A nurse assumes the leading role on the hazardous materials team immediately following a chemical mass casualty incident in the community. As clients arrive at the designated triage area outside the hospital, which of the following actions should the nurse take?

Rationale:
A. Nurse 3 was providing CPR at the family's request and following the client’s wishes regarding DNR status. There is no breach of confidentiality in this action.

B. Nurse 2 left a computer logged in, which allowed another provider to access client information using the nurse’s active login. This is a breach of confidentiality because it allowed unauthorized access to protected health information (PHI). Nurses should always log off or lock computers when unattended.

C. Nurse 1 disclosed information about a client admitted from the emergency department to another client, sharing details about their injury. This is a breach of confidentiality because the nurse shared private client information with someone not involved in the client’s care.

D. Nurse 5 administered pre-operative medication and explained surgery details without ensuring the client’s questions were answered. While this is a consent and patient rights issue, it does not constitute a breach of confidentiality.

E. Nurse 4 allowed a roommate to interpret medication instructions instead of using a professional interpreter. This is a violation of patient rights and informed consent, but it is not primarily a breach of confidentiality since the client’s information was communicated to someone already in the room with them, with consent implied.

Rationale:

A. Having assistive personnel double-check packed RBCs is inappropriate and unsafe, as this task requires nursing knowledge, critical thinking, and accountability. Delegating this to an AP violates ethical standards related to patient safety.

B. Delegating the removal of an IV catheter to an LPN is appropriate, as LPNs are trained and licensed to perform certain procedures under the supervision of an RN. This demonstrates understanding of the ethical principle of delegation within scope of practice.

C. Accepting gifts from clients or families can lead to conflicts of interest or perceived favoritism. The Code of Ethics advises nurses to avoid situations that compromise professional judgment, making this statement indicate a lack of understanding.

D. Attending continuing education classes for professional growth reflects the nurse’s ethical obligation to maintain competence and provide safe, evidence-based care, which aligns with the Code of Ethics.

E. Administering pain medication regardless of a client’s history of narcotic addiction demonstrates the ethical principle of nonmaleficence and beneficence, ensuring that clients receive appropriate pain management without discrimination or bias.