The major difference between the nursing diagnoses "inadequate nutritional intake related to vomiting as manifested by 3-pound weight loss" and "risk for impaired skin integrity related to inadequate nutrition" is that the second diagnosis:

Choice A rationale

This is a closed-ended question that requires a yes or no answer. While it gathers specific information about breathing difficulty, it limits the patient's ability to describe their chest pain experience in their own words and provide richer details.

Choice B rationale

This question focuses on the duration of the chest pain. While this is important information for the nurse to know, it does not elicit a description of the pain itself, which is crucial for understanding the potential underlying cause and guiding further assessment.

Choice C rationale

This open-ended question encourages the patient to describe the characteristics of their chest pain, such as its quality (e.g., sharp, dull, crushing), location, radiation, and intensity. This detailed information is vital for differentiating between various causes of chest pain, including cardiac, musculoskeletal, or gastrointestinal issues.

Choice D rationale

While family history is relevant to the patient's overall health status and potential risk factors for certain conditions like heart disease, it does not directly address the patient's immediate experience of chest pain or provide details about the current symptom.

Choice A rationale

Sharing a password with the information system representative would violate security protocols. Passwords provide individual accountability and prevent unauthorized access to sensitive patient data. Allowing others access under your credentials compromises the system's integrity and audit trails, making it difficult to track actions and ensure data security.

Choice B rationale

Providing a password to the unit clerk would similarly breach confidentiality and security measures. Unit clerks may not have the same level of authorization or training regarding data privacy as nurses, increasing the risk of inappropriate access or misuse of patient information within the electronic health record.

Choice C rationale

Even sharing a password with the nurse manager is inappropriate. While the nurse manager is a supervisor, each individual user should have their own unique login credentials to maintain accountability and security. System access is granted based on individual roles and responsibilities, not shared passwords.

Choice D rationale

Maintaining the confidentiality of one's password is a fundamental principle of information security in healthcare. Each user is responsible for protecting their login credentials to prevent unauthorized access to patient records and ensure compliance with privacy regulations like HIPAA. This safeguards patient confidentiality and the integrity of the electronic health record.