A nurse working on a psychiatric unit receives a telephone call from a client’s employer. The employer asks for a copy of the client’s latest laboratory work and psychological testing results so that the client’s medical records in employee health can be updated. Based on the nurse’s knowledge of breach of confidentiality, which response would be appropriate?
“Sure, give me your address, and I will see that the information is sent to you.”
“I’ll have to get the client’s signed consent before we can send that information to you.”
“I’m sorry, we’re not allowed to give out that information about our client.”
“I am unable to acknowledge whether or not your employee is a client on this unit.”
The Correct Answer is D
Choice A reason:
Agreeing to send the information without the client’s consent is a breach of confidentiality. Healthcare providers must protect patient privacy and cannot disclose medical information without explicit permission from the client.
Choice B reason:
While obtaining the client’s signed consent is necessary before releasing information, this response still acknowledges that the person in question is a client, which could be a breach of confidentiality.
Choice C reason:
Stating that the information cannot be given out is correct, but it still indirectly confirms that the person is a client, which could be a breach of confidentiality.
Choice D reason:
“I am unable to acknowledge whether or not your employee is a client on this unit” is the most appropriate response. This statement protects the client’s privacy by not confirming or denying their presence in the unit, thus maintaining confidentiality.
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Correct Answer is C
Explanation
Choice A reason:
Putting the client in a quiet room can help reduce external stimuli and may be beneficial in managing anxiety. However, it does not address the immediate need for support and reassurance. The presence of a nurse can provide a sense of safety and help the client feel more secure during a highly anxious state.
Choice B reason:
Teaching the client deep breathing techniques is an effective strategy for managing anxiety. However, in the immediate aftermath of a traumatic event, the client may not be able to focus on learning new techniques. Providing immediate support and reassurance is more critical at this stage.
Choice C reason:
Remaining with the client is the most appropriate immediate intervention. The nurse’s presence can provide comfort, reassurance, and a sense of safety, which are crucial in managing acute anxiety. This approach helps to stabilize the client and allows for further assessment and intervention once the client is calmer.
Choice D reason:
Encouraging the client to talk about their feelings and concerns is an important part of anxiety management, but it may not be the best immediate intervention in a severe state of anxiety. Initially, the client may need more direct support and reassurance before they are able to articulate their feelings effectively. Once the client is calmer, discussing their feelings can be beneficial.
Correct Answer is B
Explanation
Choice A reason:
Libel involves making false and damaging statements about someone in written form. It is not relevant to the situation described, where the issue is the use of physical restraints on a voluntarily admitted client.
Choice B reason:
False imprisonment refers to the unlawful restraint of an individual against their will. In this case, applying physical restraints to a voluntarily admitted client who is demanding discharge could be considered false imprisonment if the restraints are not justified by the client’s behavior posing an immediate threat to themselves or others.
Choice C reason:
Medical beneficence refers to the ethical principle of acting in the best interest of the patient. While this principle guides nursing actions, it does not directly address the legal ramifications of using physical restraints.
Choice D reason:
Autonomy is the ethical principle that respects the patient’s right to make their own decisions. Restraining a voluntarily admitted client who wishes to leave the hospital can violate their autonomy. However, the legal issue at hand is more specifically related to false imprisonment.