A nurse observes two assistive personnel (AP) discussing a client's information in the facility cafeteria. Which of the following actions should the nurse take?

Remind the AP about maintaining client confidentiality.

Notify the client of the breach of confidentiality.

Notify the ethics committee of the breach of confidentiality.

File an incident report with the risk management department.

Answer and Explanation

The Correct Answer is A

A. Reminding the AP about confidentiality is the appropriate immediate response. The nurse should provide education and reinforce HIPAA regulations to prevent future breaches.
B. Notifying the client is unnecessary and could cause undue distress. The priority is to address the behavior and prevent further violations.
C. Notifying the ethics committee is excessive for a first-time or minor violation. This step may be necessary if breaches continue despite education.
D. Filing an incident report is not required unless the breach has significant consequences. The best first step is direct education.

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Correct Answer is A

Explanation

A. Measure and record the client's leg circumferences daily. This is correct because measuring leg circumference helps assess for changes in swelling and monitor the progression or improvement of deep-vein thrombosis.
B. Place the client with their knees in a sharply flexed position. This is incorrect because sharply flexing the knees can impede blood flow and increase the risk of clot formation. The client should be encouraged to keep their legs extended and slightly elevated.
C. Monitor the client's RBCs every 4 hr. This is incorrect because deep-vein thrombosis does not typically require frequent RBC monitoring. Instead, coagulation studies such as PT, aPTT, and INR are more relevant.
D. Administer warfarin PO daily. This is incorrect because warfarin is contraindicated during pregnancy due to its teratogenic effects. Instead, low-molecular-weight heparin or unfractionated heparin is the preferred anticoagulant during pregnancy.

A. Choose the client's dominant arm for IV access whenever possible. B. Select a site proximal to previous venipuncture sites. C. Initiate IV access on the palmar side of the client's wrist. D. Insert a larger gauge IV catheter to prevent phlebitis.

Correct Answer is B

Explanation

A. Choose the client's dominant arm for IV access whenever possible. The nondominant arm is preferred to minimize interference with daily activities.
B. Select a site proximal to previous venipuncture sites. This is the appropriate action because using a site above a previous one ensures better vein integrity and reduces complications.
C. Initiate IV access on the palmar side of the client's wrist. This site should be avoided as it is more painful and increases the risk of nerve damage.
D. Insert a larger gauge IV catheter to prevent phlebitis. A smaller gauge catheter is preferred when possible, as larger catheters can increase the risk of vein irritation and phlebitis.

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A nurse observes two assistive personnel (AP) discussing a client's information in the facility cafeteria. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

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