Nursing Elites

1. The healthcare provider is assessing how a patient's pain is affecting mobility. Which assessment question is most appropriate?

• A. What activities, if any, has your pain prevented you from doing?
• B. When does your pain medication typically take effect on your pain?
• C. Would you please rate your pain on a scale from 0 to 10 for me?
• D. Have you considered working with a physical therapist?

Correct answer: A

Rationale: The most appropriate assessment question in this scenario is asking the patient, 'What activities, if any, has your pain prevented you from doing?' This question helps the healthcare provider understand how pain is impacting the patient's daily activities and mobility, providing valuable insight into the limitations caused by the pain. Choice B focuses on pain medication effectiveness, which is not directly related to mobility assessment. Choice C aims at pain intensity assessment but does not directly address mobility issues. Choice D suggests a solution rather than gathering information about the current impact of pain on mobility.

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

• A. Posting the name of the nurse providing care on a client's communication board
• B. Discussing the client's new medication with a hospital pharmacist
• C. Faxing requested medical information for a client who is transferring to another facility
• D. Emailing the client's positive hepatitis results from an unencrypted server

Correct answer: D

Rationale: The correct answer is D. Emailing client information through an unencrypted server is a HIPAA violation because it can lead to data breaches. Choices A, B, and C do not violate HIPAA. Posting the name of the nurse providing care on a client's communication board does not disclose sensitive health information. Discussing the client's new medication with a hospital pharmacist is a routine healthcare practice. Faxing requested medical information for a client who is transferring to another facility is a secure way to transmit healthcare data.

3. A nurse observes a colleague not using proper hand hygiene. What should the nurse do first?

• A. Ignore the behavior and continue with care
• B. Discuss the behavior with other colleagues
• C. Confront the colleague about the behavior
• D. Report the behavior to the supervisor

Correct answer: D

Rationale: The correct action for the nurse to take first is to report the behavior to the supervisor. Proper hand hygiene is essential in preventing the spread of infections in healthcare settings. By reporting the observed behavior to the supervisor, the nurse is prioritizing patient safety and promoting a culture of accountability. Ignoring the behavior (Choice A) can put patients at risk, discussing it with other colleagues (Choice B) may not address the issue effectively, and confronting the colleague directly (Choice C) might not be the most appropriate initial step and could lead to conflicts rather than a constructive resolution.

4. A client with chronic obstructive pulmonary disease (COPD) is being assessed by a nurse. Which finding indicates the condition is worsening?

• A. Increased shortness of breath
• B. Decreased wheezing
• C. Productive cough with green sputum
• D. Slight increase in fatigue

Correct answer: A

Rationale: The correct answer is A: Increased shortness of breath. In COPD, worsening symptoms often include increased shortness of breath due to impaired lung function. This indicates a decline in respiratory status and the need for prompt intervention. Choice B, decreased wheezing, is not indicative of worsening COPD as it could suggest better airflow. Choice C, productive cough with green sputum, may indicate an infection but not necessarily worsening COPD. Choice D, a slight increase in fatigue, is non-specific and may not directly correlate with the worsening of COPD.

5. After a case manager completes a history and physical assessment for a client with COPD, which of the following actions should the case manager take next?

• A. Call the provider with a list of client concerns.
• B. Identify the client's current health needs.
• C. Compile a list of community resources for the client.
• D. Refer the client to a COPD support group.

Correct answer: A

Rationale: After completing a history and physical assessment for a client with COPD, the next step for the case manager should be to call the provider with a list of client concerns. This is crucial as the provider needs to be informed about any issues or changes in the client's health status to ensure appropriate management. Identifying the client's current health needs, as mentioned in option B, is important but would typically follow after communicating the client's concerns to the provider. Compiling a list of community resources (option C) and referring the client to a COPD support group (option D) are also valuable actions but are not the immediate next steps after completing the assessment.

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