A nurse is caring for an adolescent who requests screening for sexually transmitted infections (STI). The client asks the nurse. "Do you have to tell my parents?" How should the nurse respond to the adolescent?

"We only have to tell your parents if your test comes back positive."

"We need your parents" permission if you are on their insurance."

"We will have to get your parents' consent before testing you for STIs."

“We can test you for STIs without informing your parents."

Answer and Explanation

The Correct Answer is D

Rationale:

A. "We only have to tell your parents if your test comes back positive.": Giving conditional privacy based on test results is misleading. Confidentiality in STI testing applies regardless of the outcome and is protected by law in many regions for adolescents.

B. "We need your parents' permission if you are on their insurance.": Insurance coverage does not determine the legal right to consent. While explanation of benefits forms may create confidentiality challenges, consent laws usually allow minors to access STI testing independently.

C. "We will have to get your parents' consent before testing you for STIs.": Requiring parental consent for STI testing contradicts legal protections in many areas that allow minors to access sexual and reproductive health care without parental involvement.

D. “We can test you for STIs without informing your parents.": Supporting the adolescent's autonomy and legal rights, this answer provides accurate information about confidential care and encourages open, respectful communication between the nurse and client.

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Correct Answer is C

Explanation

Rationale:

A. Thoracotomy set: A thoracotomy set is used for emergency chest procedures, such as to relieve a pneumothorax or drain the pleural space. It is not relevant to a thyroidectomy, which involves the neck and airway rather than the thoracic cavity.

B. Vacuum assisted wound device: A vacuum-assisted wound device is used for chronic or large open wounds requiring negative pressure therapy. It is not indicated for fresh surgical incisions or preventive airway management following thyroid surgery.

C. Tracheostomy kit: A tracheostomy kit should be readily available at the bedside following thyroid surgery because of the risk of airway obstruction from swelling, bleeding, or damage to the recurrent laryngeal nerve. Immediate airway access may be needed in case of respiratory distress.

D. Tuning fork: A tuning fork is used in auditory and vibration assessments, such as during Rinne and Weber tests. It has no relevance to the immediate post-operative care of a client undergoing a thyroidectomy.

A. Deliver 2 L of oxygen via partial nonrebreather mask. B. Give epinephrine intramuscularly C. Administer diazepam PO. D. Notify the radiology department

Correct Answer is B

Explanation

Rationale:

A. Deliver 2 L of oxygen via partial nonrebreather mask: While oxygen can support airway function, it does not address the underlying cause of anaphylaxis. Airway closure due to an allergic reaction requires immediate pharmacologic intervention, not just oxygen delivery.

B. Give epinephrine intramuscularly: Epinephrine is the first-line treatment for anaphylaxis. It counteracts bronchoconstriction, airway edema, and hypotension by stimulating alpha and beta receptors, and should be administered immediately when signs of airway compromise are present.

C. Administer diazepam PO: Diazepam is used for anxiety or seizures, not for acute allergic reactions. It has no effect on reversing airway swelling or bronchospasm and would delay the appropriate emergency treatment needed in this situation.

D. Notify the radiology department: Contacting the radiology department is not relevant or urgent in this scenario. The client is experiencing a life-threatening reaction that requires immediate medical intervention, not communication with non-emergency services.

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A nurse is caring for an adolescent who requests screening for sexually transmitted infections (STI). The client asks the nurse. "Do you have to tell my parents?" How should the nurse respond to the adolescent?

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