A nurse is teaching a newly licensed nurse about maintaining confidentiality within the nurse-client relationship. The nurse should include that which of the following situations warrants reporting confidential information?

When the client has a cognitive disorder

When the client's hospitalization is involuntary

When a member of the client's immediate family requests information

When the client has communicated an intention to harm someone

Answer and Explanation

The Correct Answer is D

A. When the client has a cognitive disorder: A cognitive disorder does not automatically remove a client’s right to confidentiality. Information should still be protected unless the client has a legal guardian or specific exceptions apply.

B. When the client's hospitalization is involuntary: Even in involuntary admissions, the client retains rights to confidentiality. Disclosure requires consent unless there is a risk of harm to self or others.

C. When a member of the client's immediate family requests information: Confidentiality must be maintained unless the client provides explicit permission for the information to be shared with family.

D. When the client has communicated an intention to harm someone: This is an exception to confidentiality. The nurse has a legal and ethical duty to report threats of harm to protect potential victims (duty to warn).

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Correct Answer is C

Explanation

A. "Give your son plenty of alone time with his sister." While supervised interaction is important, unsupervised alone time is not recommended for preschoolers and newborns due to safety concerns. Young children may not fully understand appropriate handling or boundaries.

B. "Plan for your son to meet his sister for the first time at home." Introducing the baby at the hospital is generally encouraged, as it allows for early bonding in a supportive environment. Waiting until home may delay adjustment and could create feelings of exclusion.

C. "Give your son a little gift from his new sister." This strategy helps reduce feelings of jealousy and promotes positive associations with the new baby. It can make the older sibling feel acknowledged and included in the family transition.

D. "Hold your daughter when your son first meets her." Holding the baby during the first introduction may make the older child feel displaced. Allowing the parent to focus attention on the older sibling during the initial meeting can foster reassurance and connection.

A. Hang the transfusion with dextrose 5% in 0.9% sodium chloride. B. Infuse the transfusion over 5 hr. C. Use a 20 gauge IV catheter to transfuse the blood. D. Monitor vital signs every hour throughout the transfusion.

Correct Answer is C

Explanation

A. Hang the transfusion with dextrose 5% in 0.9% sodium chloride:Blood products should only be administered with 0.9% sodium chloride. Dextrose-containing solutions can cause red blood cell clumping and hemolysis, making them unsafe for use during transfusion.

B. Infuse the transfusion over 5 hr:Blood transfusions must be completed within 4 hours to reduce the risk of bacterial growth. Infusing over 5 hours exceeds this safe limit and increases the risk of infection.

C. Use a 20 gauge IV catheter to transfuse the blood:A 20-gauge catheter is appropriate for administering packed RBCs, especially in older adults with fragile veins. It allows sufficient flow rate without causing undue vessel trauma.

D. Monitor vital signs every hour throughout the transfusion:While hourly monitoring may be appropriate, the nurse must assess vital signs more frequently at the beginning before starting, 15 minutes after initiation, and then per facility protocol (often every 30–60 minutes). Early detection of reactions is crucial.

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A nurse is teaching a newly licensed nurse about maintaining confidentiality within the nurse-client relationship. The nurse should include that which of the following situations warrants reporting confidential information?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is postpartum and expresses concern about how her preschool-age son will react to having a baby sister. Which of the following strategies should the nurse suggest?

Correct Answer is C

Explanation

A nurse is planning to administer packed RBCs to an older adult client who has a low hemoglobin level. Which of the following actions should the nurse plan to take?

Correct Answer is C

Explanation

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