A patient who is very angry and is leaving the hospital against medical advice (AMA) demands to have the medical record to take, because it is her personal property. An appropriate response would be:
“The information in your medical record is confidential, and you cannot leave this facility with it."
"Because you are leaving against the medical advice of your primary care provider, you may not have the medical record."
"You are entitled to the information in your medical record, but the medical record is the property of the hospital. I will see about having a copy made for you."
"Certainly. This hospital doesn't need to keep it if you are leaving and will not be returning here."
The Correct Answer is C
A. “The information in your medical record is confidential, and you cannot leave this facility with it." While confidentiality is true, this response may seem dismissive and doesn’t address the patient’s right to access their health information.
B. "Because you are leaving against the medical advice of your primary care provider, you may not have the medical record." Leaving AMA does not negate the patient’s rights to access their medical information.
C. "You are entitled to the information in your medical record, but the medical record is the property of the hospital. I will see about having a copy made for you." This response respects the patient’s rights and explains that while the original record is hospital property, a copy can be made.
D. "Certainly. This hospital doesn't need to keep it if you are leaving and will not be returning here." This response is inaccurate as the original medical record must remain with the hospital per legal guidelines.
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Correct Answer is A
Explanation
A. "What was your daughter's reaction to your desire for hospice?" This is an open-ended question as it invites the patient to share feelings or reactions in a broad, unrestricted way.
B. "Did you sleep all night without waking?" This is a closed-ended question that can be answered with a simple "yes" or "no."
C. "How many bowel movements have you had today?" This is a closed-ended question asking for a specific number.
D. “Is your pain less today than it was yesterday?" This is a closed-ended question that requires a "yes" or "no" answer.
Correct Answer is C
Explanation
A. Share information with the patient about other patients and why they are hospitalized. Sharing information about other patients violates confidentiality and does not help establish trust. This is unprofessional and goes against HIPAA guidelines.
B. Share his own personal experiences so that the patient gets to know him as a friend. Although occasional sharing of personal experiences may enhance rapport, extensive sharing can shift focus from the patient to the nurse, which is unprofessional and can create boundary issues.
C. Act in a trustworthy and reliable manner; respect the individuality of the patient. Acting in a trustworthy, reliable manner and respecting the patient's individuality establishes rapport by building trust, ensuring the patient feels valued and respected. This is the most professional approach.
D. Identify himself by name and title each time he introduces himself. Introducing oneself by name and title is essential, but it alone does not fully establish rapport. It is part of a courteous approach, but rapport-building requires deeper engagement.