A nurse on a medical-surgical unit receives a telephone call from an individual who identifies himself as the client's employer. The employer asks the nurse about the client's condition. Which of the following is an appropriate response by the nurse?
"I cannot confirm or deny that we have a client by that name."
"I will tell him you called."
"The client's condition is stable right now."
"He is here in the hospital, but I cannot tell you anything else."
The Correct Answer is A
Choice A Reason:
"I cannot confirm or deny that we have a client by that name." This response respects the patient's right to confidentiality under HIPAA (Health Insurance Portability and Accountability Act) regulations. It neither confirms nor denies the patient's presence in the hospital, preserving the patient's privacy and confidentiality.
Choice B Reason:
"I will tell him you called." This response doesn't uphold patient confidentiality. Revealing that the employer called could indirectly confirm the patient's presence in the hospital, potentially breaching confidentiality.
Choice C Reason:
"The client's condition is stable right now." Sharing any information about the patient's condition with someone who hasn't been authorized to receive it breaches patient confidentiality. Even sharing a seemingly benign statement about stability can indirectly disclose the patient's presence in the hospital.
Choice D Reason:
"He is here in the hospital, but I cannot tell you anything else. “While it refrains from divulging more information, it still confirms the patient's presence in the hospital, breaching confidentiality.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
"Consume 1,500 to 1,700 calories per day." Caloric needs vary among individuals based on factors like age, sex, activity level, and growth rate. While this calorie range might be suitable for some adolescents, it's not universally applicable. Individual energy needs should be assessed based on various factors.
Choice B Reason:
“Increase the amount of your dietary iron intake." During adolescence, especially in menstruating females, the body's iron requirements increase due to the onset of menstruation and rapid growth. Encouraging adequate intake of dietary iron-rich foods is important to prevent iron deficiency anemia.
Choice C Reason:
"Decrease your vitamin D intake once you start to menstruate." Vitamin D is important for bone health, and menstruation doesn't warrant a decrease in vitamin D intake. Adequate vitamin D intake remains important for bone health, especially during adolescence when bone growth is significant.
Choice D Reason:
"Limit your sodium intake to 3,000 milligrams per day." While excessive sodium intake is a concern, the recommended daily sodium intake varies depending on factors like age and health conditions. For many adolescents, the recommended limit for sodium intake might differ from the specified 3,000 milligrams per day.
Correct Answer is ["D","E"]
Explanation
Choice A Reason:
Heat the formula to 39°C (102°F) prior to administration. Formula temperature should be warm, but heating it to a specific temperature like 39°C (102°F) is not typically necessary. Room temperature or slightly warm formula is often suitable.
Choice B Reason:
The supine position (lying flat on the back) is not recommended during enteral feedings. Infant should be placedin a semi-upright position (usually around 30 to 45 degrees)- this helps prevent aspiration and aids in proper digestion and passage of the feeding into the stomach.
Choice C Reason:
Offer the infant a pacifier during feedings. Offering a pacifier during enteral feedings could potentially interfere with the feeding process and may increase the risk of aspiration. It's generally not recommended during tube feedings.
Choice D Reason:
Instill the formula over a period of 30 to 45 minutes. Slowly administering the formula over this duration allows for proper digestion and reduces the risk of feeding-related complications.
Choice E Reason:
Check for residual volumes by aspirating stomach contents. Checking for residual volumes helps ensure the stomach is adequately emptying and can help prevent complications such as aspiration or feeding intolerance.
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