A home health nurse is visiting a client who has advanced Alzheimer's disease. The client's partner states, "I miss being able to go places with my friends." Which of the following is an appropriate response by the nurse?

Choice A Reason:

To an employer for a pre-employment screening is correct. Generally, healthcare information disclosure to an employer for pre-employment screening requires the client's written consent. The Health Insurance Portability and Accountability Act (HIPAA) and other privacy regulations typically protect a client's health information from disclosure to employers without explicit authorization from the client.

Choice B Reason:

To a medical interpreter service on behalf of a client is incorrect. In situations where a medical interpreter service is required to facilitate communication between the healthcare provider and the client, limited disclosure of health information may be necessary to ensure proper care. However, the information shared should be relevant to the immediate healthcare needs and should not exceed what's necessary for effective communication.

Choice C Reason:

To a family member when the client is not available is incorrect. In certain circumstances, especially if the client is incapacitated or unavailable, disclosing limited health information to a family member might be necessary for the client's best interests, such as for care coordination or emergencies. However, the information shared should be limited to what's essential and relevant to the situation.

Choice D Reason:

To an insurance agency in regard to a life insurance policy is incorrect. Health information disclosure to an insurance agency might be permitted in the context of processing a life insurance policy, typically under the Health Insurance Portability and Accountability Act (HIPAA) and as allowed by state laws. However, this disclosure is usually limited to information necessary for underwriting the policy and may not require the client's explicit written consent.

Choice A Reason:

Urinating after the specimen collection is incorrect. While it's important to ensure urine doesn't contaminate the stool specimen during collection, the instruction to urinate after the collection doesn't directly impact the collection process itself. The primary focus is on avoiding contamination of the stool sample with urine or toilet tissue during collection.

Choice B Reason:

Placing 1.3 cm (0.5 in) of formed stool into a culture tube is incorrect. The amount of stool needed for a specimen can vary based on the specific test requirements or laboratory instructions. A fixed measurement, like 1.3 cm of formed stool, might not accurately represent the necessary quantity for all types of stool tests. Specific instructions from the healthcare provider or laboratory should be followed for proper collection.

Choice C Reason:

Keeping the specimen in a warm area is incorrect. Stool specimens are typically collected and stored at room temperature unless otherwise specified by specific test instructions. Placing the specimen in a warm area could alter the characteristics of the sample or promote bacterial growth, potentially affecting test accuracy. The specimen should be handled according to the specific requirements outlined for the particular test.

Choice D Reason:

Avoid placing toilet tissue in the bedpan after defecation is correct. Placing toilet tissue in the bedpan after defecation can contaminate the stool specimen, affecting the accuracy of test results. It's important to collect the stool sample without any contamination from toilet tissue or urine.