A nurse is caring for a client who has bipolar disorder. The client's employer contacts the nurse to discuss the client's condition. Which of the following actions should the nurse take?

Verify the employer's identity prior to disclosing information.

Refer the employer to the charge nurse to share the client's information.

Contact the client's family to verify the client's employment status.

Obtain the client's permission to share their health care information.

Answer and Explanation

The Correct Answer is D

A. Verify the employer's identity prior to disclosing information: While verifying the caller’s identity is important for security, it does not address the requirement for consent before sharing private health information. Identity verification alone does not authorize disclosure.

B. Refer the employer to the charge nurse to share the client's information: Referring the employer does not resolve the legal and ethical obligation to protect client confidentiality. Sharing information without client consent is prohibited, regardless of who the nurse contacts.

C. Contact the client's family to verify the client's employment status: Involving the client’s family without consent violates privacy and confidentiality. Employment status alone does not justify disclosure of health information to family or employer.

D. Obtain the client's permission to share their health care information: Health information is protected under HIPAA and ethical standards. The nurse must secure explicit consent from the client before discussing their condition with the employer to maintain confidentiality and legal compliance.

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Correct Answer is ["B","D","F"]

Explanation

A. Medical history: While limited medical history may affect care planning, the lack of other medical conditions does not pose an immediate safety concern and does not require urgent reporting.

B. Heart rate: A heart rate of 121/min indicates tachycardia, which, in the context of recent substance injection and agitation, may signal acute toxicity or cardiovascular stress. This finding requires immediate attention and reporting to the charge nurse.

C. Respiratory rate: A respiratory rate of 20/min is within normal limits for an adult and does not indicate immediate compromise. While monitoring is necessary, it does not require urgent reporting.

D. Pupils: Dilated pupils can indicate recent stimulant use or other substance effects, suggesting acute intoxication. This finding may correlate with life-threatening complications and should be reported immediately for safety and intervention planning.

E. Oxygen saturation: Oxygen saturation of 98% on room air is within normal limits and does not indicate hypoxia, so it is not an urgent concern in this context.

F. Orientation: The client is oriented only to person, indicating confusion or impaired cognitive function, possibly due to intoxication or withdrawal. This acute change in mental status is a safety concern and should be reported immediately.

A. Client denies that substance use was triggered by any childhood trauma B. Client has identified several coping mechanisms when they feel tempted to use the substances C. Client states that they are looking forward to seeing old friends when they are released from the hospital D. Client states that they have a plan to receive their methadone daily following discharge E. The client has written a plan for what to do if relapse should occur F. Client states that they are willing to participate in outpatient therapy following discharge

Correct Answer is ["B","D","E","F"]

Explanation

Rationale for correct choices

• Client has identified several coping mechanisms when they feel tempted to use the substances: Developing coping strategies is a key indicator of progress in substance use disorder treatment. It shows the client is gaining insight into triggers and is preparing practical approaches to manage cravings, reducing the likelihood of relapse.

• Client states that they have a plan to receive their methadone daily following discharge: Adherence to medication-assisted therapy like methadone demonstrates the client is engaging in ongoing treatment, which supports sustained recovery and helps prevent withdrawal symptoms or relapse.

• The client has written a plan for what to do if relapse should occur: Creating a relapse prevention plan reflects proactive problem-solving and understanding of recovery challenges. It indicates the client is taking responsibility for their own care and preparing for potential setbacks, which is expected progress.

• Client states that they are willing to participate in outpatient therapy following discharge: Willingness to continue therapy after discharge demonstrates commitment to long-term recovery. Engagement in structured follow-up is a positive outcome and reflects the client’s motivation to maintain sobriety.

Rationale for Incorrect choices

• Client denies that substance use was triggered by any childhood trauma: While the client’s perception is noted, this statement does not directly reflect progress in coping, treatment adherence, or relapse prevention. It is informational but does not indicate measurable advancement in recovery goals.

• Client states that they are looking forward to seeing old friends when they are released from the hospital: Anticipating contact with old friends may pose a risk of relapse if these friends are associated with substance use. This statement may indicate potential triggers rather than expected improvement.

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A nurse is caring for a client who has bipolar disorder. The client's employer contacts the nurse to discuss the client's condition. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is ["B","D","F"]

Explanation

Correct Answer is ["B","D","E","F"]

Explanation

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