A nurse is caring for a client on a medical-surgical unit. Which of the following actions should the nurse take to maintain the client's confidentiality?

Discuss the client's condition with a nurse on another unit.

Fax client information with a cover sheet.

List the client's name and condition on board at the nurses’ station.

Post client diagnosis on message board in their room.

Answer and Explanation

The Correct Answer is B

A. Discuss the client's condition with a nurse on another unit: Sharing a client’s condition with a nurse on another unit without a need-to-know basis violates confidentiality rules. Discussions about client conditions should be limited to personnel involved in care.

B. Fax client information with a cover sheet: A fax cover sheet protects the confidentiality of client information by identifying the contents and indicating that it is confidential. This ensures that the information is not exposed to unauthorized individuals during transmission.

C. List the client's name and condition on board at the nurses station: Displaying client information in public or semi-public areas, violates confidentiality. Client information should be kept private and only accessed by those who are involved in the client’s care.

D. Post client diagnosis on message board in their room: Posting the client’s diagnosis in their room is a violation of confidentiality, as other individuals (like visitors or hospital staff) may have access to that information without a need to know.

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Correct Answer is C

Explanation

A. Bathe the client with soap and hot water: Hot water and soap can dry out the skin and worsen skin breakdown. The nurse should use lukewarm water and mild soap to prevent skin irritation, ensuring proper hydration and skin care.

B. Massage bony prominences four times daily: Massaging bony prominences can increase the risk of skin breakdown, as it may cause further tissue damage. Instead, the nurse should avoid massaging these areas and focus on preventive measures, such as repositioning.

C. Keep the head of the client's bed at 30° or less: Keeping the head of the bed at a 30° angle or less reduces pressure on the sacrum and other bony prominences. This position helps prevent further skin breakdown and promotes comfort for immobile clients.

D. Slide the client up in bed every 2 hr: Sliding the client up in bed increases friction, which can exacerbate skin breakdown. The nurse should use proper lifting techniques or assistive devices to reposition the client while minimizing friction and shearing forces.

A. Place the client in a room with negative-pressure airflow. B. Ensure visitors use a surgical mask when they enter the client's room. C. Remove isolation gown before removing gloves. D. Use designated equipment that stays in the client's room.

Correct Answer is D

Explanation

A. Place the client in a room with negative-pressure airflow: Negative-pressure airflow is used for airborne precautions. MRSA requires contact precautions, which include placing the client in a private room or a room with others who have the same infection.

B. Ensure visitors use a surgical mask when they enter the client's room: Surgical masks are not required for MRSA unless there is a respiratory complication. For MRSA, visitors should use gloves and gowns for contact precautions, but a mask is not necessary.

C. Remove isolation gown before removing gloves: The gown should be removed after the gloves to prevent contamination. The gloves should be removed first to avoid touching any surfaces with contaminated hands, and then the gown can be safely removed.

D. Use designated equipment that stays in the client's room: To prevent the spread of MRSA, designated equipment (such as blood pressure cuffs, stethoscopes, and thermometers) should stay in the client's room. This minimizes risk of cross-contamination and ensures infection control.

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