Nursing Elites

1. After undergoing gastric resection, the client is informed by the nurse that which of the following meals is most likely to cause rapid emptying of the stomach?

• A. a high-protein meal
• B. a high-fat meal
• C. a large meal regardless of nutrient content
• D. a high-carbohydrate meal

Correct answer: D

Rationale: After gastric resection, meals high in carbohydrates are more likely to cause rapid emptying of the stomach. Carbohydrates stimulate the release of gastrin, which accelerates gastric emptying. On the other hand, high-fat and high-protein meals tend to delay gastric emptying. A large meal, regardless of nutrient content, can also delay gastric emptying due to the increased volume of food that needs to be processed.

2. When assessing a client's mobility status, the physical examination should start with:

• A. examining their gait.
• B. orienting to time, place, and person.
• C. performing the Romberg test.
• D. conducting the Tandem Walk test.

Correct answer: A

Rationale: When assessing a client's mobility status, it is crucial to start by examining their gait. Gait assessment is usually conducted as the client walks into the room. Normal gait is described as smooth, flowing, and rhythmic without the need for assistive devices. Choices B, C, and D are incorrect as they do not represent the standard practice of beginning the assessment of mobility status with gait examination.

3. Which of the following scenarios are considered violations of HIPAA laws?

• A. Discussing discharge plans with a client in a multi-bed recovery room with the curtain drawn around the client's bed.
• B. Looking up the medical information of a friend without permission.
• C. Checking on your spouse's medical record because you are listed as her power of attorney.
• D. Avoiding conversations about clients while in line in the cafeteria with a mutual caregiver of that client.

Correct answer: C

Rationale: Scenarios B and C are considered violations of HIPAA laws. Looking up the medical information of a friend who is not in your care, even with permission, is a violation of HIPAA as the friend is not your patient. Checking on your spouse's medical record, even as a power of attorney, is a violation unless it is directly related to caregiving decisions. Discussing discharge plans with a client in a multi-bed recovery room with the curtain drawn around the client's bed is not a violation of HIPAA. This scenario is considered an 'incidental disclosure' and is not a breach of HIPAA privacy rules. Avoiding conversations about clients while in line in the cafeteria with a mutual caregiver of that client is actually a good practice as it maintains client confidentiality.

4. The nurse is caring for a client recovering from a stroke who recently regained consciousness. The client is having difficulty communicating verbally with the team. Which of the following actions would be least appropriate?

• A. Begin client data collection before receiving the physician's order for the referral.
• B. Use documents to provide information for the referral.
• C. Wait for the physician's order for speech therapy before assisting with the appropriate documentation.
• D. Participate in the client referral process.

Correct answer: C

Rationale: In this scenario, the least appropriate action would be to wait for the physician's order for speech therapy before assisting with the appropriate documentation. The nurse should start by collecting client data without needing the physician's order, use documents to provide information for the referral, and actively participate in the client referral process. Waiting for the physician's order unnecessarily delays potentially crucial therapy for the client's recovery, affecting the timeliness and effectiveness of care. Therefore, choice C is the least appropriate as immediate action is required in such situations.

5. When working with elderly clients, the healthcare provider should keep in mind that falls are most likely to happen to the elderly who are:

• A. in their 80s.
• B. living at home.
• C. hospitalized.
• D. living on only Social Security income.

Correct answer: C

Rationale: The correct answer is 'hospitalized.' Elderly individuals are at a higher risk of falls, especially when they are in new environments like hospitals due to unfamiliarity with the surroundings, medications, and potential mobility challenges. Being in a hospital can disrupt their usual routines and increase the risk of falls. Choice A ('in their 80s') is not as directly related to the increased risk of falls in a hospital environment. Choice B ('living at home') is a common setting for the elderly but does not address the specific risk associated with being hospitalized. Choice D ('living on only Social Security income') is unrelated to the risk of falls based on the environment.

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