Author Question: The nurse is conducting a health history on a client who is being admitted to a medical-surgical ... (Read 76 times)

tiara099 · **on:** Jun 25, 2018

The nurse is conducting a health history on a client who is being admitted to a medical-surgical unit for the treatment of chronic pain.

The client is concerned about privacy and asks why it is necessary for the nurse to ask for private information and then document it in the medical record. Which response by the nurse is most appropriate?
A) You will be able to read the record and review your care.
B) Documentation decreases the likelihood that you will have to repeat this information to others who will care for you.
C) Your family can review the record and ensure that care is appropriate.
D) A record ensures there are no breaches of confidentiality.

Question 2

A nurse mistakenly gives a client, who is NPO for surgery, a morning breakfast tray. After realizing the mistake, the nurse notifies the healthcare provider as well as the client; explains the consequences of this mistake,

which includes a delay in the client's surgery; and documents the situation in the client's medical record. Which is demonstrated by the actions of this nurse?
A) Social justice
B) Human dignity
C) Reliability
D) Accountability

tandmlomax84 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Answer: B

The client's record serves as a vehicle by which different health professionals who interact with a client communicate with one another. This prevents fragmentation, repetition, and delays in client care, and relieves the client from having to repeat information to each provider offering care. The client can read the record, but that is not a reason to keep one. The client's family does not have access to the record. Record keeping does not prevent breaches of confidentiality.

Answer to Question 2

Answer: D

Accountability is accepting responsibility and the consequences of one's actions. By taking the responsibility for the mistake, the nurse is accountable with the physician as well as the client and provides accurate documentation of the action. Reliability implies that the nurse is dependable, such as arriving at work in a timely fashion. Social justice is upholding moral, legal, and humanistic principles. Human dignity is respect for the worth and uniqueness of individuals and populations.