A nurse is preparing an in-service for a group of newly licensed nurses about client confidentiality. The nurse should explain that they may share a client's protected health information with which of the following groups?

A. A durable power of attorney for health care (DPOA-HC) allows a designated person to make health decisions only when the client cannot, but they cannot override or cancel the client’s living will. The living will represents the client’s direct written wishes, which must be followed.

B. The Patient Self-Determination Act requires healthcare facilities to inform clients of their rights to make decisions regarding medical care, including advance directives, but it does not grant families the authority to modify an existing living will once the client is incapacitated.

C. The case manager facilitates coordination of care and client services but has no legal authority to alter or amend a client’s advance directive or living will.

D. This is the correct and legally accurate statement. A living will is a written legal document that outlines a client’s preferences for lifesaving or life-sustaining treatments (such as CPR, mechanical ventilation, or tube feeding) if they become incapacitated. Once the client is unconscious or unable to communicate, healthcare providers must honor the instructions in the living will as it reflects the client’s autonomous decisions.

A. Gathering information about the client’s family history, symptoms, and health background occurs during the assessment phase of the nursing process. This helps the nurse identify problems and plan appropriate care.

B. The evaluation phase occurs after interventions have been implemented and focuses on determining whether the client’s outcomes or goals have been achieved. It does not involve gathering new health history data.

C. This step involves putting the nursing plan into action, such as administering medications, providing teaching, or offering therapeutic support. It follows planning, not data collection.

D. The planning phase comes after assessment and diagnosis, when the nurse develops measurable goals and determines appropriate interventions to address identified health problems. It relies on the information gathered during the assessment phase.