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. Insulin forces which of the following electrolytes out of the plasma and into the cells?

• A. Calcium
• B. Magnesium
• C. Phosphorus
• D. Potassium

Correct answer: D

Rationale: Insulin forces potassium out of the plasma and into the cells, which can cause hypokalemia. This is because insulin enhances the activity of the sodium-potassium pump in cell membranes, promoting the movement of potassium from the extracellular fluid into the cells. Choices A, B, and C are incorrect as insulin does not directly influence the movement of calcium, magnesium, or phosphorus in the same manner as it does with potassium.

3. What is the primary focus of primary healthcare?

• A. Emergency care
• B. Preventive care
• C. Specialized treatment
• D. Hospital-based services

Correct answer: B

Rationale: The correct answer is B: Preventive care. Primary healthcare emphasizes preventive care, which includes promoting overall health, preventing diseases, and providing early intervention to avoid the progression of illnesses. Emergency care (choice A) is focused on immediate medical attention for urgent health situations but is not the primary focus of primary healthcare. Specialized treatment (choice C) refers to care provided by specialists for specific health conditions, which is not the main focus of primary healthcare. Hospital-based services (choice D) involve inpatient care provided in a hospital setting, which is not the primary focus of primary healthcare that aims to provide comprehensive and accessible care at the community level.

4. A nurse on a med-surg unit is caring for a group of clients with the assistance of an LPN and an AP. Which of the following tasks should the nurse assign to the LPN?

• A. Reinforce dietary teaching with a client who has heart disease.
• B. Obtaining a urine specimen from an older adult client
• C. Providing postmortem care for a client who has just died.
• D. Accompanying a client who just had a wound debridement to PT.

Correct answer: A

Rationale: The correct answer is to reinforce dietary teaching with a client who has heart disease. This task falls within the LPN's scope of practice as they can provide education and support related to nutrition. Obtaining a urine specimen (Choice B) is typically performed by nursing assistants. Providing postmortem care (Choice C) is a sensitive task usually performed by registered nurses. Accompanying a client to physical therapy (Choice D) is often done by nursing assistants or other supportive staff.

5. Which of the following best describes evidence-based practice?

• A. Using outdated research
• B. Relying on personal experience alone
• C. Integrating clinical expertise with the best available evidence
• D. Disregarding patient preferences

Correct answer: C

Rationale: Evidence-based practice involves integrating clinical expertise with the best available evidence to make informed decisions about patient care. Choice A is incorrect as evidence-based practice relies on current and relevant research. Choice B is incorrect as it emphasizes the importance of not relying solely on personal experience. Choice D is incorrect as patient preferences play a significant role in evidence-based practice.

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