In which situation would the nurse be justified in overriding a client's right to confidentiality?

A teenage client asks the nurse not to tell her parents that she is pregnant.

A client does not want her husband to know that she is a client on the unit.

An older adult client discloses to the nurse that her son occasionally hits her.

A client states that he does not want to know the results of his recent diagnostic test.

Answer and Explanation

The Correct Answer is C

A.   While this situation raises ethical considerations, particularly regarding adolescent confidentiality, the nurse is not justified in overriding the client's right to confidentiality solely based on the request. In many jurisdictions, minors may have the right to confidentiality about reproductive health issues, though this can vary.
B.   The nurse is generally required to respect this client's confidentiality. Unless there is a specific safety concern (e.g., domestic violence), the nurse should honor the client's request to keep this information private. Confidentiality should be upheld unless there is a clear and immediate risk of harm.
C.   In this situation, the nurse may be justified in overriding the client’s confidentiality due to the disclosure of potential abuse. Healthcare professionals are often mandated reporters in cases of suspected abuse or neglect, particularly involving vulnerable populations such as older adults. The nurse has a duty to report this situation to ensure the safety of the client.
D.   A client's wish not to know their diagnostic results does not justify overriding their confidentiality. The nurse must respect the client’s autonomy and decision-making regarding their own health information. The nurse should provide support and discuss the implications of this decision but should not disclose the results without the client’s consent.

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Correct Answer is ["A","B","C","E"]

Explanation

A. Pain is one of the hallmark symptoms of sickle cell anemia, particularly during a sickle cell crisis. The sickling of red blood cells can obstruct blood flow, leading to ischemia and severe pain in various parts of the body, including the chest, abdomen, and joints.
B. Clients with sickle cell anemia often experience anxiety, especially during pain crises or hospitalizations. The uncertainty surrounding pain episodes, potential complications, and the chronic nature of the disease can contribute to feelings of anxiety.
C. Many individuals with sickle cell anemia may experience sleeplessness due to pain, discomfort, or anxiety related to their condition. Pain episodes can disrupt sleep patterns, leading to fatigue and further complicating their overall health.
D. Difficulty speaking is not a typical manifestation of sickle cell anemia. While severe complications, such as stroke, can occur in individuals with sickle cell disease and may lead to speech difficulties, this is not a direct manifestation of the condition itself.
E. Depression is common among individuals with chronic illnesses, including sickle cell anemia. The ongoing challenges of managing pain, frequent medical visits, and the impact of the disease on daily life can contribute to feelings of depression.

A. Bradycardia B. Constipation C. High fever D. Pain

Correct Answer is D

Explanation

A. Bradycardia, or a slow heart rate, is not a typical finding during a sickle cell crisis. In fact, during a crisis, the child may exhibit tachycardia (increased heart rate) due to pain, stress, and potential hypoxia.
B. While constipation can be a complication in children with sickle cell disease (often related to pain medications or dehydration), it is not a primary symptom of a sickle cell crisis itself. The immediate concerns in a crisis are related to pain and vaso-occlusive episodes.
C. High fever is not a direct symptom of a sickle cell crisis. Although children with sickle cell disease are at increased risk for infections, which can cause fever, a fever is not a typical finding specifically related to a sickle cell crisis. It is essential to assess for infection, especially if fever is present.
D. Pain is the hallmark symptom of a sickle cell crisis, often referred to as a vaso-occlusive crisis. The sickle-shaped red blood cells can block blood flow in small vessels, leading to severe pain in various parts of the body, such as the chest, abdomen, and joints.

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In which situation would the nurse be justified in overriding a client's right to confidentiality?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is admitting a client who has sickle cell anemia. Which of the following manifestations should the nurse expect with this condition?(Select All that Apply.)

Correct Answer is ["A","B","C","E"]

Explanation

A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

Which term best describes sickle cell disease?

The RN overbears the nurses' aide speaking in a harsh tone to a client with early Alzheimer's memory loss. Which statement should the EN make to begin addressing this issue?

A nurse is discharging a child who has sickle cell anemia after an acute crisis episode. Which of the following instructions should the nurse include in the teaching?

A member of the team has been delegated some tasks and reports, "I've been given too much to do and I'm not going to be able to complete the work on time." What is the RN's best initial action?

The preoperative admitting nurse witnessed a client sign an operative consent form. The nurse then cosigned the same document as a witness. The client suffered an injury during surgery and names the nurse in the suit because the nurse witnessed the consent form. What is the most likely outcome?.

Which infection control activity should the nurse delegate to an experienced unlicensed assistive personnel (UAP)?

Which of the following behaviors would not have disciplinary or legal consequences?

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