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

Explanation

A. In many institutions, when a nurse administers a controlled substance and has leftover medication, it is standard practice to have another nurse witness the disposal of the excess. This is a safeguard against misuse and ensures accountability.
B. While a sharps container is appropriate for disposing of needles and other sharp objects, it is not suitable for liquid medications. Discarding liquid medications in a sharps container could lead to contamination and is not compliant with disposal protocols.
C. Medications, especially controlled substances, should never be saved for later use once they have been drawn up or prepared. This practice poses a significant risk for medication errors and misuse.
D. Generally, the waste amount is not sent to the pharmacy. Instead, it should be wasted according to the facility's policy, typically in the presence of another nurse. Sending it to the pharmacy is unnecessary and could create logistical complications.

A. The integrity of the unit B. The nurse's personal growth C. The safety of clients and families D. The nurse's well-being

Correct Answer is C

Explanation

A. While maintaining the integrity of the unit is important, particularly concerning safety and professionalism, it should not be the primary focus in this scenario. Addressing the underlying issue of substance abuse is more crucial to ensure a safe environment for patients and staff.
B. Supporting the nurse's personal growth is important, especially in recovery. However, personal growth cannot be the primary concern when the nurse's behavior poses significant risks to patient safety. While this can be a component of the overall approach, it should not overshadow immediate safety concerns.
C. The safety of clients and families must be the top priority in this situation. The nurse’s substance abuse poses a direct risk to patient safety, and addressing this risk is essential. Ensuring that clients and families are safe should guide the manager's actions in handling the nurse's behavior.
D. The well-being of the nurse is certainly important and should be considered in the context of providing support and resources for recovery. However, in this case, the immediate risk to patients takes precedence.

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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 preparing to administer morphine 4 mg IV bolus to a client who reports pain. Available is morphine 10 mg/mL. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse-manager discovered that a nurse was retrieving narcotics from sharps containers and has been abusing these medications for several months. When addressing this behavior and assisting the nurse, what factor should the manager prioritize?

Correct Answer is C

Explanation

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