A nurse overhears two assistive personnel discussing a client’s care in the cafeteria. Which of the following actions should the nurse take?
Complete an incident report about the breach of client confidentiality
Reassign the AP to other clients on the unit
Instruct the AP to discontinue the conversation
Notify the client’s provider about the incident
The Correct Answer is C
a. Complete an incident report about the breach of client confidentiality:
While documenting the incident is important, completing an incident report alone may not address the immediate need to stop the breach of confidentiality.
b. Reassign the AP to other clients on the unit:
Reassignment may be considered after addressing the immediate issue, but it doesn't directly address the inappropriate conversation.
c. Instruct the AP to discontinue the conversation:
This is the correct immediate action. The nurse should intervene and instruct the assistive personnel to stop discussing the client's care in a non-secure location like the cafeteria.
d. Notify the client’s provider about the incident:
While notifying the client's provider may be necessary in certain situations, the immediate concern is to stop the breach of confidentiality and address the inappropriate conversation.
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Correct Answer is D
Explanation
a. Involve the client’s partner to assist with the teaching session: While involving the client's partner can be helpful, it may not ensure effective communication if the partner also does not speak the same language as the client.
b. Incorporate gestures and hand signals when presenting information: This is an effective strategy to enhance communication with a client who speaks a different language. Non-verbal cues such as gestures and hand signals can help convey meaning and facilitate understanding.
c. Validate understanding by interpreting the client’s body language: Interpreting the client's body language can be helpful in assessing their level of understanding and engagement. However, it may not be sufficient for effective communication, especially if the client has questions or needs clarification.
d. Provide an interpreter when obtaining consent from the client: This is the most appropriate intervention. Using a professional interpreter ensures accurate communication between the nurse and the client, facilitating understanding and ensuring that the client's rights are upheld during the consent process.
Correct Answer is B
Explanation
a. "If you have the procedure now, you won’t have to deal with pain and disability later."
This response dismisses the client's concerns about pain and focuses solely on the potential benefits of the surgery. It fails to address the client's apprehension and does not provide support or empathy. Furthermore, it oversimplifies the situation and may come across as dismissive of the client's feelings.
b. “I understand, and it’s not too late to change your mind.”
This response demonstrates empathy and validation of the client's concerns. It acknowledges the client's autonomy and gives them the option to reconsider without judgment or pressure. It encourages open communication between the nurse and the client, fostering a supportive environment.
c. “Why didn’t you discuss your concerns with your provider?”
This response may come across as accusatory or blaming, which can further distress the client. It does not offer immediate support or validation of the client's concerns. While discussing concerns with the provider is important, this response fails to address the client's immediate distress and need for reassurance.
d. “You’ll be fine. You’ll receive a prescription for pain medication.”
This response minimizes the client's concerns by reassurance without addressing the underlying issue. It also assumes that pain medication will resolve all concerns related to pain, which may not be the case for the client. Additionally, it overlooks the client's emotional needs and autonomy in decision-making.
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