A nurse is assigned a group of clients at the start of the shift. Which of the following clients should the nurse plan to care for first?

Correct Answer: C

Rationale: The correct answer is C, the client asking about his PCA pump containing morphine. This client should be cared for first because the PCA pump is delivering a potent medication that requires close monitoring to prevent adverse effects. The nurse needs to assess the client's pain level, pump settings, and any signs of overdose or underdose. This situation requires immediate attention to ensure the client's safety. Choice A is incorrect because a client needing assistance with a bath can typically wait and does not pose an immediate risk to their health or safety. Choice B is incorrect as a client requesting a referral for home health services is important but can be addressed after the client with the PCA pump. Choice D is also incorrect because a client with questions about a new prescription can typically wait as long as it is not urgent.

Correct Answer: D

Rationale: The correct answer is D because according to HIPAA regulations, a client's medical records are confidential and can only be shared with the client's permission. The nurse should inform the family member that the client must provide permission to access the medical records. A: Asking the nursing supervisor to obtain the medical records is not appropriate as it bypasses the client's right to privacy. B: The health care provider cannot share the information without the client's consent. C: Involving the ethics committee is unnecessary and does not address the issue of the client's permission. In summary, choice D is correct as it upholds the client's right to privacy and follows legal and ethical guidelines. Choices A, B, and C are incorrect as they do not consider the client's autonomy and confidentiality.

Correct Answer: D

Rationale: Rationale for Correct Answer D: 1. Notify the nursing supervisor: This is the appropriate action to ensure patient safety and address the provider's behavior through the appropriate channels. 2. Counseling the provider (Option A) may not be effective as immediate action is needed. 3. Encouraging clients to change providers (Option B) does not address the underlying issue. 4. Informing the state medical board (Option C) could be premature without internal investigation.

Correct Answer: A

Rationale: The correct answer is A: Sensory perceptual alterations related to decreased vision. Elderly clients with decreased vision are at greater risk for falls due to impaired depth perception, reduced awareness of obstacles, and difficulty navigating their environment. This nursing diagnosis directly impacts the client's ability to detect potential fall hazards. Incorrect Choices: B: Alteration in mobility related to fatigue - Fatigue may contribute to falls but is not as directly related to fall risk as sensory perceptual alterations. C: Impaired gas exchange related to retained secretions - This nursing diagnosis is not directly associated with an increased risk of falls. D: Altered patterns of urinary elimination related to nocturia - Nocturia may impact mobility during nighttime bathroom trips but is not as critical in fall risk assessment compared to sensory perceptual alterations.

Correct Answer: A

Rationale: The correct answer is A because washing hands thoroughly before and after client contact is the primary nursing intervention to limit transmission of a client's Salmonella infection. Handwashing is crucial in removing and preventing the spread of pathogens. Choice B is incorrect because gloves alone do not replace proper hand hygiene. Choice C is not the primary intervention and does not address overall hand hygiene. Choice D is also incorrect as wearing gloves during linen disposal does not address the root of transmission, which is hand contamination. In summary, handwashing is the most effective and fundamental measure in preventing the transmission of infections like Salmonella.