Nursing Elites

1. Which of the following healthcare providers can legally have access to all, or part, of a patient's medical record because they have a 'need to know'? Select one that does not apply.

• A. Student nurses caring for a particular patient
• B. Registered nurses when they are not caring for a particular patient
• C. The Vice President for nursing who is investigating a patient fall
• D. Licensed practical nurses caring for a particular patient

Correct answer: B

Rationale: Student nurses, licensed practical nurses, the Vice President for nursing investigating a fall, and quality assurance nurses have a 'need to know' basis to access patient records. Registered nurses who are not directly involved in the care of a patient do not have a legitimate reason or 'need to know' to access that patient's medical records, making choice B the correct answer. The Vice President for nursing investigating a specific incident and licensed practical nurses directly involved in a patient's care have legitimate reasons to access the medical records, ensuring continuity and quality of care.

2. You are caring for a neonate who has a cleft palate. You should inform the mother that surgical correction will be done when the infant is:

• A. 8 to 12 months of age.
• B. 20 to 24 months of age.
• C. 16 to 20 months of age.
• D. 12 to 16 months of age.

Correct answer: A

Rationale: The correct answer is A: 8 to 12 months of age. Surgical correction for a cleft palate is typically performed around this age to optimize speech development and prevent feeding difficulties. Options B, C, and D suggest later ages for surgery, which may lead to speech and feeding issues due to the delay in correction.

3. What are the fine, down-like hairs on the newborn's ears, shoulders, lower back, and/or forehead known as?

• A. Vernix.
• B. Lanugo.
• C. Milia.
• D. Vibrissae.

Correct answer: B

Rationale: Lanugo is the term used to describe the fine, down-like hairs found on a newborn's ears, shoulders, lower back, and/or forehead. These hairs are different from vernix, which is a waxy or cheese-like white substance covering the skin of newborns. Milia are small, white, or yellowish cysts that commonly appear on a newborn's face, while vibrissae are the thick, stiff hairs commonly found around the nose and other parts of the face.

4. A nurse is preparing to delegate bathing and turning of a newly admitted client who has end-stage cancer to an experienced assistive personnel (AP). Which of the following assessments should the nurse make before delegating care?

• A. Is the client's family present so the AP can show them how to turn the client?
• B. Has data been collected about specific client needs related to turning?
• C. Does the AP have time to change the client's central IV line dressing after turning her?
• D. Has the AP checked the client's pain level prior to turning her?

Correct answer: B

Rationale: Before delegating the task of bathing and turning a client with end-stage cancer to an experienced assistive personnel (AP), the nurse must assess specific client needs related to turning. This assessment ensures that the delegated care is tailored to the client's individual requirements, promoting safe and effective care. Option A is incorrect because the presence of the client's family is not directly related to assessing the client's specific needs for turning. Option C is incorrect as it refers to a different task (changing the central IV line dressing) and is not directly related to the turning assessment. Option D is incorrect as checking the client's pain level, although important, is not directly related to the specific needs related to turning the client.

5. A client is preparing for an elective mastectomy. The client is wearing a plain gold wedding band. Which of the following is an appropriate procedure for taking care of this client's ring?

• A. Agree to keep the ring for the client until after surgery
• B. Place the ring in the bag with the client's clothing
• C. Tape the ring securely to the client's finger
• D. Place the client's ring in the facility safe

Correct answer: D

Rationale: In this scenario, placing the client's ring in the facility safe is the most appropriate procedure. This ensures the ring is kept secure and prevents any risk of loss or damage during the surgery. Agreeing to keep the ring for the client could raise concerns about accountability, while placing it in the bag with the client's clothing might lead to misplacement. Taping the ring securely to the client's finger is not recommended as it may hinder blood circulation or cause discomfort.

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