A nurse manager observes an unknown man in a laboratory coat making copies of a client's medical record. Which of the following actions should the nurse plan to take first?
Report the observation to the nurse caring for that client.
Inform the nursing supervisor.
Approach the man and ask why he is making copies.
Notify hospital security.
The Correct Answer is C
Rationale:
A. Reporting the observation to the nurse caring for that client is important but not the immediate priority.
B. Informing the nursing supervisor is necessary but should be done after assessing the situation directly.
C. Approaching the man and asking why he is making copies is the most immediate and direct action. It allows the nurse to assess the situation and determine if the man has legitimate access to the client's medical record or if further action is needed.
D. Notifying hospital security may be necessary if the man’s actions are unauthorized, but the first step is to gather more information.
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Correct Answer is A
Explanation
Rationale:
A. The client should sign the informed consent if they are alert, oriented, and capable of making decisions. The client's ability to understand the procedure and its implications is key to valid informed consent.
B. The client's son, who has a durable power of attorney would only sign the consent if the client were not competent or unable to understand the procedure, which is not the case here.
C. The client's partner may be involved in the decision-making process but does not have the legal authority to sign the consent unless designated as a legal representative.
D. The client's daughter, who is the primary caregiver would also not have the legal authority to sign the consent unless she holds a durable power of attorney or the client is deemed incapable of giving consent.
Correct Answer is B
Explanation
Rationale:
A. A young adult client admitted for acute glomerulonephritis following a viral infection does not indicate a mandatory report situation.
B. A dependent adult admitted for the treatment of a spiral fracture suggests potential abuse or neglect. As mandated reporters, nurses are required to report suspicions of abuse or neglect to the appropriate authorities.
C. A young adult client admitted for asthma and has track marks that may indicate IV drug abuse does not necessarily require mandatory reporting unless there is evidence of abuse or harm that needs to be reported.
D. An emancipated minor who has acute appendicitis and wants to leave the facility without treatment may raise concerns about the minor's capacity to make decisions, but it does not automatically necessitate reporting to an outside agency.