An adolescent asks a nurse conducting an assessment interview, "Why should I tell you anything? You'll just tell my parents whatever you find out." Which response by the nurse is appropriate?
a. "That isn't true. What you tell us is private and held in strict confidence. Your parents have no right to know."
b. "Yes, your parents may find out what you say, but it is important that they know about your problems."
c. "What you say about feelings is private, but some things, like suicidal thinking, must be reported to the treatment team."
d. "It sounds as though you are not really ready to work on your problems and make changes."
ANS: C
Adolescents are very concerned with confidentiality. The patient has a right to know that most information will be held in confidence but that certain material must be reported or shared with the treatment team, such as threats of suicide, homicide, use of illegal drugs, or issues of abuse. The incorrect responses are not true, will not inspire the confidence of the patient, or are confrontational.
You might also like to view...
A patient with paraplegia tells the nurse that paraplegia has some advantages. What are some secondary gains to which the patient may be referring? Select all that apply
1. Attention 2. Sympathy 3. Personal services 4. Disability benefits 5. Escape from some responsibilities
What specific precaution would you teach the family of a patient prescribed amantadine?
a. "Be sure that the patient performs mouth care four to six times daily." b. "Remind the patient that monthly follow-up lab tests will be needed." c. "Contact the prescriber immediately for any worsening of depression or thoughts of suicide." d. "Ensure that the patient takes in at least 1000 mL more fluids that he or she puts out."
A patient is told that a baseline electrocardiogram (ECG) is necessary before surgery. Which of the following instructions by the nurse is best?
1. "You will need to have nothing to eat or drink for 4 hours before the test." 2. "The test involves attaching 10 small electrodes to your chest, arms, and legs to measure electrical impulses of your heart." 3. "After they attach a number of wires to your body, you will feel a small jolt of electricity." 4. "You will not be able to drive for at least 6 hours after the test, so it is important to have someone along with you to provide transportation."
In each of the following situations, identify which option has the highest risk for HIV transmission?
a. Transmission to women OR to men during sexual intercourse b. hollow-bore needle used for vascular access OR used for IM injections c. first 2 to 6 months of infection OR 1 year after infection d. perinatal transmission from HIV-infected mothers taking antiretroviral therapy OR HIV infected mothers using no therapy e. a splash exposure of HIV infected blood on skin with an open lesion OR a needle-stick exposure to HIV infected blood