With whom should a nurse share her password for access to the facility’s computer system?

No one

The nurse manager

The unit clerk

The facility’s information system representative

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Confidentiality: Patient information stored within the facility's computer system is highly confidential and protected by various laws and regulations, such as HIPAA (Health Insurance Portability and Accountability Act). Sharing a password with anyone, even trusted colleagues, could potentially compromise patient privacy and lead to unauthorized access or breaches of sensitive data. Nurses are ethically and legally obligated to safeguard patient confidentiality and uphold the highest standards of privacy protection.

Accountability: Each nurse is held individually accountable for any actions taken under their unique login credentials. Sharing a password blurs the lines of responsibility and makes it difficult to trace actions back to the specific individual who performed them. This can create accountability issues and impede investigations in cases of errors, misconduct, or security breaches.

Security Best Practices: Password sharing is universally discouraged by cybersecurity experts as it significantly weakens system security. Strong passwords, kept confidential and changed regularly, are essential for protecting sensitive information from unauthorized access, malware, and potential cyberattacks.

Facility Policies: Most healthcare facilities have strict policies prohibiting password sharing to maintain compliance with regulations and safeguard patient privacy. Violating these policies could lead to disciplinary action, including termination of employment.

Choice B rationale:

While a nurse manager may have a legitimate need to access patient information in certain situations, sharing a password is not the appropriate method for granting such access. Facilities typically have designated procedures for authorized individuals to obtain temporary or secondary login credentials, ensuring accountability and adherence to security protocols.

Choice C rationale:

Unit clerks, while often responsible for administrative tasks within a unit, do not have a clinical role that necessitates access to patient information through the nurse's password. Sharing a password with a unit clerk could lead to unauthorized access and potential privacy violations.

Choice D rationale:

The facility's information system representative is responsible for maintaining the technical infrastructure of the computer system, but they do not require access to patient information through individual nurse passwords. They have their own authorized means of accessing the system for troubleshooting and maintenance purposes.

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Correct Answer is A

Explanation

Choice A rationale:

Hypovolemic shock is a life-threatening condition that occurs when the body loses a significant amount of blood or fluids, leading to a decrease in circulating blood volume. This can result in inadequate perfusion of organs and tissues, which can cause damage and even death if not treated promptly.

In this case, the athlete's symptoms and vital signs are consistent with hypovolemic shock. The athlete has been practicing twice a day in the heat, which can lead to significant fluid loss through sweating. The athlete is also dizzy, which is a common symptom of hypovolemia due to decreased blood flow to the brain. The athlete's blood pressure is low (100/2 mm Hg), pulse rate is elevated (100 beats/minute), and respiratory rate is increased (26 breaths/minute), all of which are compensatory mechanisms to try to maintain blood pressure and perfusion in the setting of hypovolemia. The athlete's skin is cool to touch

and pale in color, which is due to decreased blood flow to the skin. The athlete also does not remember the last voiding time, which may indicate decreased urine output, another sign of hypovolemia.

Key points supporting hypovolemic shock:

Significant fluid loss due to exercise in the heat Dizziness

Low blood pressure Elevated pulse rate Increased respiratory rate Cool, pale skin

Decreased urine output Additional details:

Hypovolemic shock can be caused by various factors, including:

Hemorrhage (blood loss) Severe dehydration Burns

Severe vomiting or diarrhea

Treatment for hypovolemic shock typically involves:

Intravenous fluid replacement to restore circulating blood volume Blood transfusion if the shock is due to hemorrhage

Oxygen therapy to support breathing

Medications to support blood pressure and heart function

A. “I’m sorry, but you do not have the right to read your chart.” B. “You will have to sign a written request for access to your record.” C. “We’ll give you a copy of your records when we are preparing you for discharge.” D. “You will have to explain why you want to review your medical record.”

Correct Answer is B

Explanation

Choice A rationale:

Incorrect. Patients have a legal right to access their medical records under the Health Information Portability and Accountability Act (HIPAA). Denying access is a violation of patient rights and could lead to legal consequences.

Undermines patient autonomy and trust. Patients have a right to know what information is in their medical records and to participate in their own healthcare decisions. Denying access can erode trust in the healthcare system.

Potential for errors and misunderstandings. If patients cannot review their records, they may not be able to identify errors or misunderstandings that could impact their care.

Choice B rationale:

Correct. This response upholds patient rights while ensuring that the request for access is documented and handled appropriately.

Protects patient privacy and confidentiality. The written request process helps to ensure that only the patient or their authorized representative has access to the records.

Provides a mechanism for tracking and auditing access requests. This can help to prevent unauthorized access and ensure compliance with HIPAA regulations.

Choice C rationale:

Incorrect. Patients have a right to access their records at any time, not just when they are being discharged.

Delays access to information. Patients may need to review their records to make informed decisions about their care, even if they are not being discharged.

Potential for records to be lost or misplaced. There is a risk that records could be lost or misplaced if they are not provided to the patient until discharge.

Choice D rationale:

Incorrect. Patients do not need to provide a reason for wanting to access their medical records.

Intrusive and unnecessary. Patients may feel uncomfortable or embarrassed about having to explain their reasons for wanting to access their records.

Potential for discrimination. Patients may be less likely to request access to their records if they feel that they will be judged or questioned about their reasons for doing so.

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With whom should a nurse share her password for access to the facility’s computer system?

Nursing Test Bank

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Correct Answer is A

Explanation

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Correct Answer is B

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