A nurse is documenting assessment findings for a client who reports severe abdominal pain. Which finding reflects a non-verbal indication of pain?

Choice A reason: Printing sensitive laboratory results and leaving them at a nurse's station creates a significant risk for unauthorized disclosure of protected health information (PHI). Physical documents are easily misplaced or viewed by non-authorized individuals, violating the Health Insurance Portability and Accountability Act (HIPAA) standards for maintaining data privacy and security.

Choice B reason: Logging off the terminal immediately after completing clinical documentation is a fundamental security practice. It prevents unauthorized access to the client’s private medical history by others who may use the same workstation. This action ensures that the nurse's unique digital signature and access privileges are not exploited by third parties.

Choice C reason: Sharing login credentials with anyone, including student nurses, is a severe breach of institutional security policy and legal regulations. Each healthcare provider must use their own unique identifiers to maintain an accurate audit trail. Allowing others to use a personal login compromises the integrity and accountability of the electronic health record.

Choice D reason: Discussing confidential patient data in public or semi-public areas where visitors or other patients can overhear is a violation of professional ethical standards and privacy laws. Nurses must ensure that all clinical handoffs and data reviews occur in private, secure environments to prevent the accidental exposure of sensitive medical information.

Choice A reason: Auscultation involves using a stethoscope to listen to internal body sounds, such as bowel motility, bruits, or heart murmurs. It is not the technique used when a nurse applies physical pressure with the fingertips to the abdominal wall to elicit a response or assess tissue density.

Choice B reason: Palpation is the clinical assessment technique that utilizes the sense of touch to determine the characteristics of body parts under the skin. By using the fingertips to apply light or deep pressure, the nurse can identify organ location, size, abnormal masses, and areas of tenderness or guarding.

Choice C reason: Inspection is the initial step of the physical examination, relying solely on visual observation. It involves looking at the client’s abdominal contour, skin integrity, and symmetrical movement without physical contact. Pressing on the abdomen exceeds the scope of visual inspection and moves into tactile assessment.

Choice D reason: Percussion is a technique where the nurse taps the body surface with sharp, short strokes to produce audible vibrations. These sounds help determine the density of underlying structures, such as identifying fluid-filled versus air-filled spaces, which differs from the steady pressure applied during digital palpation.