A nurse in a provider's office is reinforcing teaching about skin care with a client who has a new diagnosis of systemic lupus erythematosus.
Which of the following statements by the client indicates an understanding of the teaching?

Choice A rationale:

The charge nurse should identify the social worker as appropriate to share client information with when it involves an involuntarily committed school-age client. This choice is correct because sharing information with a social worker who is actively involved in the client's care and has a legitimate need to know is in line with ethical and legal confidentiality requirements. Confidentiality should be maintained to protect the client's privacy, but sharing information with a healthcare team member who needs it to provide appropriate care is acceptable.

Choice B rationale:

Sharing a client's medical information with the client's employer due to concerns about substance use is not appropriate without the client's explicit consent. It is important to respect the client's confidentiality unless there is a legal obligation or a safety concern. In this case, obtaining the client's permission to share such information is crucial.

Choice C rationale:

Sharing a client's medical information with their partner after the client reports intimate partner abuse should be done with caution. While there may be instances where sharing is necessary to ensure the client's safety, it should ideally be done with the client's consent and while involving appropriate authorities. In some jurisdictions, there may be mandatory reporting requirements for domestic violence, but the client's consent should still be sought when possible.

Choice D rationale:

Sharing a client's medical information with a nurse from another unit after the client commits suicide is not appropriate without a legitimate reason, such as continuity of care. In such cases, information sharing should be limited to what is necessary for the provision of care and should be in accordance with facility policies and privacy laws. The primary consideration should be maintaining confidentiality while ensuring the safety and well-being of other patients and healthcare staff.

The correct answer is: B. Determine the acuity and number of casualties arriving at the facility.

Choice A rationale: Assisting in discharging stable clients to home is important but not the primary focus during the immediate response to a mass casualty event.

Choice B rationale: Determining the acuity and number of casualties arriving at the facility is crucial in a mass casualty event. This involves assessing the severity of injuries and prioritizing care based on urgency, ensuring that the most critical patients receive immediate attention.

Choice C rationale: Delegating tasks to emergency health care specialists is typically the responsibility of team leaders or incident command staff, not the medical-surgical unit nurses.

Choice D rationale: Providing informational updates to members of the media is generally managed by hospital administration or public relations staff, not by medical-surgical nurses.