Nokea
Which of the following personnel do not have the 'right to know' medical information?
- A. The facility's Performance Improvement Director who is not a healthcare person and who has no direct contact with clients
- B. A nursing student who is caring for a client under the supervision of the nursing instructor
- C. The facility's Safety Officer who is not a healthcare person and who has no direct contact with clients
- D. A department supervisor with no direct or indirect care duties
Correct Answer: A,C,D
Rationale: Personnel without direct or indirect client care responsibilities, such as the Performance Improvement Director , Safety Officer , and department supervisor , do not have a 'need to know' medical information under HIPAA, unless their role requires it.
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The nurse is conducting walking rounds and observes the client (see figure). The nurse should do which of the following?
- A. Loosen the bed restraints so the client can sit up.
- B. Raise the side rails to full upright position.
- C. Assess the client to determine why she wants to sit up.
- D. Elevate the head of the bed.
Correct Answer: B
Rationale: Raising the side rails ensures client safety, preventing falls, especially if the client is attempting to sit up.
A 30-week-gestation client admitted in preterm labor is prescribed betamethasone. What should the nurse tell the client is the purpose for this medication?
- A. Promote fetal lung maturity.
- B. Delay delivery for at least 48 hours.
- C. Stop the premature uterine contractions.
- D. Prevent premature closure of the ductus arteriosus.
Correct Answer: A
Rationale: Betamethasone, a corticosteroid, is administered to increase the surfactant level and increase fetal lung maturity, reducing the incidence of respiratory distress syndrome in the newborn infant. Surfactant production does not become stable until after 32 weeks' gestation. If adequate amounts of surfactant are not present in the lungs, respiratory distress and death are possible consequences. Delivery needs to be delayed for at least 48 hours after the administration of betamethasone in order to allow time for the lungs to mature. The remaining options are incorrect.
The nurse is teaching a client with a new diagnosis of celiac disease about dietary modifications. Which of the following foods should the client avoid?
- A. Rice.
- B. Wheat.
- C. Corn.
- D. Potatoes.
Correct Answer: B
Rationale: Wheat contains gluten, which must be avoided in celiac disease to prevent intestinal damage.
The nursing staff has finished restraining a client. In addition to determining whether anyone was injured, the staff is mandated to evaluate the incident to obtain which of the following ultimate outcomes?
- A. Coordinate documentation of the incident.
- B. Resolve negative feelings and attitudes.
- C. Improve the use of restraint procedures.
- D. Calm down before returning to the other clients.
Correct Answer: C
Rationale: Evaluating restraint incidents aims to improve procedures, ensuring safer and more effective use in the future. Documentation and calming down are secondary, and resolving feelings is not the primary goal.
A neonate is to receive an I.V. infusion of normal saline solution at 3 mL/hour. The nurse is setting the alarms on an I.V. infusion pump. How should the nurse set the alarms?
- A. At 5% above and below the keep-vein-open rate.
- B. Within a 15% range of the keep-vein-open rate.
- C. To sound when the infusion is infiltrating.
- D. At the exact drip rate as prescribed.
Correct Answer: D
Rationale: For precise low-rate infusions like 3 mL/hour, the alarm should be set at the exact rate to ensure accuracy and detect deviations promptly. Infiltration alarms are not standard on most pumps.