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A nurse is providing teaching about confidentiality with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?
- A. "The courts might require me to discuss confidential information."
- B. "I am required to provide confidential information to insurance companies."
- C. "If questioned during a police investigation, I am required to divulge confidential information."
- D. "I am legally allowed to discuss confidential information with the client's former therapist."
Correct Answer: A
Rationale: Confidentiality may be broken if required by law, such as with a court order.
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A nurse is caring for a client who is experiencing acute alcohol withdrawal. Which of the following findings should the nurse expect?
- A. Hand tremors
- B. Stuporous level of consciousness
- C. Bradycardia
- D. Hypotension
Correct Answer: A
Rationale: The correct answer is A: Hand tremors. During acute alcohol withdrawal, the central nervous system is hyperexcitable due to the sudden absence of alcohol. This can lead to symptoms such as hand tremors, anxiety, agitation, and even seizures. Stuporous level of consciousness (choice B) is not expected in alcohol withdrawal, as clients typically exhibit hyperactivity. Bradycardia (choice C) and hypotension (choice D) are unlikely findings, as alcohol withdrawal commonly causes increased heart rate and blood pressure due to sympathetic nervous system activation.
A nurse is assessing a client who has illness anxiety disorder. Which of the following findings should the nurse expect?
- A. Prior physical health followed by the need for two surgeries within the last three months.
- B. Obsession over a fictitious defect in physical appearance.
- C. Sudden unexplained loss of peripheral sensation.
- D. Constant worry about the undiagnosed presence of an illness.
Correct Answer: D
Rationale: The correct answer is D because individuals with illness anxiety disorder experience persistent and excessive worry about having a serious medical condition despite reassurance from healthcare providers. This constant preoccupation with the possibility of being sick is a key characteristic of the disorder. Option A is incorrect as surgeries do not directly relate to illness anxiety disorder. Option B describes body dysmorphic disorder, not illness anxiety disorder. Option C does not align with the typical presentation of illness anxiety disorder.
A nurse is caring for a newly admitted client who has obsessive-compulsive disorder (OCD). Which of the following actions should the nurse take first?
- A. Discuss alternative coping strategies with the client.
- B. Identify precipitating factors for ritualistic behaviors.
- C. Instruct the client on relaxation techniques for use when anxiety increases.
- D. Provide a structured activity schedule for the client.
Correct Answer: B
Rationale: The correct answer is B: Identify precipitating factors for ritualistic behaviors. This is the first action the nurse should take because understanding the triggers for the client's ritualistic behaviors is essential in developing an effective care plan. By identifying these factors, the nurse can work with the client to address them and potentially reduce the frequency or intensity of the OCD symptoms. Discussing coping strategies (choice A), teaching relaxation techniques (choice C), and providing a structured activity schedule (choice D) are important interventions but should come after identifying the triggers to ensure they are tailored to the individual's specific needs.
A nurse is caring for a client who is hospitalized and says to the nurse, "My partner called and told me my boss hired someone to take my place." Which of the following responses should the nurse make?
- A. "You should call your boss and ask if you can have your job back."
- B. "I don't understand why your partner would upset you with news like that."
- C. "There really isn't much you can do about that until you are discharged."
- D. "You must feel very concerned and disappointed by that information."
Correct Answer: D
Rationale: Acknowledging the client’s emotions promotes therapeutic communication.
A nurse is discussing legal exceptions to client confidentiality with nursing staff. Which of the following statements by a staff member indicates an understanding of the teaching?
- A. "The legal requirement for client confidentiality ceases if the client is deceased."
- B. "Staff members are required to divulge information to attorneys if they call for information."
- C. "Health care workers are not required to answer a court's requests for information about a client's disclosure."
- D. "Providers are required to warn individuals if the client threatens harm."
Correct Answer: D
Rationale: The correct answer is D because it refers to the duty to warn, which is a legal exception to client confidentiality. When a client poses a serious and imminent threat of harm to others, healthcare providers have a duty to warn those at risk. This exception prioritizes public safety over confidentiality.
Explanation of why other choices are incorrect:
A: Incorrect. Confidentiality typically extends even after a client's death to protect their privacy rights and maintain trust in healthcare providers.
B: Incorrect. Disclosing information to attorneys without client consent violates confidentiality unless required by law or court order.
C: Incorrect. Healthcare workers are generally required to comply with court requests for information unless protected by a legal privilege.
E, F, G: Not provided.