A nurse enters the hallway and discovers a visitor looking at a client’s medical information on a computer. Which of the following actions should the nurse take first?

Close the documentation program on the computer

Find out which staff member left the documentation program on the screen

Tell the charge nurse that a visitor viewed a client’s protected health information

Inform the visitor that client records are confidential

Answer and Explanation

The Correct Answer is A

a. Close the documentation program on the computer:

This action is appropriate as it immediately stops unauthorized access to the client's medical information and prevents further viewing of protected health information (PHI).

b. Find out which staff member left the documentation program on the screen:

While it's important to identify any staff member who may have left the documentation program open, addressing this issue should not be the first priority. The immediate concern is stopping the unauthorized access to the client's information and ensuring that the visitor is aware of the confidentiality breach.

c. Tell the charge nurse that the visitor viewed a client’s protected health information:

Notifying the charge nurse about the incident is important, but it should not be the first action taken. The priority is to address the immediate breach of confidentiality and prevent further unauthorized access to the client's information.

d. Inform the visitor that client records are confidential:

This action may be appropriate after addressing the immediate breach of confidentiality. However, it should not be the first action taken as it does not immediately stop the unauthorized access to the client's information.

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Correct Answer is A

Explanation

a. "I will wear a surgical mask within 3ft of the client":

This statement is correct. Wearing a surgical mask within 3 feet of the client helps prevent the transmission of respiratory droplets from the client to the healthcare provider or others in close proximity.

b. "I will check that the room has a high-efficiency particulate air filtration system":

This statement is not directly related to implementing droplet precautions. While a high-efficiency particulate air (HEPA) filtration system can help improve air quality in a healthcare setting, it is not a standard requirement for implementing droplet precautions.

c. "I will wear an N95 respirator when providing care for the client":

This statement is not accurate for implementing droplet precautions for influenza. N95 respirators are used for airborne precautions, which are indicated for diseases transmitted by smaller droplet nuclei (e.g., tuberculosis). Surgical masks are typically sufficient for preventing the transmission of respiratory droplets during care for clients with influenza.

d. "I will assign the client to a room with positive airflow":

This statement is not appropriate for implementing droplet precautions. Positive airflow rooms are typically used for clients requiring airborne precautions to prevent the spread of infectious agents in the air. In the case of influenza, droplet precautions are sufficient, and assigning the client to a room with standard airflow is appropriate.

A. “A nurse can disclose information to a family member with the client’s permission.” B. “A nurse is responsible for informing clients about treatment options.” C. “A nurse can apply restraints on a PRN basis.” D. “A nurse can administer medications without consent to a client as part of a research study.”

Correct Answer is ["A"]

Explanation

A. Nurses are permitted to share a client’s information with family members only if the client grants permission. This aligns with the Health Insurance Portability and Accountability Act (HIPAA) and ensures the client’s right to privacy and confidentiality is upheld.

B.While nurses play a critical role in client education, it is the provider’s responsibility to explain treatment options, including risks, benefits, and alternatives. Nurses can reinforce this information and answer questions but are not the primary party responsible for obtaining informed consent.

C.Restraints must never be applied on a "PRN" (as needed) basis. They require a specific, time-limited order from a provider, and their use must be justified and continually reassessed. This ensures that client rights and safety are maintained.

D.Participation in a research study requires informed consent from the client. Administering medications without consent is a violation of the client’s rights and ethical standards, even in research settings.

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A nurse enters the hallway and discovers a visitor looking at a client’s medical information on a computer. Which of the following actions should the nurse take first?

Nursing Test Bank

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