A nurse is assisting in planning care for a 16-year-old client in a pediatric clinic. Which of the following actions would be a breach of confidentiality?

Reviewing the results of the client's chlamydia screening with their parents, without the client's consent.

Reviewing the results of the client's celiac screening with their parents, without the client's consent.

Reviewing the results of the client's complete blood count (CBC) with their parents, without the client's consent

Reviewing the results of the client's urinalysis with their parents, without the client's consent.

Answer and Explanation

The Correct Answer is A

A. Reviewing the results of the client's chlamydia screening with their parents, without the client's consent: Sexual health information, including STI screenings, is protected by confidentiality laws even for minors in many regions. Disclosing such sensitive information without the client's consent breaches confidentiality and can undermine trust between the adolescent and healthcare providers.

B. Reviewing the results of the client's celiac screening with their parents, without the client's consent: Celiac screening relates to general medical conditions and nutritional health, which are typically shared with parents of minors unless otherwise restricted. This does not generally breach confidentiality because it is not considered sensitive under adolescent health privacy laws.

C. Reviewing the results of the client's complete blood count (CBC) with their parents, without the client's consent: A CBC is a routine diagnostic test that checks general health indicators such as anemia or infection. Discussing these results with parents, especially for minors, is standard practice and does not usually violate confidentiality.

D. Reviewing the results of the client's urinalysis with their parents, without the client's consent: Urinalysis results typically assess general health or identify infections, which are standard to share with parents in the care of minors. This action would not be considered as a breach of confidentiality unless it revealed sensitive information like substance use without consent.

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Correct Answer is A

Explanation

A. Crackles in the lung bases: Left-sided heart failure leads to fluid buildup in the lungs due to the heart's inability to pump blood effectively. This fluid accumulation causes pulmonary congestion, which results in crackles, particularly in the lung bases. This is a common and expected finding in left-sided heart failure.

B. Anorexia: Anorexia may occur in heart failure, but it is not a primary or typical finding of left-sided heart failure. It is more commonly associated with right-sided heart failure, where digestive system congestion is more prevalent.

C. Bradycardia: Left-sided heart failure typically causes tachycardia (elevated heart rate) as the body compensates for the decreased cardiac output. Bradycardia is less commonly seen unless the client has an underlying arrhythmia or is on medications like beta-blockers.

D. Polyuria during the day: Polyuria, or excessive urination, is typically observed at night (nocturia) in clients with heart failure due to fluid redistribution when lying down. It is not commonly observed during the day.

A. Suggest the client exercise before going to bed. B. Offer the client low-protein snacks throughout the day. C. Encourage the client to use positive self-talk. D. Recommend the client spend time alone in his room.

Correct Answer is C

Explanation

A. Suggest the client exercise before going to bed: While exercise is beneficial for depression, vigorous activity before bedtime can interfere with sleep. It is generally better to recommend exercise earlier in the day to promote better rest and regulate mood.

B. Offer the client low-protein snacks throughout the day: Clients with major depressive disorder may experience changes in appetite, but offering low-protein snacks is not a specific therapeutic intervention. Balanced meals and snacks are more appropriate to support overall nutrition.

C. Encourage the client to use positive self-talk: Positive self-talk can help challenge and change negative thought patterns that are common in major depressive disorder. Encouraging cognitive restructuring strategies like positive affirmations supports emotional healing and coping.

D. Recommend the client spend time alone in his room: Isolation can worsen depressive symptoms by increasing feelings of loneliness and hopelessness. Encouraging social interaction and structured activities is more helpful in managing depression.

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Area assessed	Findings
Neurological	Drowsy but easy to arouse
Vital Signs	Temperature 35.3°C (95.5° F) Heart rate 60/min Respiratory rate 16/min Blood pressure 90/60 mm Hg Oxygen saturation 94% (oxygen at 2 L/min via nasal cannula) Rates pain as 1 on 0/10 pain scale.
Integumentary	Skin cool and moist to touch.
Cardiopulmonary	Heart rate regular. Pedal pulse +1 bilateral. Lungs clear bilateral. Respirations even, nonlabored.
Abdomen	Abdomen soft, nondistended. Bowel sounds hypoactive in all four quadrants. 2x2 gauze with a clear transparent dressing intact to right lower and upper abdominal quadrant. Moderate amount of sanguineous drainage noted on the lower dressing

A nurse is assisting in planning care for a 16-year-old client in a pediatric clinic. Which of the following actions would be a breach of confidentiality?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who has left-sided heart failure. Which of the following findings should the nurse expect?

Correct Answer is A

Explanation

A nurse is contributing to the plan of care for a client who has major depressive disorder. Which of the following should the nurse include in the plan of care?

Correct Answer is C

Explanation

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