A nurse overhears two assistive personnel (AP) discussing a client's care in the cafeteria. Which of the following actions should the nurse take?
Reassign the AP to other clients on the unit
Instruct the AP to discontinue the conversation
Complete an incident report about the breach of client confidentiality
Notify the client's provider about the incident
The Correct Answer is B
Choice A reason: Reassigning the AP to other clients on the unit is not an appropriate action for the nurse to take. This action does not address the issue of the breach of client confidentiality, and it may disrupt the continuity of care for the clients. The nurse should not punish the AP without giving them feedback and education.
Choice B reason: Instructing the AP to discontinue the conversation is an appropriate action for the nurse to take. This action stops the violation of client confidentiality and protects the client's privacy and dignity. The nurse should also remind the AP of the ethical and legal principles of confidentiality, and the consequences of violating them.
Choice C reason: Completing an incident report about the breach of client confidentiality is not an appropriate action for the nurse to take. This action is not necessary, as the breach was not intentional or harmful to the client. The nurse should document the incident in the AP's performance evaluation, and provide guidance and coaching to prevent future occurrences.
Choice D reason: Notifying the client's provider about the incident is not an appropriate action for the nurse to take. This action is not relevant, as the provider is not responsible for the AP's behavior or education. The nurse should notify the AP's supervisor or manager, and collaborate with them to address the issue.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: A nurse refusing to actively participate during an elective abortion procedure scheduled for their client is not a behavior that indicates a need for further education. The nurse has the right to conscientious objection, which means they can decline to perform or assist in a procedure that violates their moral or religious beliefs. The nurse should inform the charge nurse of their objection and request to be reassigned to another client.
Choice B reason: A nurse explaining to a client's family that a DNR order includes withholding comfort measures is a behavior that indicates a need for further education. The nurse is providing false and misleading information that can cause harm and distress to the client and the family. A DNR order only means that no cardiopulmonary resuscitation (CPR) or advanced cardiac life support (ACLS) will be initiated in the event of a cardiac or respiratory arrest. A DNR order does not affect the provision of other treatments, such as pain management, hydration, nutrition, oxygen, or emotional support.
Choice C reason: A nurse informing a confused client who wants to go home that they are going to stay at the facility until they are better is not a behavior that indicates a need for further education. The nurse is using therapeutic communication and providing reassurance to the client. The nurse is also respecting the client's autonomy and right to refuse treatment, as long as the client is competent and informed. The nurse should assess the client's mental status and decision-making capacity, and involve the client's family or surrogate decision-maker if needed.
Choice D reason: A nurse giving prescribed opioids to a client who has a terminal illness and respirations of 8/min is not a behavior that indicates a need for further education. The nurse is following the principle of beneficence, which means doing good and preventing harm to the client. The nurse is also following the principle of double effect, which means that an action that has both a good and a bad effect is morally permissible if the good effect outweighs the bad effect. The nurse is providing adequate pain relief to the client, even if it may hasten their death. The nurse should monitor the client's vital signs and level of consciousness, and adjust the opioid dose as prescribed.
Correct Answer is B
Explanation
Choice A reason: Nurses who have advanced training may provide direct care for clients, but this is not specific to case management. Case management is a collaborative process that involves assessing, planning, implementing, coordinating, monitoring, and evaluating the options and services required to meet the client's health and human service needs.
Choice B reason: Nurses use critical pathways when caring for clients as part of case management. Critical pathways are standardized plans of care that outline the expected outcomes, interventions, and time frames for a specific diagnosis or procedure. They help to ensure quality, continuity, and cost-effectiveness of care.
Choice C reason: Nurses delegate and supervise assigned tasks, but this is a general nursing responsibility and not specific to case management. Case management requires more than just task delegation and supervision. It also involves communication, coordination, and evaluation of care.
Choice D reason: The nurse completes one specific task for a group of clients is not an accurate description of case management. Case management is not task-oriented, but client-centered and outcome-focused. The nurse is responsible for the overall care of the client, not just one aspect of it.
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