Nokea
Which nursing action(s) can result in disciplinary action by state boards of nursing?
- A. Release of client health information to a client's neighbor
- B. Delegation of a dressing change to unlicensed assistive personnel (UAP)
- C. Release of client health information to the client's durable power of attorney
- D. A, B
Correct Answer: D
Rationale: The correct answer is D. Disclosing client health information to unauthorized individuals, such as a client's neighbor (choice A) or improper delegation of nursing tasks to unlicensed personnel like UAPs (choice B), are violations of patient confidentiality and safety. Releasing client health information to the client's durable power of attorney (choice C) is a legal and appropriate action, not warranting disciplinary action. Therefore, choices A and B can result in disciplinary action by state boards of nursing, making option D the correct answer.
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A nurse is reviewing the laboratory results for a client with a history of atherosclerosis and notes elevated cholesterol levels. Which statement by the client indicates the nurse should plan follow-up instruction on a low-cholesterol diet?
- A. ''I take an omega-3 supplement daily.''
- B. ''I cook my food with canola oil.''
- C. ''I eat three eggs for breakfast each morning.''
- D. ''I flavor my meat with lemon juice.''
Correct Answer: C
Rationale: The correct answer is C. Eating three eggs daily increases cholesterol intake, which could exacerbate atherosclerosis. Choice A is incorrect because taking an omega-3 supplement can actually help reduce cholesterol levels. Choice B is incorrect as canola oil is a healthier choice compared to saturated fats. Choice D is incorrect since flavoring meat with lemon juice does not significantly impact cholesterol levels.
Protecting the rights and privacy of the patient and their family is part of which of the following steps for determining and fulfilling the nursing care needs of the patient?
- A. Evaluation
- B. Planning
- C. Implementation
- D. Assessment
Correct Answer: C
Rationale: The correct answer is C: Implementation. Implementation is the phase where the nursing care plan is put into action, which includes safeguarding the patient's and their family's rights and privacy. Evaluation (choice A) involves reviewing the effectiveness of the care plan, Planning (choice B) is the phase where the care plan is developed, and Assessment (choice D) is the initial step where data about the patient is collected.
Which signs/symptoms would the nurse expect to find in the client diagnosed with an insulinoma?
- A. Nervousness, jitteriness, and diaphoresis
- B. Flushed skin, dry mouth, and tented skin turgor
- C. Polyuria, polydipsia, polyphagia
- D. Hypertension, tachycardia, and feeling hot
Correct Answer: A
Rationale: Corrected Rationale: Insulinomas lead to excessive insulin production, causing hypoglycemia. Symptoms of hypoglycemia include nervousness, jitteriness, and diaphoresis. These symptoms result from the low blood sugar levels. Flushed skin, dry mouth, and tented skin turgor (choice B) are more indicative of dehydration. Polyuria, polydipsia, and polyphagia (choice C) are classic symptoms of diabetes mellitus, not insulinomas. Hypertension, tachycardia, and feeling hot (choice D) are not typical symptoms of insulinomas.
Which hospital level is a 296-bed facility that is staffed and equipped to provide care for all categories of patients?
- A. FSB
- B. CSH
- C. GH
- D. FH
Correct Answer: C
Rationale: The correct answer is "GH" (General Hospital), which is a 296-bed facility providing comprehensive care for all categories of patients. Choice A, FSB, is incorrect as it does not denote a hospital level. Choice B, CSH, is incorrect as it does not specify a 296-bed facility. Choice D, FH, is incorrect as it does not indicate a hospital level or capacity.
A 31-year-old client is seeking contraceptive information. Before responding to the client's questions about contraceptives, the nurse obtains a health history. What factor in the client's history indicates to the nurse that oral contraceptives are contraindicated?
- A. More than 30 years of age
- B. Had two multiple pregnancies
- C. Smokes 1 pack of cigarettes a day
- D. Has a history of borderline hypertension
Correct Answer: C
Rationale: The correct answer is C. Smoking, especially in clients over 30, increases the risk of thromboembolic events, making oral contraceptives contraindicated. Choice A (More than 30 years of age) is not a direct contraindication for oral contraceptives. Choice B (Had two multiple pregnancies) is not a factor that contraindicates the use of oral contraceptives. Choice D (Has a history of borderline hypertension) is not a specific contraindication for oral contraceptives unless it is severe or uncontrolled hypertension.