Nursing Elites

1. Which of the following actions could be considered a breach of patient confidentiality?

• A. Discussing patient information with other healthcare providers in a private setting.
• B. Sharing patient information with family members without the patient's consent.
• C. Discussing patient information in public areas where others may overhear.
• D. Sharing patient information in a private, secure setting with other healthcare providers involved in the patient's care.

Correct answer: C

Rationale: Discussing patient information in public areas where others may overhear is considered a breach of patient confidentiality because it compromises the privacy and confidentiality of the patient's health information. Choices A and D are not breaches of confidentiality as discussing patient information with other healthcare providers in a private setting or in a private, secure setting with those involved in the patient's care is appropriate. Choice B is also incorrect as sharing patient information with family members without the patient's consent could potentially be a breach of privacy but is not the best answer in this context.

2. Which of the following ethical principles is demonstrated when a nurse provides truthful information to a patient?

• A. Veracity
• B. Autonomy
• C. Justice
• D. Nonmaleficence

Correct answer: A

Rationale: The correct answer is A: Veracity. Veracity is the ethical principle of truthfulness and honesty in communication. When a nurse provides truthful information to a patient, it demonstrates integrity and respect for the patient's right to know the truth about their health condition and treatment. Choice B, Autonomy, refers to respecting the patient's right to make their own decisions. Choice C, Justice, involves fairness and equality in healthcare decisions. Choice D, Nonmaleficence, relates to the obligation to do no harm and prevent harm to the patient.

3. A client with a nasogastric tube requires irrigation once every shift. The client's serum electrolyte results show a potassium level of 4.5 mEq/L and a sodium level of 132 mEq/L. Based on these findings, which solution should the nurse use for nasogastric tube irrigation?

• A. Tap water
• B. Sterile water
• C. Sodium chloride
• D. Normal saline

Correct answer: C

Rationale: The correct solution for nasogastric tube irrigation in this scenario is sodium chloride. The client's low sodium level of 132 mEq/L indicates the need to avoid further imbalance, making sodium chloride the most appropriate choice. Using tap water, which lacks electrolytes, or sterile water could potentially exacerbate the electrolyte imbalance. Normal saline, while similar to sodium chloride, may not be the best choice as it contains a higher concentration of sodium, which could further elevate the client's already borderline sodium level.

4. After undergoing a subtotal thyroidectomy, a female client develops hypothyroidism. Dr. Smith prescribes levothyroxine (Levothroid), 25 mcg P.O. daily. For which condition is levothyroxine the preferred agent?

• A. Primary hypothyroidism
• B. Graves' disease
• C. Thyrotoxicosis
• D. Euthyroidism

Correct answer: A

Rationale: Levothyroxine is the preferred agent for primary hypothyroidism because it provides the necessary replacement of thyroid hormone in patients with deficient thyroid function. Choice B, Graves' disease, is an autoimmune disorder that causes hyperthyroidism and is typically treated with antithyroid medications or radioactive iodine. Choice C, thyrotoxicosis, refers to the clinical state resulting from excessive thyroid hormone action and is not typically treated with levothyroxine. Choice D, euthyroidism, describes a normal thyroid function and would not require treatment with levothyroxine.

5. A client with DM is taking regular and NPH insulin every morning. The nurse should provide which instruction to the client?

• A. Take the regular insulin first, then the NPH insulin.
• B. Take the NPH insulin first, then the regular insulin.
• C. Mix the insulins in a separate syringe.
• D. Take the regular insulin first and immediately follow it with the NPH insulin.

Correct answer: A

Rationale: The correct instruction for the client is to take the regular insulin first, then the NPH insulin. Regular insulin should be administered before NPH insulin to prevent contamination and maintain the potency of each insulin type. Choice B is incorrect because NPH insulin should not be taken before regular insulin. Mixing the insulins in a separate syringe, as suggested in choice C, is not recommended as it may alter the effectiveness of the insulins. Choice D is also incorrect as taking the regular insulin first and immediately following it with NPH insulin is not the recommended administration sequence.

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