In which situation would the nurse be justified in overriding a client's right to confidentiality?

A teenage client asks the nurse not to tell her parents that she is pregnant.

A client does not want her husband to know that she is a client on the unit.

An older adult client discloses to the nurse that her son occasionally hits her.

A client states that he does not want to know the results of his recent diagnostic test.

Answer and Explanation

The Correct Answer is C

A.   While this situation raises ethical considerations, particularly regarding adolescent confidentiality, the nurse is not justified in overriding the client's right to confidentiality solely based on the request. In many jurisdictions, minors may have the right to confidentiality about reproductive health issues, though this can vary.
B.   The nurse is generally required to respect this client's confidentiality. Unless there is a specific safety concern (e.g., domestic violence), the nurse should honor the client's request to keep this information private. Confidentiality should be upheld unless there is a clear and immediate risk of harm.
C.   In this situation, the nurse may be justified in overriding the client’s confidentiality due to the disclosure of potential abuse. Healthcare professionals are often mandated reporters in cases of suspected abuse or neglect, particularly involving vulnerable populations such as older adults. The nurse has a duty to report this situation to ensure the safety of the client.
D.   A client's wish not to know their diagnostic results does not justify overriding their confidentiality. The nurse must respect the client’s autonomy and decision-making regarding their own health information. The nurse should provide support and discuss the implications of this decision but should not disclose the results without the client’s consent.

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Correct Answer is A

Explanation

A. Sickle cell disease is classified as an autosomal recessive disorder. This means that a child must inherit two copies of the mutated gene (one from each parent) to express the disease. Individuals with one normal and one mutated gene are carriers (sickle cell trait) but do not exhibit symptoms.
B. X-linked genetic disorders are caused by mutations on the X chromosome and typically affect males more severely than females, as males have only one X chromosome. Sickle cell disease is not located on the X chromosome; therefore, it is not classified as X-linked.
C. In an autosomal dominant disorder, only one copy of the mutated gene is needed for an individual to express the disease. Sickle cell disease does not follow this inheritance pattern; it requires two copies of the mutated gene, which makes this classification inaccurate.
D. While sickle cell disease is indeed an inherited disorder, this term is broad and could apply to many genetic conditions. It describes the general nature of the disease but does not provide the specificity that "autosomal recessive disorder" does.

A. Temperature B. Blood pressure C. Respiratory rate D. Apical heart rate

Correct Answer is C

Explanation

A. While monitoring temperature is important in assessing for infection, it is not the priority assessment before administering morphine. Temperature does not directly relate to the immediate effects or risks associated with opioid administration.
B. Blood pressure monitoring is essential, especially in a postoperative patient. However, opioids primarily impact the respiratory system rather than directly causing significant changes in blood pressure. While hypotension can occur with opioids, it is not the most immediate concern when administering morphine.
C. This is the priority assessment. Opioids, including morphine, can cause respiratory depression, which is a serious and potentially life-threatening side effect. Before administering morphine, it is crucial to assess the respiratory rate to ensure the patient is not at risk for respiratory distress. If the respiratory rate is low (typically less than 12 breaths per minute), the nurse may need to hold the medication and notify the healthcare provider.
D. While it is important to monitor heart rate, especially in postoperative patients, the primary concern with morphine administration is its effect on respiration. The heart rate may not be as critical to assess immediately before administering morphine as the respiratory rate is.

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In which situation would the nurse be justified in overriding a client's right to confidentiality?

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Naxlex Comprehensive Predictor Exams

Which term best describes sickle cell disease?

Correct Answer is A

Explanation

A nurse is caring for a client who is postoperative following abdominal surgery and reports incisional pain. The surgeon has prescribed morphine 4 mg IV bolus every 6 hr as needed. Before administering this medication, the nurse should complete which priority assessment?

Correct Answer is C

Explanation

A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect?

A nurse is providing discharge teaching to a client who had a sickle cell crisis. Which of the following health promotion strategies should the nurse include in the teaching?(Select All that Apply.)

A nurse is discharging a child who has sickle cell anemia after an acute crisis episode. Which of the following instructions should the nurse include in the teaching?

Which statement is true regarding the general delegation liability of the registered nurse (RN)?

A nurse is teaching a newly licensed nurse about reporting suspected child abuse. Which of the following statements indicates an understanding by the newly licensed nurse?

A nurse enters a client's room and finds the client pulseless. The family has requested a do-not- resuscitate (DNR) order from the provider, but he has not written the order yet. Which of the following actions should the nurse take?

Which infection control activity should the nurse delegate to an experienced unlicensed assistive personnel (UAP)?

A nurse is caring for a client who is scheduled to have surgery. In preparing the client for surgery, which of the following actions is considered outside the nurse's responsibilities?