A nurse receives a telephone call from a client's family member, who asks the nurse for an update on the client's condition.
Which of the following actions should the nurse take to maintain the client's confidentiality?

Request additional information about the caller's relationship to the client.

Provide a general update about the client's condition over the telephone.

Refer the family member to the client's provider for the update.

Encourage the family member to contact the client directly for information.

Answer and Explanation

The Correct Answer is D

The correct answer is Choice D.

Choice A rationale: Requesting additional information about the caller's relationship to the client does not ensure the caller's identity is verified, and it could still result in a breach of confidentiality.

Choice B rationale: Providing a general update about the client's condition over the telephone is not appropriate, as it could breach the client's confidentiality.

Choice C rationale: Referring the family member to the client's provider for the update respects confidentiality and ensures that information is only provided to authorized individuals, maintaining the client's privacy.

Choice D rationale: Encouraging the family member to contact the client directly for information ensures that the client has control over their own information and maintains confidentiality. This action respects the client's privacy and autonomy.

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Correct Answer is A

Explanation

Choice A rationale:

Clients with dementia often experience difficulties with memory, cognition, and orientation, which can lead to increased risk of falls and injuries, especially when trying to perform activities of daily living such as using the toilet. Assisting the client to the toilet frequently helps prevent accidents and reduces the risk of injury from falls. Timely toileting can also improve the client's comfort and overall quality of life.

Choice B rationale:

Raising the side rails up when the client is in bed can create a physical barrier, but it is not a recommended method to prevent falls in clients with dementia. In fact, it can pose a risk by confining the client and may lead to attempts to climb over the rails, resulting in falls and injuries.

Choice C rationale:

Placing the bedside table at the foot of the bed does not directly address the client's safety needs. While it might be a matter of personal preference or convenience, it does not significantly impact the client's risk of injury.

Choice D rationale:

Keeping the television on during the night does not address the client's physical safety. While it may provide entertainment or a familiar environment, it does not mitigate the risk of falls or injuries, which is the primary concern when caring for clients with dementia.

A. Tie a tourniquet around the leg distal to the wound. B. Irrigate the wound with sterile water. C. Apply direct pressure to the wound with thick dressing material. D. Apply a transparent dressing to the wound.

Correct Answer is C

Explanation

View Question and Answer

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A nurse receives a telephone call from a client's family member, who asks the nurse for an update on the client's condition. Which of the following actions should the nurse take to maintain the client's confidentiality?

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A nurse receives a telephone call from a client's family member, who asks the nurse for an update on the client's condition.
Which of the following actions should the nurse take to maintain the client's confidentiality?