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. How can the nurse best advocate for a patient who will be discharged from acute care to home?

• A. Arranging for Meals on Wheels to provide in-home meals
• B. Administering pain medication prior to discharge
• C. Teaching the patient how to take medications at home
• D. Taking the patient by wheelchair to the car

Correct answer: A

Rationale: Arranging for in-home support services like Meals on Wheels is crucial for ensuring the patient receives proper nutrition and support after discharge. This goes beyond simply administering medications or providing transportation. By arranging for in-home meals, the nurse addresses the patient's nutritional needs, promotes their overall well-being, and supports their ongoing care requirements. Administering pain medication or teaching medication management, while important, do not directly address the patient's need for nutritional support. Taking the patient by wheelchair to the car is focused on physical transportation and does not encompass the holistic care approach needed for a successful transition to home care.

3. Medicaid, which is financed by what part of the government, is jointly funded by which two entities?

• A. State
• B. Federal
• C. County
• D. State and federal

Correct answer: D

Rationale: Medicaid is a healthcare program jointly funded by the state and federal governments. States have flexibility in administering Medicaid while adhering to federal guidelines, and both entities contribute funding to support the program. Choice A (State) is incorrect as Medicaid is not solely funded by the state government. Choice B (Federal) is not the only funding source for Medicaid. Choice C (County) is not a primary entity involved in financing Medicaid, making it incorrect. The correct answer is D, as Medicaid receives funding from both the state and federal governments.

4. A healthcare professional walks into the nurse's station and sees several staff members looking at the electronic medical record for a celebrity client on another unit. Which of the following actions should the healthcare professional take first?

• A. remind the staff members that this is a breach of confidentiality
• B. discuss the issue with the unit manager
• C. request that an administrative restriction be placed on the client's medical access
• D. prepare a report for the facility ethics committee

Correct answer: A

Rationale: The correct action for the healthcare professional to take first is to remind the staff members that accessing the electronic medical record of a celebrity client from another unit is a breach of confidentiality. This immediate action addresses the ethical and legal issue at hand, emphasizing the importance of patient confidentiality and privacy. Discussing the issue with the unit manager, requesting administrative restrictions, or preparing a report for the facility ethics committee can be considered after addressing the initial breach and reminding staff members of their obligations.

5. What is the difference between the LPN and LVN nursing titles?

• A. LPNs and LVNs have the same educational program length.
• B. LVNs and LPNs have the same duties and skills but hold different titles.
• C. LVNs are able to perform venipuncture, whereas LPNs cannot.
• D. LPNs can pursue an RN license, while LVNs are not on the same path.

Correct answer: B

Rationale: The correct answer is B. LVNs and LPNs have the same duties and skills but hold different titles. The distinction between the two titles is primarily regional, with some states using LPN (Licensed Practical Nurse) and others using LVN (Licensed Vocational Nurse) to refer to the same role. Their scope of practice, responsibilities, and educational requirements are essentially equivalent, with the only notable difference being the title itself. Choices A, C, and D are incorrect because LPNs and LVNs generally have similar educational program lengths, both can perform venipuncture, and both have the potential to pursue further education and licensure to become registered nurses (RNs) if they choose to do so.

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