A nurse is reinforcing teaching with a client who has a terminal illness and is considering palliative care services. Which of the following statements by the client indicates an understanding?

Choice A reason: This statement is incorrect because protecting a client’s personal health information is not an example of client advocacy, but a legal and ethical obligation of the nurse. The nurse should follow the principles of confidentiality and privacy, and only share the client’s information with authorized persons or entities, or with the client’s consent.
Choice B reason: This statement is incorrect because keeping a promise to return to a client’s room is not an example of client advocacy, but a professional and courteous behavior of the nurse. The nurse should be honest, reliable, and respectful to the client, and follow through with their commitments and expectations.
Choice C reason: This statement is incorrect because accepting responsibility for their own actions is not an example of client advocacy, but a personal and professional accountability of the nurse. The nurse should be aware of their scope of practice, standards of care, and code of ethics, and act accordingly. The nurse should also admit their mistakes, report errors, and seek help when needed.
Choice D reason: This statement is correct because communicating a client’s wishes to their provider is an example of client advocacy. The nurse should act as a liaison between the client and the provider, and ensure that the client’s needs, preferences, and values are respected and considered in the decision-making process. The nurse should also support the client’s right to self-determination and informed consent.

Choice A reason: Obtaining a detailed history is the first action that the nurse should take. History can help the nurse determine the cause, frequency, and severity of the bruises, as well as the child's relationship with the abuser and the risk of further harm. History can also help the nurse assess the child's physical and emotional state, and provide evidence for reporting the abuse later.
Choice B reason: Reporting the suspected abuse to the authorities is not the first action that the nurse should take. The nurse should report the abuse only after obtaining a history and confirming the suspicion. Reporting the abuse prematurely can jeopardize the child's safety and the nurse's credibility. The nurse should also follow the legal and ethical guidelines for reporting abuse in their jurisdiction.
Choice C reason: Requesting a social services referral is not the first action that the nurse should take. The nurse should request a social services referral only after reporting the abuse and ensuring the child's protection. A social services referral can help the child access resources and support, such as counseling, legal aid, foster care, etc. The nurse should also collaborate with the social worker and other members of the interdisciplinary team to provide holistic care for the child.
Choice D reason: Telling the child what will happen to her when the abuse is reported is not the first action that the nurse should take. The nurse should tell the child what will happen to her only after obtaining a history and reporting the abuse. The nurse should also use age-appropriate language and reassure the child that the abuse is not her fault and that she is not alone. The nurse should avoid making promises that they cannot keep, such as saying that the abuser will never hurt her again.