A patient states, "I don't think I'll ever be able to give myself an injection." The best reply by the nurse is:
"What bothers you most about the idea of giving yourself an injection?"
"Everyone feels like that at first. You'll get over it."
“I know just how you feel. I would have trouble giving myself an injection."
"Don't be afraid. It's an easy skill for anyone to learn."
The Correct Answer is A
A. "What bothers you most about the idea of giving yourself an injection?" This open-ended question allows the patient to express specific fears or concerns, facilitating a deeper conversation to address the patient’s worries.
B. "Everyone feels like that at first. You'll get over it." This response is dismissive and may invalidate the patient’s feelings by suggesting that their concern is typical rather than unique.
C. “I know just how you feel. I would have trouble giving myself an injection." While empathetic, this response shifts focus to the nurse’s feelings rather than exploring the patient’s specific concerns.
D. "Don't be afraid. It's an easy skill for anyone to learn." This response minimizes the patient’s fear and could make them feel dismissed rather than supported.
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Correct Answer is A
Explanation
A. Guarding the confidentiality of the patient record by not leaving the patient screen "on" if he leaves the terminal. Protecting patient confidentiality is essential in electronic charting to prevent unauthorized access.
B. Learning the passwords of the staff nurses and primary care providers so that they can communicate with one another. Sharing or learning others' passwords violates security protocols and confidentiality rules.
C. Choosing whether he will use the computer to help in documentation or continue to use traditional paper documentation. In facilities using electronic charting, all staff are typically required to use the system to maintain consistent, accessible records.
D. Patient education to input information about herself, such as intake and output or symptoms the patient may experience. Patients typically do not have access to chart directly into their medical records.
Correct Answer is D
Explanation
A. Actions of the nurse are appropriate since his neighbor is his confidante, and the neighbor has assured him the information provided will not be shared. Confidentiality must be maintained regardless of assurances from others; sharing patient information outside a professional context is a violation of privacy.
B. Nurse has not violated the confidentiality of the patient because the patient is terminal; sharing this information will not harm the patient. Confidentiality must be maintained regardless of the patient's condition. Privacy and confidentiality are ethical requirements for all patients, terminal or otherwise.
C. Nurse is actively promoting nursing as a profession, and it is important to share information that might encourage others to pursue a nursing career. While promoting the profession is valuable, using a patient’s personal information is inappropriate and unprofessional. There are ethical ways to promote nursing without breaching confidentiality.
D. Nurse has violated the confidentiality of the patient by discussing personal information about the patient with his neighbor. Sharing patient information with someone who is not involved in the patient’s care violates HIPAA and confidentiality standards. This action is unprofessional and unethical.