The nurse is alert to avoid using blocks to effective communication that include: (Select all that apply.)
asking probing questions.
using nonjudgmental remarks.
changing the subject.
using clichés.
giving advice.
offering hope.
Correct Answer : A,C,D,E
A. Asking probing questions. Probing questions can feel invasive, leading to discomfort or defensiveness from the patient.
B. Using nonjudgmental remarks. Nonjudgmental remarks foster open communication, so this is not a communication block.
C. Changing the subject. Changing the subject shows disregard for the patient’s thoughts or feelings, which can block effective communication.
D. Using clichés. Clichés can make patients feel as though their concerns are not truly heard or understood.
E. Giving advice. Giving advice without patient input can make the patient feel undervalued and less autonomous.
F. Offering hope. Offering realistic hope and encouragement can actually facilitate communication, as long as it’s not false reassurance.
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Correct Answer is C
Explanation
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.
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.