Which action by a nurse demonstrates correct use of electronic health records (EHR) to protect client confidentiality?

Choice A reason: Using "why" questions in a clinical setting rarely fosters a sense of support. Instead, it often implies a judgmental tone regarding the client’s behavior. Therapeutic communication requires open-ended, non-confrontational inquiries to ensure the client feels safe rather than scrutinized for their health management choices.

Choice B reason: Asking "why" often places the client on the defensive, as it demands a justification for their actions. This can create a power imbalance and hinder the therapeutic relationship, leading the client to withhold truthful information about barriers to medication adherence, such as cost or side effects.

Choice C reason: While the nurse may intend to encourage an explanation, the phrasing usually has the opposite effect. Defensive clients often provide brief, socially acceptable answers rather than detailed, honest explanations. Using phrases like "Tell me more about your experience with the medication" is more effective for encouragement.

Choice D reason: Empowerment stems from collaborative goal setting and empathetic listening. A question that sounds like a reprimand can diminish a client’s self-efficacy and confidence. To empower a client, the nurse should identify obstacles together rather than questioning past failures in a manner that suggests culpability or negligence.

Choice A reason: Auscultation involves using a stethoscope to listen to internal body sounds, such as bowel motility, bruits, or heart murmurs. It is not the technique used when a nurse applies physical pressure with the fingertips to the abdominal wall to elicit a response or assess tissue density.

Choice B reason: Palpation is the clinical assessment technique that utilizes the sense of touch to determine the characteristics of body parts under the skin. By using the fingertips to apply light or deep pressure, the nurse can identify organ location, size, abnormal masses, and areas of tenderness or guarding.

Choice C reason: Inspection is the initial step of the physical examination, relying solely on visual observation. It involves looking at the client’s abdominal contour, skin integrity, and symmetrical movement without physical contact. Pressing on the abdomen exceeds the scope of visual inspection and moves into tactile assessment.

Choice D reason: Percussion is a technique where the nurse taps the body surface with sharp, short strokes to produce audible vibrations. These sounds help determine the density of underlying structures, such as identifying fluid-filled versus air-filled spaces, which differs from the steady pressure applied during digital palpation.