A. Nurse 1– The nurse disclosed identifiable information about a client's involvement in a motor vehicle crash to another client. Sharing such specific details violates HIPAA regulations, even if the other client heard about the event in the news.

B. Nurse 5– Although this nurse acted unethically by administering pre-op medication without ensuring informed consent, the issue is informed consent and autonomy—not confidentiality.

C. Nurse 2–Leaving a computer with an active login accessible to others is a security risk. Allowing another provider to use a computer under the nurse’s login compromises protected health information.

D. Nurse 4– Using the client’s roommate as an interpreter exposes private medical information to someone who is not authorized. Interpreters should be neutral, trained professionals to protect confidentiality and accuracy.

E. Nurse 3– Although the nurse did not follow the client’s DNR wishes, this is an ethical and legal issue regarding end-of-life care, not a confidentiality breach.

A.Droplet precautions require a surgical mask when within 3 feet of a client to prevent transmission of pathogens spread by respiratory droplets, such as influenza.
B.An N95 respirator is required for airborne precautions (e.g., tuberculosis), not droplet precautions.
C.Positive airflow rooms are used for protective environments (e.g., neutropenic clients), not for those on droplet precautions.
D.HEPA filtration systems are typically part of airborne or protective isolation protocols, not required for droplet precautions.

A.A tracheostomy dressing change is important for preventing infection but is not as urgent as a potential complication like deep vein thrombosis (DVT).
B.Discharge teaching is essential but not time-sensitive and can be safely delayed.
C.Diarrhea from enteral feedings may require adjustment of the formula, but the feeding isn’t due for 2 hours, making this less urgent.
D.A client who is 4 hr postoperative with pitting edema of the right legshould be seen first. This finding could indicate a deep vein thrombosis (DVT), a potentially life-threatening complication due to the risk of pulmonary embolism. This requires immediate assessment and intervention.

A. Petroleum jelly is not recommended for tracheostomy care because it can be aspirated and cause airway obstruction.

B. An obturator is essential to have on hand in case the tracheostomy tube becomes dislodged. It allows for safe reinsertion of the tube and is a critical emergency supply.

C. An oxygen tank may be necessary if the client requires supplemental oxygen therapy at home, depending on their respiratory status.

D. Cotton balls are not recommended for tracheostomy care because fibers can be aspirated and cause airway obstruction.

E. Pipe cleaners are unsafe for tracheostomy care because they can break or leave fragments in the airway. Proper tracheostomy cleaning supplies include sterile swabs or suction catheters.

A.Pain when chewing is more related to temporomandibular joint involvement and may require a referral to a dietitianor speech-language pathologistfor swallowing issues.
B.A support group referral would be more appropriate for a social workeror mental health professional, not an occupational therapist.
C.Requiring assistance with completing oral hygieneindicates difficulty with fine motor skills and daily living tasks—core areas of focus for occupational therapists. They help clients adapt and regain independence in performing self-care activities.
D.Difficulty ambulating with a walker would be addressed by a physical therapist, who specializes in mobility and gait training.

A. A nurse manager oversees the daily operations of the unit, ensuring quality care and appropriate staffing.
B. Nurse managers have the authority to make administrative and clinical decisions that impact the unit.
C. Nurse managers align unit performance with the broader goals of the organization, such as safety, patient satisfaction, and efficiency.
D. While nurse managers ensure proper delegation is occurring, delegation is a direct responsibility of staff nurses, not the manager unless they are functioning in a clinical role.
E. Nurse managers are responsible for performance management, including recognizing good work and addressing issues through corrective action when needed.

A.Telling a confused client that they must stay for treatment may reflect a need for better communication strategies, but it is not necessarily unethical—it prioritizes safety and care, assuming the client lacks decision-making capacity.
B.Incorrectly stating that a DNR (Do Not Resuscitate) order includes withholding comfort measuresindicates a misunderstanding of ethical and legal standards. DNR orders mean no resuscitation in the event of cardiac or respiratory arrest but do notmean withholding comfort or palliative care. This response shows a need for further ethical education.
C.Refusing to participate in an abortion procedure based on moral or religious beliefs is ethically acceptable under the principle of conscientious objection, as long as patient care is not compromised.
D.Administering prescribed opioids to a terminally ill client, even with a low respiratory rate, can be ethically appropriate under the principle of palliative care, where comfort is prioritized, especially at end of life. The nurse should, however, monitor the client closely.

A.Credible websites often include authorship with credentials and contact information, allowing users to verify the qualifications of the source. This supports transparency and accountability.
B.A ".net" domain does not guarantee credibility. While domain types like ".edu", ".gov", and ".org" are typically more reliable, ".net" can be used by any entity and does not indicate a trustworthy source by itself.
C.Functional links are helpful but do not confirm the credibility or accuracy of the content.
D.While it’s important that information is current, data updated within the last 6 years may be outdated for healthcare topics like hospital-acquired infections, which can evolve rapidly. Best practice recommends information be reviewed or updated within 2-3 years.

A. In a win-lose approach, one party (often the person in authority) dominates the decision-making, leading to a one-sided outcome.
B. This method disregards employee input, reflecting a top-down, authoritarian approach.
C. Win-lose methods often involve power struggles, as one side tries to assert control over the other.
D. This describes a win-winapproach, not win-lose. In win-lose, only one party benefits.
E. The lack of collaboration and openness in a win-lose approach can create a culture where staff feel undervalued or fearful of speaking up.

A.An ankle injury with pain is painful but not life-threatening. This client can safely wait.
B.A 2 cm head laceration with dark red blood suggests venous bleeding and is not emergent unless signs of more serious head injury are present.
C.An older adult client with dyspnea and a respiratory rate of 26/minshould be examined first. Dyspnea (shortness of breath) and elevated respiratory rate indicate possible respiratory distress or a life-threatening condition such as pulmonary embolism, heart failure, or pneumonia. Airway and breathing issues always take priority.
D.Ecchymoses (bruising) could suggest a bleeding or clotting disorder but are not immediately life-threatening without other symptoms.