You are working at the desk in your hospital when another employee of the hospital asks for information about a patient who was admitted last night with a pulmonary embolus secondary to cancer. You know the details of the case. The person requesting the information states that he is a close friend and co-worker of your patient. He shows you proper identification proving he really is a co-worker of your patient who also works in the hospital. Which of the following is the most appropriate response to this request?

Correct Answer: C

Rationale: Confidentiality is a fundamental right of all patients. As part of maintaining the patient's autonomy in revealing information only to those they wish to be informed of their condition you must refuse to release any specific information of the patient's medical history or current medical problems without direct permission from the patient. Respect this right even if the person asking is, indeed, a co-worker-or even their superior. You have no idea if medical information may be used to discriminate against the patient. Separate from this, third parties have no automatic right to a patient's medical information unless they are directly involved in the care of the patient. This would hold true even if the person seeking information is a health-care worker if they are not directly involved in the care of the patient. Have the patient- not the person requesting the information-sign the consent form for release of information confirming that they are giving you permission to release information.

Correct Answer: C

Rationale: Just because a patient may be incompetent in certain areas of his life does not mean that he is not able to consent for medical procedures. The patient described has a severe and permanent cognitive impairment; however, he is still able to refuse the procedure. A patient can be considered incompetent for financial issues but still have the ability to make medical decisions. It would not be advisable to recommend routine medical procedures against the will of the patient. This would mean literally forcing him into the endoscopy through restraints or sedation. Incompetence in one area does not mean total incompetence. The court recognizes a much lower standard of cognitive ability to reliably consent or refuse procedures compared with financial decisions. It is easier to be declared incompetent for financial decisions than it is for medical decisions.

Correct Answer: D

Rationale: Staff must not administer medications they didn't prepare to ensure the 'right medication' and avoid errors, per safety protocols.

Correct Answer: B

Rationale: The nurse must assess and adjust the order if the condition resolves, as staff cannot alter prescriptions.

Correct Answer: A

Rationale: Verifying against the MAR and consulting the nurse ensures the correct medication, as appearance changes may indicate errors.