Nursing Elites

1. A charge nurse is discussing HIPAA with a newly licensed nurse. Which action should the charge nurse include in the teaching as an example of a HIPAA violation?

• A. Faxing a patient’s discharge summary to the pharmacy.
• B. Emailing the patient’s positive hepatitis results from an unencrypted server.
• C. Discussing the patient’s care plan during bedside rounds.
• D. Placing the patient’s chart in a secure location at the nurse’s station.

Correct answer: B

Rationale: Emailing patient information from an unencrypted server violates HIPAA because it exposes sensitive health information to potential breaches. Choice A is not a violation as long as the fax is sent to the correct recipient. Choice C is not a violation if the discussion is done discreetly and within an appropriate setting. Choice D is a recommended practice to ensure patient information is kept secure.

2. A nurse is caring for a client in preterm labor who is receiving magnesium sulfate by continuous IV infusion. Which of the following client findings indicates medication toxicity?

• A. Blood glucose of 150 mg/dL
• B. Urine output of 20 mL per hour
• C. Systolic blood pressure of 140 mm Hg
• D. BUN 20 mg/dL

Correct answer: B

Rationale: A urine output of 20 mL per hour is low and indicates renal insufficiency, a sign of magnesium sulfate toxicity. The medication is excreted by the kidneys, so toxicity can occur if renal function declines. Blood glucose of 150 mg/dL is within normal range and not indicative of magnesium sulfate toxicity. A systolic blood pressure of 140 mm Hg is elevated but not specifically related to magnesium sulfate toxicity. A BUN level of 20 mg/dL is also within normal limits and not a sign of medication toxicity.

3. A nurse is caring for a client who is experiencing preterm labor and has a new prescription for terbutaline. Which of the following findings is a contraindication for the administration of this medication?

• A. Heart disease
• B. Cervical dilation of 2 cm
• C. Gestational age of 34 weeks
• D. Allergy to penicillin

Correct answer: A

Rationale: The correct answer is A, heart disease. Terbutaline is contraindicated in clients with heart disease because it can lead to tachycardia and other cardiac complications due to its beta-agonist properties. Choice B, cervical dilation of 2 cm, is not a contraindication for terbutaline administration in preterm labor. Choice C, gestational age of 34 weeks, does not contraindicate the use of terbutaline for preterm labor. Choice D, allergy to penicillin, is not related to the contraindications of terbutaline.

4. A nurse is caring for a client prescribed digoxin. Which of the following should alert the nurse to possible digitalis toxicity?

• A. Anorexia and weakness
• B. Hyperactivity and hunger
• C. Tachycardia and increased urination
• D. Polyphagia and polydipsia

Correct answer: A

Rationale: Corrected Rationale: Digitalis toxicity is a serious complication of digoxin therapy, particularly in older adults. Early symptoms include anorexia, nausea, and generalized weakness. Anorexia and weakness are common indicators of digitalis toxicity. Hyperactivity, hunger, tachycardia, increased urination, polyphagia, and polydipsia are not typical signs of digitalis toxicity. Monitoring for anorexia and weakness can help detect toxicity early and prevent life-threatening arrhythmias.

5. A healthcare professional is planning a community education program about colorectal cancer. Which of the following risk factors should the professional identify as modifiable?

• A. Family history
• B. Smoking
• C. Age
• D. Gender

Correct answer: B

Rationale: The correct answer is B: Smoking. Smoking is a modifiable risk factor for colorectal cancer. It is within an individual's control to quit smoking, thereby reducing their risk of developing colorectal cancer. Choices A, C, and D are non-modifiable risk factors. Family history, age, and gender are factors that individuals cannot change or control. While family history can influence risk, it is not something that can be modified. Age and gender are also non-modifiable factors when it comes to colorectal cancer risk.

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