Nursing Elites

1. You are turning your patient in bed and notice that a confused and lethargic patient had loose car keys and lipstick in the bed and had been lying on them. What is this person at risk for due to all three of these factors: confusion, lethargy, and items in the bed?

• A. Falls
• B. Skin breakdown
• C. Apnea
• D. Lack of mobility

Correct answer: B

Rationale: This patient is at great risk for skin breakdown due to the presence of three specific risk factors: confusion, lethargy, and items in the bed. While confusion puts the patient at risk for falls, confusion and lethargy together may lead to a lack of mobility. However, skin breakdown is the primary concern in this scenario as it is associated with all three risk factors - confusion, lethargy, and the presence of items in the bed. Therefore, the correct answer is 'Skin breakdown'.

2. A patient with peripheral vascular disease is receiving discharge instructions. Which of the following information should be included?

• A. Walk barefoot whenever possible.
• B. Use a heating pad to keep feet warm.
• C. Avoid crossing the legs.
• D. Use antibacterial ointment to treat skin lesions prone to infection.

Correct answer: C

Rationale: Patients with peripheral vascular disease should be advised to avoid crossing their legs as this can impede blood flow. Peripheral vascular disease, also known as arteriosclerosis obliterans, is primarily caused by atherosclerosis. Atherosclerosis results in the gradual progression of arterial occlusion due to the formation of atheromas. Crossed legs can further restrict blood flow, exacerbating the condition. Walking barefoot should be discouraged to prevent potential injuries to the feet. Using a heating pad can lead to burns and should be avoided to prevent thermal injuries. While using antibacterial ointment for skin lesions may be beneficial, it is not the priority instruction for patients with peripheral vascular disease.

3. In which of the following examples would informed consent not be required?

• A. A patient is apprehensive about an upcoming surgery and chooses not to learn of the risks involved with the procedure.
• B. A child is rushed to the Emergency Room after falling from a third-story window.
• C. An adult in a coma in a mental health institution with no listed next of kin.
• D. Informed consent is not required in any of the above examples.

Correct answer: D

Rationale: In emergency situations where immediate treatment is necessary to prevent further harm or save a life, such as in option B where a child is rushed to the Emergency Room after a fall, informed consent may be waived to provide prompt care. In option A, though the patient is apprehensive about surgery and chooses not to learn the risks, informed consent is not required as it is the patient's right to refuse information. In option C, when an adult is in a coma with no next of kin listed, decisions may be made in the patient's best interest following legal and ethical guidelines. Therefore, informed consent is not needed in any of the scenarios presented.

4. Sinusitis is caused by:

• A. Bacteria
• B. Fungus
• C. Virus
• D. Any of the above

Correct answer: D

Rationale: Sinusitis can be caused by bacteria, viruses, or fungi. While bacterial infections are the most common cause, viral or fungal infections can also lead to sinusitis. Therefore, the correct answer is 'Any of the above.' Choices A, B, and C are incorrect because they only represent individual causes of sinusitis, whereas choice D encompasses all possible causes.

5. According to HIPAA, which of the following is considered an individual right for privacy of a client's protected health information?

• A. The right to receive a copy of the organization's privacy practices
• B. The right to receive medical bills for care received
• C. The right to change personal health information
• D. An understanding that protected health information will only be used in regards to client treatments

Correct answer: A

Rationale: According to HIPAA, individuals receiving care at healthcare facilities have rights surrounding their protected health information. One of these rights is to receive a copy of the organization's privacy practices, which outlines how their health information will be used and protected. This ensures transparency and allows individuals to understand how their information is handled. The other choices are incorrect because while individuals have the right to access their health information, receive explanations of how it is used, and ensure its confidentiality, receiving medical bills or changing personal health information are not specifically outlined as rights related to the privacy of protected health information.

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