A client states “I have something to tell you in confidence.” Which response by the nurse would be appropriate?
“I don’t want to know this. Tell your health care provider.”.
“I’m your nurse and you can tell me anything.”.
“I’ll close the door first so that no one will hear you.”.
“I can’t promise that the information won’t be shared if your health or safety is involved.”.
The Correct Answer is D
“I can’t promise that the information won’t be shared if your health or safety is involved.” This response by the nurse would be appropriate because it respects the client’s confidentiality while also acknowledging its limits of it. The nurse has a duty to report any information that may indicate a risk of harm to the client or others.
Choice A is wrong because it dismisses the client’s need to share something and implies that the nurse is not interested or trustworthy.
Choice B is wrong because it gives a false assurance of confidentiality and may lead to ethical dilemmas if the client reveals something that requires reporting.
Choice C is wrong because it does not address the issue of confidentiality and may give the impression that the nurse is trying to avoid the conversation.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Face the client while speaking and ask them to verify understanding. This intervention would help the client to read the nurse’s lips and confirm the message.
It would also show respect and empathy for the client’s condition.
Choice A is wrong because using exaggerated mouth and hand movements when speaking can be distracting and insulting to the client.
It can also distort the words and make them harder to understand.
Choice C is wrong because standing in front of a light when speaking to the client can create glare and make it difficult for the client to see the nurse’s face.
Touching the client to be sure they know where you are can be startling and unnecessary if the client is not visually impaired.
Choice D is wrong because obtaining an interpreter for sign language is inappropriate unless the client knows sign language.
Not all hearing-impaired clients use sign language, and some may prefer other methods of communication.
Correct Answer is B
Explanation
Notify the health care provider. The nurse should take this action first because the provider can prescribe appropriate interventions to prevent or minimize harm to the client.
The nurse should also inform the unit supervisor, document the error in the client’s medical record, and record the error on the appropriate quality improvement report, but these are not the priority actions.
Choice A is wrong because informing the unit supervisor is not the most urgent action. The supervisor can provide support and guidance to the nurse, but cannot prescribe interventions for the client.
Choice C is wrong because documenting the error in the client’s medical record is not the most urgent action.
The nurse should document the error after notifying the provider and assessing the client. Documentation should include the medication name, dose, route, time, client’s response, and actions taken.
Choice D is wrong because recording the error on the appropriate quality improvement report is not the most urgent action.
The nurse should record the error after notifying the provider and assessing the client. The report should include a factual description of what happened and what was done.
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