Nursing Elites

1. Your patient has been diagnosed with herpes simplex virus 2. Which of the following would NOT be included in your teaching of this patient?

• A. If you have symptoms, you should avoid sexual contact with other individuals.
• B. With treatment, this condition can be cured.
• C. This disease is highly contagious.
• D. You may experience tingling in the skin before an active outbreak occurs.

Correct answer: B

Rationale: The correct answer is 'With treatment, this condition can be cured.' The treatment for herpes simplex virus (HSV) is symptomatic and palliative, aimed at managing symptoms rather than curing the infection. HSV is highly contagious, so sexual contact should be avoided during active outbreaks to prevent transmission. Many patients experience a tingling sensation in the skin before an active outbreak, known as a prodrome. Educating the patient that the condition is not curable but manageable with treatment is vital to set realistic expectations and promote proper management of the disease.

2. The depressed client verbalizes feelings of low self-esteem and self-worth, typified by statements such as "I'm such a failure"? I can't do anything right!"? The best nursing response would be:

• A. To tell the client this is not true; that we all have a purpose in life.
• B. To remain with the client and sit in silence; this will encourage the client to verbalize feelings.
• C. To reassure the client that you know how the client is feeling and that things will get better.
• D. To identify recent behaviors or accomplishments that demonstrate skill ability.

Correct answer: C

Rationale: The correct response in this situation is to reassure the client that you understand how they are feeling and provide hope for improvement. While acknowledging the client's feelings, it is essential to offer support and encouragement. Choice A is not the best response as it dismisses the client's feelings and offers a generalized statement. Choice B, remaining silent, may lead the client to feel unheard or unsupported. Choice D, identifying recent behaviors or accomplishments, may not be as effective in addressing the immediate emotional distress and negative self-talk expressed by the client. Therefore, choice C is the most appropriate response in this scenario, offering empathy and optimism to help the client feel understood and supported.

3. Choose the BEST answer. To ensure adequate protection for legal issues, offices should maintain patients' charts for:

• A. 10 years
• B. Forever
• C. Until the age of majority
• D. 2 years after the patient was last seen in the office

Correct answer: B

Rationale: The correct answer is 'Forever.' Maintaining patients' charts indefinitely ensures comprehensive legal protection by having all relevant information available in case of litigation or if patient history needs to be referenced in the future. Choice A, '10 years,' may not be sufficient to cover the entire period within which legal issues may arise. Choice C, 'Until the age of majority,' is not ideal as legal matters may extend beyond this age limit. Choice D, '2 years after the patient was last seen in the office,' is inadequate as legal actions can occur beyond this timeframe, necessitating the need for long-term retention of patient charts.

4. Which of the following is an example of a breach of a client's right to privacy?

• A. A nurse who is not caring for the client reads the client's personal information in the chart
• B. A client is not allowed to keep a copy of their original medical record
• C. A nurse files an incident report about a client that is reviewed with all staff at a meeting
• D. A client's photograph is used without permission for the hospital newsletter

Correct answer: D

Rationale: A breach of a client's right to privacy can occur when their personal information is used or disclosed without their consent. In this scenario, using a client's photograph without permission for the hospital newsletter violates their privacy rights. It is important to respect a client's confidentiality and seek their consent before using their personal information. Choices A, B, and C do not directly relate to breaching a client's right to privacy. Reading a client's personal information in their chart, not allowing a client to keep a copy of their medical record, and filing an incident report about a client do not necessarily violate their privacy rights as long as the information is handled appropriately and within legal and ethical boundaries.

5. Mr. K is admitted to the orthopedic unit one morning in preparation for a total knee replacement to start in two hours. Which of the following is a priority topic to instruct this client on admission?

• A. The approximate length of the surgery
• B. The type of anticoagulants that will be prescribed
• C. The time of the next meal of solid food
• D. The length of time until the client can return to work

Correct answer: A

Rationale: The priority topic to instruct a client admitted for a total knee replacement surgery should be the approximate length of the surgery. Pre-surgical teaching should focus on preparing the client for the upcoming procedure. Providing information about the duration of the surgery can help manage the client's expectations, reduce anxiety, and ensure they are mentally prepared for the operation. While details about post-operative care, anticoagulants, meals, and return to work are important, they are not the immediate priority during the preoperative phase. These aspects can be addressed at a later stage in the client's care journey.

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