A nurse is preparing a client for transfer to a long-term rehabilitation facility following a below-the-knee amputation of the right leg.
Which of the following actions should the nurse take to protect the client's confidentiality?
Provide a verbal report of the client's condition to the paramedic performing the transfer.
Fax the client's name and identifiable information to the rehabilitation facility.
Email the client's health information to the facility in an unencrypted file.
Discuss the client's response to the transfer with another staff nurse.
The Correct Answer is A
Choice A rationale:
Providing a verbal report of the client's condition to the paramedic performing the transfer violates the client's confidentiality. Protected health information should not be disclosed verbally to individuals who do not have a need to know. Confidentiality must be maintained during all stages of care, including transfers.
Choice B rationale:
Faxing the client's name and identifiable information to the rehabilitation facility is not a secure method of transmitting sensitive health information. Faxed documents can be intercepted, compromising the client's confidentiality. Secure electronic methods or encrypted communication should be used for transmitting such information.
Choice C rationale:
Emailing the client's health information to the facility in an unencrypted file is also insecure and violates the client's confidentiality. Unencrypted emails can be intercepted and read by unauthorized individuals. Protected health information should be transmitted using secure, encrypted methods to maintain confidentiality.
Choice D rationale:
Discussing the client's response to the transfer with another staff nurse is inappropriate and breaches confidentiality. Sharing patient information, even within the healthcare team, should only be done on a need-to-know basis and in a secure, private setting.
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Correct Answer is D
Explanation
Explanation: Making funeral arrangements is an indication of hopelessness because it shows that the client has given up on the possibility of recovery or improvement. A decreased energy level, requesting a second opinion, and wanting to talk about the diagnosis are not necessarily signs of hopelessness, but rather normal reactions to a terminal illness.
Correct Answer is A
Explanation
The correct answer is Choice a.
Choice a rationale: The nurse should obtain the specimen immediately upon the client waking up, as sputum from deep in the lungs is usually more easily collected at this time. Sputum collected upon waking up is more likely to contain secretions from the lower respiratory tract, providing a better sample for tuberculosis diagnosis. This timing maximizes the chance of detecting the bacteria.
Choice b rationale: Choice b is incorrect because the typical volume of sputum needed for testing is about 1 teaspoon (5 mL), not 15 to 20 mL. Collecting such a large volume could be challenging for the client and unnecessary for diagnostic purposes.
Choice c rationale: Choice c is incorrect because while gloves should be worn, they do not need to be sterile, just clean. The use of clean gloves is sufficient to prevent contamination during specimen collection, and sterile gloves are not required for this procedure.
Choice d rationale: Choice d is incorrect because it’s important to try to collect the specimen as soon as possible, not wait a full day. Delaying collection for a day could result in a missed opportunity to diagnose tuberculosis and initiate appropriate treatment promptly. Collecting the specimen promptly maximizes the accuracy of diagnostic testing and facilitates timely intervention for the client's health.
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