A nurse on a medical-surgical unit is caring for a client who asks about advance directives and states that he wants to appoint a health care proxy. Which of the following responses should the nurse make?

a. Close the documentation program on the computer:

This action is appropriate as it immediately stops unauthorized access to the client's medical information and prevents further viewing of protected health information (PHI).

b. Find out which staff member left the documentation program on the screen:

While it's important to identify any staff member who may have left the documentation program open, addressing this issue should not be the first priority. The immediate concern is stopping the unauthorized access to the client's information and ensuring that the visitor is aware of the confidentiality breach.

c. Tell the charge nurse that the visitor viewed a client’s protected health information:

Notifying the charge nurse about the incident is important, but it should not be the first action taken. The priority is to address the immediate breach of confidentiality and prevent further unauthorized access to the client's information.

d. Inform the visitor that client records are confidential:

This action may be appropriate after addressing the immediate breach of confidentiality. However, it should not be the first action taken as it does not immediately stop the unauthorized access to the client's information.

a. "If you have the procedure now, you won’t have to deal with pain and disability later."

This response dismisses the client's concerns about pain and focuses solely on the potential benefits of the surgery. It fails to address the client's apprehension and does not provide support or empathy. Furthermore, it oversimplifies the situation and may come across as dismissive of the client's feelings.

b. “I understand, and it’s not too late to change your mind.”

This response demonstrates empathy and validation of the client's concerns. It acknowledges the client's autonomy and gives them the option to reconsider without judgment or pressure. It encourages open communication between the nurse and the client, fostering a supportive environment.

c. “Why didn’t you discuss your concerns with your provider?”

This response may come across as accusatory or blaming, which can further distress the client. It does not offer immediate support or validation of the client's concerns. While discussing concerns with the provider is important, this response fails to address the client's immediate distress and need for reassurance.

d. “You’ll be fine. You’ll receive a prescription for pain medication.”

This response minimizes the client's concerns by reassurance without addressing the underlying issue. It also assumes that pain medication will resolve all concerns related to pain, which may not be the case for the client. Additionally, it overlooks the client's emotional needs and autonomy in decision-making.