A nurse is caring for a client who is 4 days postoperative following a right radical mastectomy. Which of the following activities should the nurse anticipate being the most difficult for this client to perform with her right hand?

Choice A:This response suggests that a physical examination is necessary before providing contraceptive advice. While a healthcare provider may conduct a physical examination as part of comprehensive care, making it a prerequisite for discussing contraception can create barriers for adolescents seeking information. Emphasizing a physical exam may deter open communication, as adolescents might feel apprehensive or judged. Effective contraceptive counseling should prioritize building rapport and understanding the individual's needs and concerns before proceeding to clinical

Choice B: "You are so young. Are you ready for the responsibilities of a sexual relationship?" This response is inappropriate and judgmental because it implies that the client is too immature or irresponsible to have a sexual relationship. It also discourages the client from seeking help or information from the nurse and may make her feel ashamed or guilty about her sexuality.

Choice C: "Because of your age, I think that a barrier method would be the best choice." This response is inappropriate and paternalistic because it assumes that the nurse knows what is best for the client without considering her individual situation or preferences. It also limits the client's options and may not address her specific needs or concerns.

Choice D:This response is appropriate as it seeks to gather more information about the adolescent's sexual activity, which is crucial for providing tailored contraceptive advice. Understanding the individual's sexual behavior, frequency of activity, number of partners, and risk factors allows the healthcare provider to recommend the most suitable contraceptive methods and address any concerns about sexually transmitted infections. The Centers for Disease Control and Prevention highlight the importance of personalized counseling that takes into account the adolescent's specific circumstances to promote effective contraceptive use and sexual health.

Choice A: "Information about a client can be disclosed to family members at any time." This statement indicates a need for further teaching because it is false and violates HIPAA. HIPAA protects the privacy and security of clients' health information and limits who can access or share it without their consent. Information about a client can only be disclosed to family members if they are involved in the client's care or payment, or if the client gives permission.

Choice B: "HIPAA established regulations of individually identifiable health information in verbal, electronic, or written form." This statement does not indicate a need for further teaching because it is true and reflects HIPAA. HIPAA defines individually identifiable health information as any information that relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual; and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual.

Choice C: "HIPAA is a federal law, not a state law." This statement does not indicate a need for further teaching because it is true and reflects HIPAA. HIPAA is a federal law that was enacted in 1996 by Congress and signed by President Clinton. It applies to all states and territories of the United States. However, some states may have additional or stricter laws that protect clients' health information.

Choice D: "A client's address would be an example of personally identifiable information." This statement does not indicate a need for further teaching because it is true and reflects HIPAA. HIPAA lists 18 identifiers that can be used to identify an individual, such as name, address, phone number, email address, social security number, medical record number, or biometric identifiers. A client's address is one of these identifiers and must be protected under HIPAA.