A nurse in a provider’s office receives a telephone call from a client’s sibling requesting current information about the client’s condition. Which of the following actions should the nurse take?
Request that the caller contact the client’s provider directly for information.
Ask the caller to contact the client directly for information.
Gather additional information from the caller to verify their identity.
Provide the caller with a brief update about the client’s condition.
The Correct Answer is C
Choice A reason: Requesting that the caller contact the client’s provider directly for information is not the best action. The nurse should first determine if the caller has the client’s consent to receive information and if the caller is authorized to do so.
Choice B reason: Asking the caller to contact the client directly for information is not appropriate. The client may not be able to communicate or may not want to share information with the caller. The nurse should respect the client’s privacy and confidentiality.
Choice C reason: Gathering additional information from the caller to verify their identity is the most appropriate action. The nurse should ask the caller for their name, relationship to the client, and other details that can confirm their identity. The nurse should also check the client’s record for any written or verbal consent to disclose information to the caller.
Choice D reason: Providing the caller with a brief update about the client’s condition is not advisable. The nurse should not share any information without verifying the caller’s identity and the client’s consent. The nurse should also follow the provider’s office policy and the Health Insurance Portability and Accountability Act (HIPAA) guidelines for disclosing information.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This is correct because measuring the intake and output of a client is a routine task that can be delegated to an AP.
Choice B reason: This is incorrect because reinforcing teaching with a client requires the nurse's knowledge and judgment and cannot be delegated to an AP.
Choice C reason: This is incorrect because assessing the pain level of a client is a nursing responsibility that involves critical thinking and evaluation and cannot be delegated to an AP.
Choice D reason: This is incorrect because checking a client's peripheral IV site for redness or swelling is a nursing skill that requires the nurse's assessment and intervention and cannot be delegated to an AP.
Correct Answer is A
Explanation
Choice A reason: Calf swelling is a sign of deep vein thrombosis, which is a blood clot that forms in a deep vein, usually in the lower leg or thigh. The clot can block the blood flow and cause inflammation, pain, and edema. The nurse should measure the circumference of both calves and compare them for any difference. The nurse should also report any other signs of deep vein thrombosis, such as warmth, redness, or tenderness.
Choice B reason: Clammy skin is not a sign of deep vein thrombosis, but of shock. Shock is a life-threatening condition that occurs when the body's organs do not receive enough blood and oxygen. The nurse should monitor the client's vital signs, such as blood pressure, pulse, and temperature, and report any abnormal findings.
Choice C reason: Tortuous veins are not a sign of deep vein thrombosis, but of varicose veins. Varicose veins are enlarged and twisted veins that appear near the surface of the skin, usually in the legs. They are caused by weak or damaged valves that allow blood to pool and stretch the veins. The nurse should assess the client's skin for any ulcers, bleeding, or infection.
Choice D reason: Bradycardia is not a sign of deep vein thrombosis, but of a slow heart rate. Bradycardia is a condition that occurs when the heart beats less than 60 times per minute. It can be caused by various factors, such as medication, heart disease, or hypothyroidism. The nurse should check the client's pulse and rhythm, and report any irregularities.
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