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 C
Explanation
Choice A reason: Assist the client to sit upright in a chair for 4 hours at a time:
While it is important to mobilize patients after surgery, sitting upright for 4 hours at a time is excessive and can cause discomfort and strain on the surgical site. Early postoperative care focuses on gradual mobilization and avoiding prolonged positions that could stress the spine.
Choice B reason: Expect clear drainage on the spinal dressing:
Clear drainage on the spinal dressing is not typical and could indicate a cerebrospinal fluid (CSF) leak, which is a serious complication. Any unexpected drainage should be reported to the healthcare provider immediately.
Choice C reason: Log roll the client every 2 hours:
Log rolling is a technique used to turn patients while keeping the spine in alignment. This method is crucial for patients who have undergone spinal surgery to prevent twisting or bending of the spine, which could disrupt the surgical site and impede healing. Regular repositioning also helps prevent pressure ulcers.
Choice D reason: Perform neurological checks every 8 hours:
Neurological checks are essential after spinal surgery to monitor for any changes in sensation, movement, or function. However, these checks are typically performed more frequently than every 8 hours, especially in the immediate postoperative period.
Correct Answer is B
Explanation
Choice A reason:
Intense pruritus: While itching (pruritus) can be a symptom of skin conditions, it is not a definitive sign of malignancy in nevi. Pruritus can be associated with benign conditions such as eczema or allergic reactions. However, if a mole starts to itch, it should be monitored closely, but it is not as strong an indicator of malignancy as irregular borders.
Choice B reason:
Irregular borders: This is a significant sign of potential malignancy in nevi. Melanomas often have uneven, notched, or scalloped borders, unlike benign moles, which typically have smooth, even borders. The irregularity in the border is due to the uncontrolled growth of melanocytes, which can spread unevenly.
Choice C reason:
Uniform pigmentation: Uniform pigmentation is generally a sign of a benign mole. Malignant moles often have multiple colors or an uneven distribution of color, which can include shades of brown, black, red, white, or blue. A mole with uniform color is less likely to be malignant.
Choice D reason:
Purulent drainage: While purulent drainage (pus) indicates an infection, it is not a typical sign of malignancy in nevi. Infections can occur in any skin lesion, but they do not specifically indicate cancer. Malignant moles are more likely to change in size, shape, or color rather than produce pus.