A nurse is preparing to discharge a client who is to be transferred to a long-term care facility. The nurse should recognize that which of the following actions is a breach of client confidentiality?

Providing a verbal report of the client's status to a paramedic performing the transfer

Faxing the client's medical records to the long-term care facility

Discussing the client's reaction to the transfer with another staff nurse

Leaving a phone message for the provider regarding the status of the client's transfer

Answer and Explanation

The Correct Answer is C

A. Providing a verbal report of the client's status to a paramedic performing the transfer: Sharing relevant health information with personnel directly involved in the client’s care is appropriate and necessary for continuity of care. This does not constitute a breach of confidentiality because it is directly related to the client’s treatment and transfer.

B. Faxing the client's medical records to the long-term care facility: Sending medical records to the receiving facility ensures that the client’s care can continue without interruption. As long as the transmission is secure and the information is limited to what is necessary, this is an appropriate and legally permissible action.

C. Discussing the client's reaction to the transfer with another staff nurse: Sharing personal information about the client’s emotional response outside of a care-related context is not necessary for treatment or transfer and constitutes a breach of confidentiality. Such discussions should be avoided to protect the client’s privacy.

D. Leaving a phone message for the provider regarding the status of the client's transfer: Communicating with the provider about the client’s care is appropriate. Leaving a message regarding transfer status is relevant to the client’s treatment and does not violate confidentiality, provided the information is limited to necessary clinical details.

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Correct Answer is A

Explanation

A. Cheddar cheese: Cheddar and other aged cheeses contain high levels of tyramine, which can precipitate a hypertensive crisis when consumed by clients taking MAOIs like phenelzine. Avoiding aged cheeses is critical to prevent severe cardiovascular complications.

B. Bananas: Fresh bananas contain low levels of tyramine and are generally safe to consume in moderation while taking MAOIs. Only overripe bananas with high tyramine content should be limited, but this is less of a concern than aged cheeses.

C. Chicken: Fresh chicken does not contain significant tyramine and is safe to include in the diet while taking phenelzine. Properly cooked and stored poultry does not pose a risk for hypertensive crisis.

D. Peanut butter: Peanut butter contains minimal tyramine and is considered safe for clients on MAOIs. Only improperly stored or aged peanut products might pose a slight risk, making it much less critical than avoiding aged cheeses.

A. Limit each of the client's visitors to 1hr per day B. Remove dirty linens from the room after double bagging C. Wear a dosimeter film badge while in the client's room D. Ensure family members remain at least 1m (3.2 feet) from the client

Correct Answer is C

Explanation

A. Limit each of the client's visitors to 1 hr per day: Visitor restrictions for clients with sealed radiation implants typically focus on limiting cumulative exposure to radiation rather than a strict daily time limit. The exact duration may vary, but monitoring personal exposure is more critical for staff safety.

B. Remove dirty linens from the room after double bagging: For sealed radiation implants, the radioactive source remains contained, and linens are not highly radioactive. Standard precautions are sufficient, so special double-bagging is not required unless the linens are contaminated with bodily fluids.

C. Wear a dosimeter film badge while in the client's room: Staff who care for clients with sealed radiation implants must wear a dosimeter to monitor cumulative radiation exposure. This ensures that occupational safety limits are not exceeded and provides documentation of exposure levels, which is a key safety measure in the plan of care.

D. Ensure family members remain at least 1 m (3.2 feet) from the client: Family members may need limited exposure, but strict distance alone is not sufficient for safety or required for all types of sealed implants. Staff exposure monitoring via dosimeter is more critical, as they spend more time in the room and are at greater risk for cumulative exposure.

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A nurse is preparing to discharge a client who is to be transferred to a long-term care facility. The nurse should recognize that which of the following actions is a breach of client confidentiality?

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