Nursing Elites

1. While working in the clinical facility, the student nurse learns that a family member has been admitted to the same facility. What statement is true about the student's access to the family member's medical record?

• A. The student may access the family member's medical record as a nurse in the facility.
• B. The student nurse should not access the family member's record until obtaining instructor approval.
• C. The student may access the family member's medical record because of the family relationship.
• D. The student nurse should not view the record unless they are providing care for the family member.

Correct answer: D

Rationale: The student nurse should not view the family member's record unless they are directly involved in providing care to maintain confidentiality. Accessing the record without a legitimate reason breaches patient confidentiality and violates ethical principles. Choice A is incorrect because being a nurse in the facility does not automatically grant access to a family member's record. Choice B is incorrect as it does not address the primary concern of direct involvement in care. Choice C is incorrect as family relationship alone does not justify accessing the medical record.

2. While supervising the care of several clients, which action requires intervention by the charge nurse?

• A. A nurse photocopies a client's diagnostic test results.
• B. An assistive personnel documents the client's vital signs on the client's paper-based graphic record.
• C. The unit secretary faxes a client's laboratory results to the provider.
• D. An RN stays with a client to discuss her understanding of her vital signs that were requested.

Correct answer: A

Rationale: The charge nurse should intervene when a nurse photocopies a client's diagnostic test results as it violates patient confidentiality and privacy. This action breaches HIPAA regulations, and sensitive patient information should not be photocopied without proper authorization. The other actions are within the scope of practice and do not raise concerns regarding patient privacy or confidentiality.

3. In a unionized hospital, nurses receive compensatory pay for working holidays based on the hours worked with no extra compensation. Despite management refusing to consider changes to the compensatory pay system suggested by nurses during the annual employee satisfaction survey, a trend member listened to both parties and made non-legally binding recommendations. What is this type of settlement known as?

• A. Collective bargaining
• B. Mediation
• C. Grievance
• D. Binding arbitration

Correct answer: B

Rationale: Mediation involves a neutral third party who assists in resolving disputes by providing non-legally binding recommendations. In this scenario, the trend member acted as a mediator by listening to both nurses and management and offering suggestions without the authority to enforce them as a legally binding decision. Collective bargaining refers to negotiations between labor unions and employers to determine terms of employment. Grievance is a formal complaint by an employee against an employer. Binding arbitration involves a neutral third party making a final and legally binding decision to resolve a dispute.

4. What may the patient's statement, 'I cannot read until I get my glasses,' indicate?

• A. The patient is embarrassed about needing glasses
• B. The patient has visual impairment
• C. The patient may be illiterate
• D. The patient is being uncooperative

Correct answer: C

Rationale: The patient stating they cannot read until they get their glasses suggests a potential issue with literacy rather than visual impairment or unwillingness to cooperate. This statement should prompt further assessment to determine the patient's reading abilities and potential literacy needs. Choice A is incorrect as the statement does not directly imply embarrassment. Choice B is incorrect as the statement does not necessarily indicate a visual impairment. Choice D is incorrect as there is no clear evidence of the patient being uncooperative based on the provided statement.

5. What is essential for student nurses to perform at their physical and emotional best?

• A. Engaging in adequate exercise.
• B. Eating plenty of carbohydrates the day before.
• C. Drinking caffeinated beverages before clinical.
• D. Studying late into the night to be prepared.

Correct answer: A

Rationale: To perform at their physical and emotional best, it is essential for student nurses to engage in adequate exercise. Regular physical activity not only helps maintain physical health but also contributes to emotional well-being, which is crucial for optimal clinical performance. Exercise can help reduce stress, improve mood, increase energy levels, and enhance overall cognitive function, all of which are essential for students to perform effectively in clinical settings. Choices B, C, and D are incorrect. Eating plenty of carbohydrates the day before, drinking caffeinated beverages before clinical, and studying late into the night may not necessarily lead to optimal physical and emotional performance. While nutrition is important, a balanced diet is more effective than simply focusing on carbohydrates. Caffeinated beverages can lead to dehydration and interfere with sleep patterns, and studying late into the night can impair cognitive function and increase stress levels, which are counterproductive to performing at one's best.

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