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. Which patient is exercising their right to autonomy in the context of patient rights?

• A. An 86-year-old female who remains independent in terms of the activities of daily living.
• B. An unemancipated 16-year-old who chooses to not have an intravenous line.
• C. A 32-year-old who does not need the help of the nurse to bathe and groom themselves.
• D. A 99-year-old who wants CPR despite the fact that the nurse and doctor do not think that it would be successful.

Correct answer: D

Rationale: The correct answer is D. A 99-year-old exercising their right to autonomy in the context of patient rights by choosing CPR. Autonomy in healthcare refers to the patient's right to make their own decisions about their care, even if healthcare providers may disagree. In this scenario, the 99-year-old patient is exercising autonomy by making an informed choice about their medical treatment, despite healthcare professionals having a different opinion. Choices A, B, and C do not directly demonstrate the exercise of autonomy in decision-making regarding medical treatment, making them incorrect.

3. Rotating injection sites when administering insulin prevents which of the following complications?

• A. Insulin edema
• B. Insulin lipodystrophy
• C. Insulin resistance
• D. Systemic allergic reactions

Correct answer: B

Rationale: Rotating injection sites when administering insulin helps prevent insulin lipodystrophy, which is the abnormal distribution of fat at injection sites. Insulin edema (choice A) is not prevented by rotating injection sites; it is characterized by swelling at the site of insulin injection due to increased capillary permeability. Insulin resistance (choice C) is a condition where the body's cells become less responsive to insulin, and rotating injection sites does not directly prevent this. Systemic allergic reactions (choice D) are not specifically prevented by rotating injection sites; they are related to an allergic response to insulin.

4. Which of the following joints normally allows 360-degree circumflexion?

• A. The knee
• B. The shoulder
• C. The elbow
• D. The fingertips

Correct answer: B

Rationale: The correct answer is B: The shoulder. The shoulder joint is a ball-and-socket joint that allows for a wide range of motion, including 360-degree circumflexion. This joint provides flexibility and mobility in various directions. Choice A, the knee joint, primarily allows flexion and extension but does not have a 360-degree circumflexion. Choice C, the elbow joint, is a hinge joint that permits flexion and extension but not circumflexion. Choice D, the fingertips, do not form a specific joint that allows circumflexion; rather, they have joints that enable bending and straightening movements.

5. A nurse enters a client room to witness an informed consent for a gastroscopy. The client states he does not understand the procedure. Which of the following actions should the nurse take?

• A. Educate the client about the risks of refusing medications
• B. Complete an incident report
• C. Answer the client's question concerning the procedure
• D. Inform the provider that the client requires clarification about the procedure

Correct answer: D

Rationale: The correct action for the nurse to take in this situation is to inform the provider that the client requires clarification about the procedure. This ensures that the client fully understands the gastroscopy procedure before giving consent. Choice A is incorrect as the client's issue is not about refusing medications. Choice B is irrelevant as there is no incident to report. Choice C could be misleading as the nurse should not be providing information about the procedure but rather ensuring that the client gets the necessary clarification from the provider.

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