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Difficulty: MediumConfidentiality and Information Security

A registered nurse is evaluating a newly licensed nurse's understanding of confidentiality, information security, and legal mandates in the clinical setting. Which of the following actions by the newly licensed nurse demonstrate appropriate adherence to these principles? (Select all that apply.)

  1. Logging off the electronic workstation immediately before stepping away to assist a client.Answer
  2. Using a facility-approved, encrypted mobile device to send a text message to the physician regarding a client's status.Answer
  3. C
    Declining to notify child protective services about suspected child abuse to maintain strict confidentiality of the client's medical record.
  4. Refusing to provide a client's room number to a visitor who does not know the designated privacy passcode.Answer
  5. E
    Delegating the task of explaining the facility's privacy practices to unlicensed assistive personnel (UAP) prior to obtaining the client's signature.
  6. F
    Telling an unauthorized family member in the waiting room, 'I cannot share the specifics, but you have nothing to worry about.'

Answer

The correct actions are logging off the electronic workstation before stepping away, using a facility-approved encrypted device for clinical text messages, and requiring a designated privacy passcode before sharing the client's room number.
Appropriate adherence to confidentiality involves actively securing electronic information (logging off, using encrypted facility devices) and strictly enforcing privacy protocols (requiring passcodes). These actions ensure that protected health information (PHI) is only accessible to authorized individuals directly involved in the client's care.

Step-by-Step Solution

1
Analyze the stem to determine what is being asked.
The question requires selecting all actions that correctly align with HIPAA, information security, and legal/ethical mandates.
Identifying the core concepts ensures that both data security rules and legal exceptions are considered.
2
Evaluate the actions related to electronic and verbal data security.
Logging off the computer, using encrypted messaging, and strictly enforcing passcode policies actively protect protected health information (PHI) and are correct actions.
These actions prevent unauthorized access to physical and electronic health records.
3
Evaluate the action related to mandatory reporting.
Refusing to report child abuse is incorrect because mandatory reporting laws supersede general confidentiality protections.
Nurses are mandatory reporters, and withholding such information is a legal violation.
4
Evaluate the actions related to delegation and communication.
Delegating the explanation of privacy practices to UAP is outside their scope, and giving vague reassurances to unauthorized individuals is both a HIPAA violation and non-therapeutic.
Initial teaching must be done by the RN, and unauthorized individuals should not receive any updates, implicit or explicit.

Key Concept

Information security requires protecting electronic health records and physical data from unauthorized access, though nurses must also recognize legal exceptions to confidentiality, such as mandatory reporting of abuse.
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Topics

Confidentiality and Information Security

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