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A nurse is explaining the distinction between confidentiality and privacy. Which of the following would the nurse include as reflecting privacy?
- A. Part of personal life not governed by society?s laws
- B. Ethical duty for nondisclosure
- C. Involvement of two individuals
- D. Knowledge of treatment costs and benefits
Correct Answer: A
Rationale: Privacy refers to an individual?s right to control personal information and aspects of their life not governed by laws, whereas confidentiality is the ethical and legal duty to protect disclosed information.
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A nurse is caring for a patient who is hospitalized for a mental disorder. The nurse is legally obligated to breach the patient?s confidentiality if the patient states which of the following?
- A. I think that the federal government is spying on me.
- B. I get really ?turned on? by your appearance.
- C. That doctor I had today really made me angry.
- D. When I get out of here, I?m going to kill my neighbor.
Correct Answer: D
Rationale: Nurses are legally obligated to breach confidentiality when there is a credible threat of harm to others, such as a statement of intent to kill someone, under the duty to warn (Tarasoff principle).
A psychiatric-mental health patient has an advance care directive on his medical record. A clinician provides treatment that disregards the patient?s directive. The clinician would be liable for which of the following?
- A. Assault
- B. Battery
- C. Medical battery
- D. False imprisonment
Correct Answer: C
Rationale: Disregarding an advance care directive and providing unauthorized treatment constitutes medical battery, a specific type of battery involving non-consensual medical intervention.
A nurse is preparing to administer an as-needed (PRN) medication. Which of the following would the nurse need to keep in mind when documenting administration?
- A. It requires a separate entry that includes reason for administration, dosage, route, and response to the medication the first time it is administered to a patient.
- B. It requires a separate entry that includes reason for administration, dosage, route, and response to the medication every time it is administered to a patient.
- C. It requires a separate entry that includes reason for administration, dosage, and route the first time it is administered to a patient.
- D. It requires a separate entry that includes reason for administration, dosage, and route every time it is administered to a patient.
Correct Answer: B
Rationale: PRN medication administration requires documentation each time, including the reason, dosage, route, and patient response, to ensure accurate tracking of treatment and outcomes.
A nurse is explaining advance care directives, or living wills, to a patient and the ascendancy spouse. Which of the following would the nurse include in the description?
- A. The document tells what treatment is to be omitted if the patient is unable to make the decision.
- B. It requires that the patient sign the living will document while an attorney is present.
- C. The patient?s physician must act as a witness when the patient signs the document.
- D. An attorney draws up the papers to be given to the patient and his or her family.
Correct Answer: A
Rationale: An advance care directive, or living will, specifies a patient?s preferences for medical treatment, including what treatments to omit, in cases where they are unable to make decisions due to incapacity.
A nurse working on the psychiatric unit receives a telephone call from the employer of one of the patients on the unit. The employer asks to be sent a copy of Mr. Murray?s latest laboratory work and psychological testing results so Mr. Murray?s medical records in employee health can be kept up to date. Based on the nurse?s knowledge about issues surrounding breach of confidentiality, which response would be the most appropriate?
- A. I?m sorry; we?re not allowed to give out that information about our patient.
- B. I?ll have to get the patient?s signed consent before we can send that information to you.
- C. I am unable to acknowledge whether or not a Mr. Murray is a patient on this unit.
- D. Sure, give me your address, and I will see that the information is sent to you.
Correct Answer: C
Rationale: Under HIPAA, nurses cannot confirm or deny a patient?s presence without consent, as this protects patient privacy. Acknowledging a patient?s presence or sharing records requires written authorization.