During a follow-up visit, an adolescent client expresses concerns about their privacy.
How should the nurse respond?
"I will make sure your parents know everything you tell me.”.
"It's important to share everything with your parents for your safety.”.
"Your privacy is important to us. Tell me what concerns you have.”.
"You shouldn't worry about privacy; just tell me what's wrong.”. . . .
The Correct Answer is C
Choice A rationale
Telling an adolescent that their parents will know everything is a breach of trust that can shut down the therapeutic relationship. While there are legal and safety exceptions to confidentiality, such as threats of self-harm or harm to others, adolescents have a right to private discussions regarding many aspects of their health. Dismissing their need for privacy prevents the nurse from obtaining honest information about sensitive topics like mental health, substance use, or sexual activity.
Choice B rationale
While family involvement is generally encouraged for support, forcing an adolescent to share everything for "safety" is oversimplified. Adolescence is a time of developing autonomy and identity. If a teenager feels that every word will be relayed to their parents, they are likely to withhold information that could be critical for their care. The nurse must balance safety with the adolescent's need for a private space to discuss their health concerns and navigate their growing independence.
Choice C rationale
This response validates the client's feelings and opens a dialogue about the specific boundaries of confidentiality. Acknowledging that privacy is important helps build a trusting relationship, which is essential for effective adolescent healthcare. By asking what concerns the client has, the nurse can clarify exactly what will remain private and what must be reported by law. This approach empowers the adolescent and encourages them to be more forthcoming with information, ultimately leading to better health outcomes.
Choice D rationale
Telling a client they "shouldn't worry" is dismissive and patronizing. It invalidates the adolescent's legitimate concerns about their personal information and autonomy. This type of communication creates a power imbalance that can make the client feel uncomfortable and reluctant to share necessary health data. Professional nursing communication should always involve active listening and validation of the client's perspective rather than telling them how they should or should not feel about their own privacy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
While promoting development through safe exploration is important for a 12 month old in the autonomy versus shame and doubt stage, it is not the highest priority compared to immediate physical safety. Exploratory behavior is a natural drive at this age as the child begins to walk. However, guidance regarding exploration is secondary to preventing high risk accidents like choking, which can be fatal within minutes and represents a significant cause of morbidity in this age group.
Choice B rationale
Toilet training is not a priority for a 12 month old as most children do not achieve the physiological or psychological readiness until 18 to 24 months or later. Discussing this now is premature. Readiness requires the ability to communicate needs and the neurological maturation of the anal and urethral sphincters. Prioritizing this information distracts from the more pressing safety and nutritional needs that are specific to the transition from infancy into the toddler years of life.
Choice C rationale
Choking is a leading cause of unintentional injury and death in toddlers, making the avoidance of small, round foods the highest priority for anticipatory guidance at the 12 month mark. At this age, children are transitioning to table foods but have small airways and immature chewing and swallowing coordination. Items like whole grapes and hot dog rounds are the perfect size to occlude the trachea completely, leading to rapid respiratory failure and cardiac arrest.
Choice D rationale
Sun protection is a relevant health promotion topic for all ages to prevent skin damage and future malignancy. However, in the context of a 12 month old checkup, the immediate risk of environmental skin exposure is lower in hierarchy than the risk of airway obstruction. While the nurse should eventually mention sun safety, it does not carry the same life saving weight as preventing aspiration of common household foods that the child is now regularly consuming.
Correct Answer is C
Explanation
Choice A rationale
A mammogram is a screening tool used to detect breast cancer, not colorectal cancer. While it is a routine screening recommended for older women, it does not provide any information regarding the health of the colon or rectum. Screening for colorectal cancer requires visualization or testing of the lower gastrointestinal tract. Nurses must ensure that patients understand which screenings target specific organ systems to ensure comprehensive preventative care and early detection of various types of malignancies.
Choice B rationale
A CT scan of the abdomen can visualize the organs but is not typically used as the primary routine screening for colorectal cancer due to cost and radiation exposure. While a CT colonography exists, a standard abdominal CT is less sensitive for detecting small polyps or early-stage lesions within the intestinal lumen. Colonoscopy remains the gold standard because it allows for both visualization and the immediate removal of suspicious tissue. Routine screening guidelines prioritize methods with higher diagnostic and therapeutic utility.
Choice C rationale
A colonoscopy is the recommended routine screening for colorectal cancer in older adults because it allows for direct visualization of the entire colon. During the procedure, the provider can identify and remove precancerous polyps, which significantly reduces the incidence of cancer. Current guidelines suggest starting screening at age 45 and continuing through age 75 for most individuals. This procedure is both diagnostic and preventative, making it the most effective tool for managing colorectal health and detecting early malignancies.
Choice D rationale
An electrocardiogram is used to assess the electrical activity of the heart and screen for arrhythmias or other cardiac issues. It has no role in the detection or screening of colorectal cancer. While older adults often require cardiac monitoring, this test does not provide information about the gastrointestinal system. Screening for colorectal cancer must involve the stool or the colon itself. Using an EKG for cancer screening would be an inappropriate application of the diagnostic technology.
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