What must the nurse obtain from the patient in order for medical information to be released to another health care facility or third party regarding a patient diagnosed with a mental illness?
A signed consent by the patient
A verbal consent from the patient and the patient’s guardian or next of kin
Approval from the attending psychiatrist
Permission from members of the health care team
The Correct Answer is A
Choice A reason: HIPAA requires signed patient consent for releasing medical information to third parties, ensuring patient autonomy and confidentiality. This legal standard applies to mental health records, protecting sensitive data, making this the correct choice for information release.
Choice B reason: Verbal consent, even with a guardian, is insufficient under HIPAA, which mandates written authorization for protected health information. This ensures clear documentation, making this choice incorrect, as written consent is the legal standard.
Choice C reason: Psychiatrist approval does not replace patient consent for releasing information. HIPAA prioritizes patient authorization, and provider approval alone violates privacy regulations, making this choice incorrect for legal information release protocols.
Choice D reason: Health care team permission is irrelevant to releasing information, as only the patient’s signed consent is legally required. Team collaboration does not override HIPAA’s patient-centered consent rules, making this choice incorrect.
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Correct Answer is D
Explanation
Choice A reason: Dismissing the patient’s feelings by saying they will leave is non-therapeutic, as it invalidates their emotions. Therapeutic communication requires empathy and exploration of feelings, not reassurance that may feel dismissive, as it fails to address the patient’s underlying concerns, making this choice incorrect.
Choice B reason: Encouraging effort with a promise of discharge is overly optimistic and may pressure the patient, ignoring their emotional state. Therapeutic responses focus on understanding feelings, not conditional reassurance, which can undermine trust in psychiatric care, making this response non-therapeutic and incorrect.
Choice C reason: Generalizing the patient’s feelings as common minimizes their unique experience, reducing therapeutic engagement. It fails to explore the patient’s specific concerns or foster a trusting nurse-patient relationship, which is critical in mental health care, making this response non-therapeutic and incorrect.
Choice D reason: Reflecting the patient’s statement by exploring perceived lack of progress demonstrates active listening and empathy, key to therapeutic communication. It encourages the patient to elaborate on feelings, fostering trust and insight, aligning with psychiatric nursing principles, making this the most therapeutic and correct
Correct Answer is A
Explanation
Choice A reason: Zolpidem, a nonbenzodiazepine sedative, affects the central nervous system, causing sedation and impaired coordination, particularly in the elderly. Age-related declines in metabolism and balance increase fall risk, a critical nursing consideration. Monitoring mobility and ensuring safety measures are essential to prevent injuries, making this the correct choice.
Choice B reason: While zolpidem may cause daytime drowsiness, this is not the primary nursing consideration compared to fall risk in the elderly. Drowsiness is a general side effect, but the elderly’s heightened vulnerability to falls due to sedation and impaired coordination takes precedence, making this choice less critical.
Choice C reason: Zolpidem has a lower dependence risk than benzodiazepines, and dependence is not inevitable. This assumption overstates the risk and is not the primary nursing consideration. Fall prevention, especially in vulnerable populations like the elderly, is more urgent due to immediate safety concerns, making this choice incorrect.
Choice D reason: Zolpidem induces sedation rapidly, typically within 15–30 minutes, not requiring 4 weeks. This choice is factually incorrect, as prolonged use is not necessary for efficacy. The primary concern is immediate side effects like falls, not a delayed onset, making this an invalid nursing consideration.
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