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Difficulty: MediumLegal and Ethical Practice

An adult client is scheduled for an elective bronchoscopy. The provider has not yet visited the room to discuss the procedure. The client's spouse, who is not the designated healthcare proxy, approaches the practical nurse (PN) in a public corridor and asks, "Can you explain exactly what they will do during this test and what the risks are?" Which action should the PN take?

  1. Inform the spouse that the client must give permission to share medical details, and notify the provider to speak with them.Answer
  2. B
    Describe the procedural steps and associated risks to the spouse to alleviate their anxiety before the provider arrives.
  3. C
    Open the electronic health record on a mobile workstation in the hallway to show the spouse the procedural order.
  4. D
    Delegate the task of reviewing the standard preoperative educational brochure with the spouse to an unlicensed assistive personnel.

Answer

The correct action is to inform the spouse that the client must give permission to share medical details, and to notify the provider to speak with them.
This action upholds client confidentiality by requiring explicit permission before releasing medical information. It also correctly identifies that discussing the specifics of a medical procedure and its inherent risks falls strictly under the provider's legal responsibility for informed consent.

Step-by-Step Solution

1
Identify the primary legal and ethical issues presented in the scenario.
The scenario involves client confidentiality, scope of practice regarding informed consent, and appropriate task delegation.
Understanding the multiple domains of nursing practice being tested is essential to selecting the safest action.
2
Evaluate the request for information against confidentiality regulations.
Sharing specific medical information with a spouse without the client's explicit consent violates confidentiality laws.
Unless the spouse is the designated healthcare proxy and the client is incapacitated, the client holds the right to privacy.
3
Assess the PN's scope of practice regarding the spouse's request for risk explanation.
Explaining procedural risks falls under the provider's responsibility for obtaining informed consent, not the PN's role.
The PN may witness a consent signature but cannot legally initiate the disclosure of risks and alternatives.
4
Determine the most appropriate professional response.
The PN must protect the client's privacy and contact the provider to fulfill the informed consent requirements.
This comprehensively addresses both the ethical duty of confidentiality and the legal duty of adhering to scope of practice.

Key Concept

Legal and Ethical Practice Boundaries (Confidentiality and Consent)
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Topics

Legal and Ethical Practice

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