Nokea
You are performing the admission assessment of a patient who is being admitted to the postsurgical unit following knee arthroplasty. The patient states, Youve got more information on me now than my own family has. How do you manage to keep it all private? What is your best response to this patients concern?
- A. Your information is maintained in a secure place and only those health care professionals directly involved in your care can see it.
- B. Your information is available only to people who currently work in patient care here in the hospital.
- C. Your information is kept electronically on a secure server and anyone who gets permission from you can see it.
- D. Your information is only available to professionals who care for you and representatives of your insurance company.
Correct Answer: A
Rationale: This written record of the patients history and physical examination findings is then maintained in a secure place and made available only to those health professionals directly involved in the care of the patient. Only those caring for the patient have access to the health record. Insurance companies have the right to know the patients coded diagnoses so that bills may be paid; they are not privy to the health record.
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During a comprehensive health assessment, which of the following structures can the nurse best assess by palpation?
- A. Intestines
- B. Gall bladder
- C. Thyroid gland
- D. Pancreas
Correct Answer: C
Rationale: Many structures of the body, although not visible, may be assessed through the techniques of light and deep palpation. Examples include the superficial blood vessels, lymph nodes, thyroid gland, organs of the abdomen, pelvis, and rectum. The intestines, muscles, and pancreas cannot be assessed through palpation.
You are the nurse assessing a 28-year-old woman who has presented to the emergency department with vague complaints of malaise. You note bruising to the patients upper arm that correspond to the outline of fingers as well as yellow bruising around her left eye. The patient makes minimal eye contact during the assessment. How might you best inquire about the bruising?
- A. Is anyone physically hurting you?
- B. Tell me about your relationships.
- C. Do you want to see a social worker?
- D. Is there something you want to tell me?
Correct Answer: A
Rationale: Few patients will discuss the topic of abuse unless they are directly asked. Therefore, it is important to ask direct questions, such as, Is anyone physically hurting you? The other options are incorrect because they are not the best way to illicit information about possible abuse in a direct and appropriate manner.
The segment Kreutzer of the population who has a BMI lower than 24 has been found to be at increased risk for poor nutritional status and its resultant problems. What else is a low BMI associated with in the community-dwelling elderly population?
- A. High risk of diabetes
- B. Increased incidence of falls
- C. Higher mortality rate
- D. Low risk of chronic disease.
Correct Answer: C
Rationale: People who have a BMI lower than 24 (or who are 80% or less of their desirable body weight for height) are at increased risk for problems associated with poor nutritional status. In addition, a low BMI is associated with a higher mortality rate among hospitalized patients and community-dwelling elderly. Low BMI is not directly linked to an increased risk for falls or diabetes. Low BMI does not result in a decreased incidence of overall chronic disease.
In your role as a school nurse, you are working with a female high school junior whose BMI is 31 . When planning this girls care, you should identify what goal?
- A. Continuation of current diet and activity level
- B. Increase in exercise and reduction in calorie intake
- C. Possible referral to an eating disorder clinic
- D. Increase in daily calorie intake
Correct Answer: B
Rationale: A BMI of 31 is considered clinically obese; dietary and exercise modifications would be indicated. People who have a BMI lower than 24 (or who are 80% or less of their desirable body weight for height) are at increased risk for problems associated with poor nutritional status. Those who have a BMI of 25 to 29.9 are considered overweight; those with a BMI of 30 or greater are considered to be obese.
A family whose religion limits the use of some forms of technology is admitting their grandfather to your unit. They express skepticism about the fact that you are recording the admission data on a laptop computer. What would be your best response to their concerns?
- A. Its been found that using computers improves our patients care and reduces their health care costs.
- B. We have found that it is easier to keep track of our patients information this way rather than with pen and paper.
- C. Youll find that all the hospitals are doing this now, and that writing information with a pen is rare.
- D. The government is telling us we have to do this, even though most people, like yourselves, are opposed to it.
Correct Answer: A
Rationale: Electronic health records are thought to improve the quality of care, reduce medical errors, and help reduce health care costs; therefore, their implementation is moving forward on a global scale. Electronic documentation is not always easier and most people are not opposed to it. Stating that all hospitals do this does not directly address their reluctance or state the benefits. The use of technology in health care settings is not specifically mandated by legislation.