A nurse enters the hallway and discovers a visitor looking at a client's medical information on a computer. Which of the following actions should the nurse take first?

Correct Answer: B

Rationale: The correct first action for the nurse to take is to close the documentation program on the computer to prevent further unauthorized access to the client's medical information. Choice A is incorrect because the immediate concern is to secure the information first. Choice C, while important, can be addressed after securing the information. Choice D, finding out which staff member left the program open, is not the immediate priority when patient confidentiality is at risk.

Correct Answer: C

Rationale: The correct response is C) "I cannot provide this information to you without your mother's consent." This answer respects the client's right to privacy and confidentiality regarding their medical information. As a nurse, it is crucial to uphold ethical principles such as patient confidentiality and autonomy. Sharing sensitive medical information without the client's consent could breach their trust and violate HIPAA regulations. Option A is incorrect because it does not address the need for the client's consent before sharing medical information. While involving the primary care provider is important, the client's consent should still be obtained first. Option B is incorrect as it puts the onus on the adult child to determine what information they want to know. The nurse should not assume what the adult child wants to know and should prioritize obtaining proper consent before discussing the client's treatment plan. Option D is incorrect as it disregards the client's right to privacy and autonomy. Sharing medical information directly with the adult child without the client's consent is inappropriate and can undermine the client's trust in the healthcare team. In an educational context, this scenario highlights the importance of respecting patient privacy and confidentiality in healthcare settings. Nurses must always prioritize patient autonomy and consent when sharing sensitive medical information, even with family members. Understanding and upholding these ethical principles are essential aspects of nursing leadership and management.

Correct Answer: C

Rationale: The correct answer is C. Addressing the absence of three staff members should be the nurse manager's priority as it directly impacts staffing levels and patient care. This situation can lead to staffing shortages, affecting patient safety and workload distribution. Option A, lack of transport assistance, although important, can be addressed after ensuring adequate staffing. Option B involves a client's preference and can be addressed by assigning care appropriately. Option D, a disagreement between two nurses, is important but can be addressed after ensuring adequate staffing and patient care.

Correct Answer: D

Rationale: In this scenario, placing the client's ring in the facility safe is the most appropriate procedure. This ensures the ring is kept secure and prevents any risk of loss or damage during the surgery. Agreeing to keep the ring for the client could raise concerns about accountability, while placing it in the bag with the client's clothing might lead to misplacement. Taping the ring securely to the client's finger is not recommended as it may hinder blood circulation or cause discomfort.

Correct Answer: D

Rationale: For a patient with acute hypernatremia, the nurse should include interventions like reducing free water losses, correcting sodium levels slowly, monitoring neurologic status, and ensuring adequate fluid intake. Conducting frequent neurologic checks is essential in assessing the patient's neurological status and detecting any changes promptly. Therefore, this action should not be excluded from the plan of care. Choices A, B, and C are not directly related to managing acute hypernatremia and can be safely excluded from the plan of care. Reducing IV access, limiting length of visits, and restricting fluids to 1500 mL per day are not appropriate actions for managing acute hypernatremia.