A nurse is caring for a client whose family member requests to view the client’s medical record. Which of the following responses should the nurse make?
The ethics committee will need to approve this request for you.
I will ask the nursing supervisor to obtain the medical records for you.
The healthcare provider will share this information with you.
The client must provide permission to share the records with you.
The Correct Answer is D
Choice A reason:
The ethics committee does not typically handle requests for access to medical records. Their role is more focused on addressing ethical dilemmas and conflicts in patient care, rather than routine administrative tasks like granting access to medical records.
Choice B reason:
Asking the nursing supervisor to obtain the medical records for a family member is not appropriate without the client’s consent. Medical records are confidential and protected under laws such as HIPAA (Health Insurance Portability and Accountability Act), which require patient authorization for disclosure.
Choice C reason:
The healthcare provider cannot share medical information with a family member without the client’s explicit permission. This is to ensure the privacy and confidentiality of the client’s health information.
Choice D reason:
The correct procedure is for the client to provide permission to share their medical records. Under HIPAA, a healthcare provider can only share a patient’s medical information with family members if the patient has given explicit consent. This ensures that the patient’s privacy rights are respected and that their health information is protected.
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Correct Answer is A
Explanation
Choice A reason:
Metoprolol is a beta-blocker commonly used to treat high blood pressure (hypertension). One of its primary therapeutic effects is the reduction of blood pressure. By blocking beta-adrenergic receptors, metoprolol decreases the heart rate and the force of contraction, leading to lower blood pressure.
Choice B reason:
While metoprolol can help manage certain types of dysrhythmias by slowing the heart rate and stabilizing the heart’s rhythm, the primary therapeutic effect for which it is most commonly prescribed is the reduction of blood pressure.
Choice C reason:
Increased urine output is not a direct therapeutic effect of metoprolol. This effect is more commonly associated with diuretics, which are often used in conjunction with beta-blockers to manage hypertension and heart failure.
Choice D reason:
Decreased pulse is a potential effect of metoprolol, as it slows the heart rate. However, this is not the primary therapeutic goal. The main therapeutic effect is the reduction of blood pressure.
Correct Answer is ["C","E"]
Explanation
Choice A: Plan a plan of care for a client when postoperative from an appendectomy
Planning a plan of care for a client, especially postoperatively, is a complex task that requires comprehensive assessment and critical thinking skills. This responsibility typically falls within the scope of practice of a registered nurse (RN) rather than an LPN. The RN is trained to develop individualized care plans based on a thorough assessment of the client’s condition, medical history, and specific needs. This ensures that the care plan is holistic and addresses all aspects of the client’s recovery.
Choice B: Provide discharge instructions to a confused client’s spouse
Providing discharge instructions, particularly to a confused client’s spouse, involves detailed communication and education. This task is generally performed by an RN, who has the expertise to ensure that the instructions are clear, comprehensive, and tailored to the client’s specific needs. The RN can also assess the spouse’s understanding and provide additional clarification as needed. This ensures that the client receives appropriate care at home and reduces the risk of complications.
Choice C: Administer a tap-water enema to a client who is preoperative
Administering a tap-water enema is a task that can be safely delegated to an LPN. LPNs are trained to perform routine procedures such as enemas, which do not require the advanced assessment skills of an RN. This task involves following established protocols and ensuring the client’s comfort and safety during the procedure. By delegating this task to an LPN, the RN can focus on more complex aspects of client care.
Choice D: Clean vital signs from a client who is 6 hours postoperative
The task of cleaning vital signs is not clearly defined in the context provided. However, if it refers to monitoring and recording vital signs, this is a task that can be delegated to an LPN. LPNs are competent in taking and recording vital signs, which is a routine part of client care. Accurate monitoring of vital signs is essential for assessing the client’s postoperative status and identifying any potential complications.
Choice E: Catheterize a client who has not voided in 8 hours
Catheterization is a procedure that LPNs are trained to perform. This task involves inserting a catheter to relieve urinary retention, which can be a common issue in postoperative clients. LPNs can perform this procedure safely and effectively, following established protocols to minimize the risk of infection and ensure the client’s comfort. Delegating this task to an LPN allows the RN to focus on other critical aspects of client care.