A school nurse is assessing a child and notes various bruises on the child's body that are unexplained. Which of the following actions should the school nurse take?

Rationale:

A. Allow extra time for the client to perform tasks: Clients with vision loss may need additional time to orient themselves, perform activities of daily living, and navigate safely. Allowing extra time supports independence and reduces the risk of injury or frustration.

B. Touch the client gently to announce presence: Gently touching the client on the arm or shoulder before speaking helps prevent startling them and provides a clear cue that someone is nearby. This enhances safety and effective communication for clients with impaired vision.

C. Keep objects in the client's room in the same place: Consistently organizing personal items and equipment in fixed locations helps clients with vision loss locate items safely and reduces the risk of tripping or injury. This is an essential component of creating a safe environment.

D. Ensure there is high-wattage lighting in the client's room: Excessive or harsh lighting can cause glare, which may worsen visual difficulties for clients with certain types of vision loss. Appropriate lighting should be sufficient but not overly bright, emphasizing contrast rather than intensity.

E. Approach the client from the side: Approaching from the side may startle a client with vision loss. It is safer and more effective to approach from the front while identifying oneself to maintain clear communication and orientation.

Rationale:

A. "You have the right to decide who receives information.": Clients have the legal and ethical right to confidentiality regarding their medical care under HIPAA and patient privacy regulations. Respecting the client’s decision about who can receive health information reinforces autonomy and ensures that the nurse supports the client’s rights in healthcare decision-making.

B. "Your partner can be a great source of support for you at this time.": While acknowledging the potential benefits of support is empathetic, this statement does not address the client’s request for privacy. It may inadvertently pressure the client to share information, which could violate confidentiality and autonomy.

C. "Is there a reason you don't want your partner to know about your procedure?": Asking for justification may make the client feel challenged or judged. The client is not required to explain their choice, and pressing for reasons can undermine trust and respect for their privacy.

D. "The provider will be tactful when talking to your partner.": This statement assumes the provider will communicate with the partner and disregards the client’s expressed wishes. It could lead to disclosure against the client’s consent, violating confidentiality and patient rights.