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A student nurse is assigned to a clinical unit on which one of the patients is a nationally known celebrity. The student reads the chart to find out why the celebrity is being treated. The student who is not the assigned caregiver is:

A.

motivated to learn about the health problem of this patient and is appropriately seeking knowledge during his clinical experience.

B.

doing appropriate research about nursing care as long as information is not divulged.

C.

violating the confidentiality of the patient's record.

D.

neglecting the assigned patient load and should read the unassigned patient's medical record only after his assigned work is completed.

Answer and Explanation

The Correct Answer is C

A. Motivated to learn about the health problem of this patient and is appropriately seeking knowledge during his clinical experience.
Accessing information without being the assigned caregiver is inappropriate, regardless of motivation, as it breaches confidentiality and privacy protocols.

 

B. Doing appropriate research about nursing care as long as information is not divulged. Even without sharing information, accessing a patient’s chart without need-to-know status is a privacy violation and does not constitute appropriate research.

 

C. Violating the confidentiality of the patient's record.
This choice is correct as the student is breaching confidentiality by accessing patient records without a care-related need to know. Only those involved in the patient's care should access their chart.

 

D. Neglecting the assigned patient load and should read the unassigned patient’s medical record only after his assigned work is completed.
Reading an unassigned patient’s record, even after finishing other duties, is still a breach of confidentiality.


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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.

Correct Answer is B

Explanation

A. Speaking in simple sentences, as if to a child. This is inappropriate and could be perceived as patronizing, which may hinder communication. Older adults should be treated with respect, not as children.

B. Speaking slowly in order to allow the patient to process the message. Older adults may need more time to process information, so speaking slowly can aid understanding without appearing patronizing.

C. Addressing him by his first name to encourage a therapeutic relationship. Addressing older adults by their first names may be seen as disrespectful or overly familiar, unless the patient specifically requests it.

D. Standing in the doorway rather than entering the room to give the older adult patient more privacy. Standing in the doorway may create a physical barrier and distance, which can hinder effective communication and rapport.

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