The nurse educators on a cardiovascular unit of a health care facility are creating a social media project that addresses improving outcomes for clients with heart failure. Which action should the nurses implement to protect client privacy?

Remove client identifying information of those who participate.

Implement full disclosure policy especially when giving examples.

Respect all copyright laws when adding website content.

May use information from the client's relatives instead.

Answer and Explanation

The Correct Answer is A

A. Remove client identifying information of those who participate is correct because protecting client confidentiality is a fundamental principle of ethical nursing practice. De-identifying data ensures compliance with privacy regulations like HIPAA.

B. Implement full disclosure policy especially when giving examples is not appropriate as sharing identifiable client information, even with disclosure, violates privacy laws.

C. Respect all copyright laws when adding website content is important but does not directly address client privacy, which is the primary concern in this scenario.

D. May use information from the client's relatives instead still violates privacy laws if the information is related to the client’s care, even if shared by relatives.

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Correct Answer is A

Explanation

A. Reduce the stimuli in the area before continuing the teaching is the best action. Sensory overload can interfere with a client's ability to learn effectively. By reducing distractions and environmental stimuli, the nurse can create a more conducive learning environment.

B. Reassure the client that the skill is not difficult to learn may be helpful, but it does not address the immediate issue of sensory overload. The client needs to be in an environment where they can focus and process information before reassurance is effective.

C. Provide the client with step-by-step written instructions may be helpful later, but in the context of sensory overload, the priority is to first reduce the stimuli. Written instructions can be given once the client is in a calmer state.

D. Demonstrate the skill, speaking slowly and using simple terms is a helpful teaching strategy, but if the client is experiencing sensory overload, the first step should be to reduce the environmental stimuli. Once the environment is conducive to learning, the nurse can proceed with demonstrating the skill.

A. Prescription for ceftriaxone PO every 12 hours. B. A 26-year-old client. C. Blood pressure is 80/48 mm Hg. D. Admitted after a motor vehicle collision.

Correct Answer is C

Explanation

A. Prescription for ceftriaxone PO every 12 hours is not relevant in the initial "Situation" section of SBAR. This would fit better under the "Recommendation" or "Background" sections.

B. A 26-year-old client is part of the background information but does not immediately address the critical issue requiring attention.

C. Blood pressure is 80/48 mm Hg is the most urgent information and provides a clear reason for contacting the healthcare provider.

D. Admitted after a motor vehicle collision is part of the background and would follow the situation statement.

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The nurse educators on a cardiovascular unit of a health care facility are creating a social media project that addresses improving outcomes for clients with heart failure. Which action should the nurses implement to protect client privacy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While teaching a client how to perform a skill, the nurse determines that the client is experiencing sensory overload and is unable to learn effectively. Which action should the nurse implement?

Correct Answer is A

Explanation

The nurse notifies the healthcare provider related to client information using the Situation, Background, Assessment, Recommendation (SBAR) technique. Which information should the nurse provide first?

Correct Answer is C

Explanation

The nurse assists a client who has obstructive sleep apnea (OSA) with evening care. Which intervention is most important for the nurse to implement before leaving the client alone?

The nurse is administering an intradermal (ID) injection to a client. Which action should the nurse take?

The healthcare provider prescribes streptomycin 200 mg intramusculary every 12 hours. The vial is labeled, "Streptomycin 1 gram/2.5 mL". How many milliliters should the nurse administer? (Enter numerical value only. (If rounding is required, round to the nearest tenth.)

When assessing a client with a serum potassium level of 2.5 mEq/L (2.5 mmol/L), which intervention is most important for the nurse to implement?

While preparing to obtain a stool specimen for occult blood, the nurse observes that the client's feces is soft, solid, and light brown. Which action should the nurse implement?

While measuring vital signs, the nurse observes that a client is using accessory neck muscles during respirations. Which follow-up action should the nurse take first?

The nurse observes the unlicensed assistive personnel (UAP) securing a client's wrist restraints to the bedside rails. Which action is most important for the nurse to implement?

A client with a sprained ankle is seen at the clinic and is given a pair of crutches. When the client stands with the aid of the crutches, the nurse notes a space of three finger-widths between the top of the crutch and the client's axilla. Which action should the nurse take?