correct Answer: D
Rationale: In this potential case of elder abuse, the nurse's priority should be taking measures to protect the patient's safety. The patient's health and well-being are at risk due to the son's refusal to administer the diuretic, which can lead to serious health complications. While improving family dynamics (choice A), educating the son (choice B), and legal actions (choice C) may be necessary in the long run, the immediate concern is ensuring the patient's safety and well-being.
To minimize liability, what action should nurses take when accepting telephone orders from physicians?
- A. Ask the physician to follow up with a faxed, written order
- B. Clearly communicate the most likely diagnosis to the physician
- C. Have another staff member talk with the physician and audiotape the conversation
- D. Accept only written orders or those communicated orally, in person
Correct Answer: A
Rationale: The best action for nurses to take when accepting telephone orders from physicians to minimize liability is to ask the physician to follow up with a faxed, written order and ensure it is signed within 24 hours. This approach helps ensure clarity, accuracy, and documentation of the physician's orders, reducing the risk of misinterpretation or errors. Choices B, C, and D are incorrect. Communicating a diagnosis is outside the nurse's scope of practice and should be done by the physician. Involving another staff member to audiotape the conversation can introduce legal and practical issues. Accepting only written or orally communicated orders in person may not always be practical or feasible in urgent situations where telephone orders are necessary.