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 B

Explanation

A. While it’s true that surgery itself is beyond the nurse's scope of practice, liability can still arise from the actions taken in relation to the consent process. The issue is not about the surgery itself but about the responsibility associated with witnessing the consent.
B. The nurse’s role in this context is to witness the client’s signature, not to guarantee the client’s understanding of the procedure or the risks involved. The witness signature generally indicates that the nurse observed the client signing the document but does not imply that the nurse ensured the client understood all aspects of the surgery.
C. Cosigning a consent form does not make the nurse an equal member of the surgical team in terms of decision-making or responsibilities. The nurse's role as a witness is limited to observing the signing process.
D. The nurse’s signature does not imply that they confirmed the client's understanding of the risks involved. The responsibility for explaining the risks and ensuring the client’s understanding typically falls to the physician or surgeon.

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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The preoperative admitting nurse witnessed a client sign an operative consent form. The nurse then cosigned the same document as a witness. The client suffered an injury during surgery and names the nurse in the suit because the nurse witnessed the consent form. What is the most likely outcome?.

Correct Answer is B

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

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