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Difficulty: EasyConfidentiality and Information Security

An emergency department nurse is evaluating a 14-year-old client who privately discloses being frequently struck by a household member. The client pleads with the nurse to keep this information a secret. Which of the following actions must the nurse take?

  1. Notify the designated child welfare or protective services agency about the disclosure.Answer
  2. B
    Promise to keep the disclosure private to maintain the client's trust and prevent them from leaving.
  3. C
    Confront the adults in the waiting room to verify the accuracy of the client's statements.
  4. D
    Delegate the continuous monitoring of the client's emotional state to an unlicensed assistive personnel (UAP).

Answer

Notify the designated child welfare or protective services agency about the disclosure.
In nursing practice, client confidentiality is a fundamental right; however, there are strict legal exceptions to this rule. All 50 states mandate that healthcare professionals report suspected child abuse or neglect to the appropriate child welfare or protective services agency. Ensuring the safety of a vulnerable minor legally and ethically supersedes the client's request for secrecy.

Step-by-Step Solution

1
Identify the conflict between the client's request for confidentiality and the nurse's legal mandates.
The client requests secrecy regarding physical abuse, but child abuse falls under mandatory reporting laws.
Nurses must recognize legal exceptions to standard confidentiality and HIPAA regulations.
2
Determine the priority nursing intervention.
The nurse must report the suspected abuse to the appropriate authorities.
Protecting a vulnerable minor from harm supersedes the general rule of maintaining client confidentiality.

Key Concept

Exceptions to Confidentiality: Mandatory Reporting
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Topics

Confidentiality and Information Security

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