A nurse is planning care for a client who has lung cancer and who requests a do-not-resuscitate (DNR) prescription. Which of the following actions should the nurse take?

A. Respecting and documenting a client’s right to refuse treatment supports their autonomy, a core principle of advocacy.
B. Offering clear, understandable information empowers the client to make informed decisions about their care—an essential part of advocacy.
C. Performing procedures without explanation or consent (even on clients with cognitive impairment) violates advocacy and autonomy. The nurse should attempt to communicate and explain procedures as clearly as possible.
D. Ensuring effective communication through appropriate resources supports the client’s right to understand their care and make informed choices.
E.Client advocacy involves basing care on the client’sgoals and preferences—not solely the nurse’s objectives.

A. Nurse 1– The nurse disclosed identifiable information about a client's involvement in a motor vehicle crash to another client. Sharing such specific details violates HIPAA regulations, even if the other client heard about the event in the news.

B. Nurse 5– Although this nurse acted unethically by administering pre-op medication without ensuring informed consent, the issue is informed consent and autonomy—not confidentiality.

C. Nurse 2–Leaving a computer with an active login accessible to others is a security risk. Allowing another provider to use a computer under the nurse’s login compromises protected health information.

D. Nurse 4– Using the client’s roommate as an interpreter exposes private medical information to someone who is not authorized. Interpreters should be neutral, trained professionals to protect confidentiality and accuracy.

E. Nurse 3– Although the nurse did not follow the client’s DNR wishes, this is an ethical and legal issue regarding end-of-life care, not a confidentiality breach.