A nurse notices that a client's health information is visible on an unattended computer screen at the nurses' station. Which of the following actions should the nurse take first?
Complete an incident report.
Log the previous user out of the system.
Report the incident to the charge nurse.
Offer to conduct a unit in-service on client confidentiality
The Correct Answer is B
B) Log the previous user out of the system:
The immediate action the nurse should take is to protect the client's confidentiality by logging out the previous user from the computer system. This ensures that unauthorized individuals do not have access to the client's health information. By taking this step promptly, the nurse mitigates the risk of unauthorized viewing of sensitive information.
A) Complete an incident report:
While completing an incident report is important for documenting the occurrence, it is not the first action the nurse should take. The priority is to address the immediate breach of confidentiality by securing the computer system to prevent further unauthorized access.
C) Report the incident to the charge nurse:
Reporting the incident to the charge nurse is essential, but it should follow the immediate action of logging out the previous user from the system. The charge nurse can then coordinate any necessary follow-up actions and ensure that appropriate measures are taken to prevent similar incidents in the future.
D) Offer to conduct a unit in-service on client confidentiality:
While staff education on client confidentiality is valuable for preventing future breaches, it is not the first action needed in response to the immediate situation. Addressing the current breach takes precedence to protect the client's privacy. Staff education can be considered as a proactive measure after addressing the immediate concern.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) The client rates her pain at a 3 on a 0 to 10 pain rating scale:
In the SBAR communication technique, "A" stands for "Assessment." This portion of the report should include concise and pertinent information about the client's current condition or status. The client's pain level, rated on a standardized pain scale, is a crucial assessment parameter that provides immediate insight into the client's comfort and potential need for intervention or further assessment.
B) The client has type 2 diabetes mellitus:
While the client's medical history of type 2 diabetes mellitus is important information, it is more relevant to the client's overall health status and background. In the SBAR framework, this information would typically be included in the "B" (Background) portion of the report, which focuses on contextual information such as medical history, current diagnoses, and relevant background information about the client.
C) The client is 2 hours postoperative following a cholecystectomy:
The fact that the client is 2 hours postoperative following a cholecystectomy is significant information regarding the client's recent surgical procedure and immediate postoperative status. However, this information falls under the "B" (Background) portion of the SBAR report, which includes details about the client's recent events, procedures, or treatments.
D) The client should wear compression stockings:
Information about the client's prescribed interventions or treatments, such as wearing compression stockings, is essential for continuity of care and ensuring that appropriate interventions are continued. However, this information is typically included in the "R" (Recommendation) portion of the SBAR report, where the nurse may provide recommendations for ongoing care or interventions based on the client's current condition and needs.
Correct Answer is ["A","B"]
Explanation
A) Undergoing cardiac catheterization:
Cardiac catheterization is an invasive procedure that involves threading a thin tube (catheter) through blood vessels to the heart. It carries potential risks, including bleeding, infection, and damage to blood vessels or the heart. Therefore, obtaining informed consent is essential to ensure that the client understands the procedure, its risks, benefits, and alternatives before undergoing it.
B) Receiving moderate sedation:
Moderate sedation (conscious sedation) is a drug-induced state of depressed consciousness during which the client remains responsive to verbal commands. While it is less invasive than general anesthesia, it still carries risks, including respiratory depression, hypotension, and allergic reactions. Informed consent is required to ensure that the client understands the potential side effects and complications associated with sedation.
C) Suctioning a tracheostomy tube:
Suctioning a tracheostomy tube is a routine nursing intervention to remove secretions and maintain airway patency. It does not typically require informed consent unless there are specific circumstances or the client's condition warrants additional explanation or consent, such as if the client is at risk for complications or discomfort during the procedure.
D) Inserting a peripheral IV catheter:
Inserting a peripheral IV catheter is a common nursing procedure that typically does not require informed consent unless there are unusual circumstances or the client's condition warrants additional explanation or consent, such as if the client has specific concerns or medical conditions that may affect the procedure.
E) Inserting an indwelling urinary catheter:
Inserting an indwelling urinary catheter is a routine nursing procedure commonly performed to drain urine from the bladder. Informed consent may be required in certain situations, such as if the client lacks decision-making capacity or if the procedure involves specific risks or considerations that require explanation to the client or their legal representative. However, in most cases, informed consent is obtained as part of the general consent for treatment upon admission to the healthcare facility.
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