A nurse in a facility elevator overhears two assistive personnel (AP) discussing the diagnosis of a client recently admitted to the medical-surgical unit. Which of the following actions should the nurse take first?

Notify the nurse manager of the medical-surgical unit of the incident.

Review HIPAA guidelines with the AP.

Submit a written statement regarding the incident to the risk manager.

Inform the AP that their conversation violates the client's privacy.

Answer and Explanation

The Correct Answer is D

A. Notify the nurse manager of the medical-surgical unit of the incident:
This is appropriate for reporting the breach, but the immediate priority is to stop the ongoing violation.

B. Review HIPAA guidelines with the AP:
Education is important, but it should occur after the immediate breach has been stopped.

C. Submit a written statement regarding the incident to the risk manager:
This is part of follow-up reporting but is not the first priority in the moment.

D. Inform the AP that their conversation violates the client's privacy:
The nurse should first intervene directly to stop the HIPAA violation in progress, then address education and reporting.

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Correct Answer is A

Explanation

A. Inform the charge nurse:
The client is not competent to give informed consent after receiving sedation. The nurse should inform the charge nurse and delay obtaining consent until the client is fully alert and capable of understanding.

B. Obtain consent from a family member:
This is only appropriate if the client is legally incapable of giving consent and has a legal representative or healthcare proxy.

C. Wake the client and ask them to sign the form:
Even if awake, sedation impairs decision-making capacity; consent obtained at this time would not be legally valid.

D. Send the client for the test with the unsigned form:
The procedure should not proceed without valid informed consent.

A. Reduced skin elasticity over the hands and forearms B. Ecchymoses over the buttocks and lower back C. Hirsutism on the face and chest D. Increased macules on the arms and legs

Correct Answer is B

Explanation

A. Reduced skin elasticity over the hands and forearms:
This is a normal age-related change due to loss of collagen and elastin.

B. Ecchymoses over the buttocks and lower back:
Bruising in these areas is suspicious for possible abuse or injury from falls and should be reported for further investigation.

C. Hirsutism on the face and chest:
This can occur due to hormonal changes with aging, particularly in postmenopausal women, and is not necessarily reportable unless new and unexplained.

D. Increased macules on the arms and legs:
Age spots (lentigines) are common with sun exposure over time and are benign.

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A nurse in a facility elevator overhears two assistive personnel (AP) discussing the diagnosis of a client recently admitted to the medical-surgical unit. Which of the following actions should the nurse take first?

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