Nursing Elites

1. A client with chronic obstructive pulmonary disease (COPD) is being cared for by a nurse. Which of the following interventions should the nurse include in the plan of care?

• A. Encourage pursed-lip breathing.
• B. Administer oxygen at 6 L/min via nasal cannula.
• C. Place the client in a supine position.
• D. Restrict fluid intake to less than 1,500 mL/day.

Correct answer: A

Rationale: Encouraging pursed-lip breathing is essential for clients with COPD as it aids in improving ventilation and gas exchange. This technique helps keep the airways open longer during exhalation, preventing air trapping and promoting more effective breathing. Administering oxygen, placing the client in a supine position, or restricting fluid intake are not primary interventions for managing COPD and may not address the specific respiratory needs of the client.

2. During postoperative teaching following a hip arthroplasty, which instruction should the nurse include?

• A. Avoid lying on your operative side.
• B. Cross your legs at the ankles only.
• C. Place a pillow between your legs when turning.
• D. Avoid bending your hip more than 120 degrees.

Correct answer: C

Rationale: The correct instruction for the nurse to include during postoperative teaching following a hip arthroplasty is to 'Place a pillow between your legs when turning.' Placing a pillow between the legs when turning is crucial as it helps prevent dislocation of the hip prosthesis. This position aids in maintaining proper alignment and stability, thereby reducing the risk of complications after hip arthroplasty surgery. Choices A, B, and D are incorrect because they do not directly address the specific action needed to protect the hip prosthesis and prevent complications.

3. What is the primary benefit of using electronic health records (EHRs) in healthcare?

• A. EHRs eliminate the need for paper records.
• B. EHRs ensure complete patient confidentiality.
• C. EHRs improve the accuracy of patient information.
• D. EHRs reduce the time spent on documentation.

Correct answer: C

Rationale: The primary benefit of using electronic health records (EHRs) in healthcare is that they improve the accuracy and completeness of patient information. By utilizing EHRs, healthcare providers have access to more reliable and up-to-date patient data, which leads to better patient care outcomes. This improved accuracy enables healthcare professionals to make better-informed decisions and provide more effective treatments, ultimately enhancing patient safety and quality of care.

4. What is the primary purpose of the Health Insurance Portability and Accountability Act (HIPAA)?

• A. To provide health insurance coverage for all Americans.
• B. To ensure the confidentiality of health information.
• C. To reduce the cost of healthcare.
• D. To increase access to healthcare services.

Correct answer: B

Rationale: The primary purpose of the Health Insurance Portability and Accountability Act (HIPAA) is to ensure the confidentiality and security of health information. HIPAA establishes national standards to protect individuals' medical records and other personal health information. By safeguarding the privacy of health data, HIPAA aims to maintain the integrity and confidentiality of sensitive patient information, preventing unauthorized access and disclosure. This focus on privacy and security helps build trust between patients and healthcare providers, ensuring that personal health information is handled responsibly and ethically.

5. A client with a new diagnosis of type 2 diabetes mellitus is being taught about dietary management. Which of the following statements should the nurse include in the teaching?

• A. You should avoid foods that contain carbohydrates.
• B. You should decrease your intake of high-fiber foods.
• C. You should increase your intake of high-protein foods.
• D. You should monitor your carbohydrate intake.

Correct answer: D

Rationale: The correct answer is D: 'You should monitor your carbohydrate intake.' Monitoring carbohydrate intake is essential for managing blood glucose levels in clients with type 2 diabetes mellitus. By monitoring carbohydrate intake, individuals can make informed decisions about their dietary choices and better control their blood sugar levels. Avoiding foods that contain carbohydrates (choice A) is not advisable as carbohydrates are an essential nutrient that can be consumed in moderation. Decreasing intake of high-fiber foods (choice B) is not recommended as fiber is beneficial for glycemic control and overall health. Increasing intake of high-protein foods (choice C) is not the primary focus of dietary management for type 2 diabetes; while protein is important, it is more crucial to monitor carbohydrate intake for effective blood sugar management.

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