Client Rights And Advocacy
Help Questions
NCLEX-PN › Client Rights And Advocacy
A 39-year-old client is admitted for injuries after a motor vehicle crash. A coworker visits and asks, "Was alcohol involved?" The client has not approved sharing any information. How should the nurse respond to a request for confidential information?
State that you cannot share any information without the client’s permission and redirect the visitor to speak with the client
Provide limited information since the visitor knows the client personally
Explain that the client’s blood alcohol level is private but share the diagnosis
Confirm the client is stable but decline to discuss details
Explanation
This question tests understanding of client rights and advocacy. The primary client right involved is confidentiality. The nurse should state that they cannot share any information without the client’s permission and redirect the visitor to speak with the client, fully protecting privacy. Option B provides unauthorized status; option C breaches selectively; and option D assumes relationship allows sharing. This adheres to the ethical principle of confidentiality. Legally, HIPAA requires safeguarding details. A transferable strategy for advocating client rights is to redirect inquirers to the client for direct communication.
A 74-year-old client with a valid DNR order is admitted to the hospital. During shift change, a family member tells the nurse, "Do everything—ignore that DNR." The client is sleeping and cannot participate at the moment. Which action should the nurse take to uphold client rights?
Agree to honor the family’s request to avoid conflict
Discuss the client’s prognosis and lab results with the family to help them accept the DNR
Explain that the care team must follow the existing DNR and notify the RN/charge nurse to address the family’s concerns
Shred the DNR form and request a new consent for full code
Explanation
This question tests understanding of client rights and advocacy. The primary client right involved is autonomy through advance directives. The nurse should explain that the care team must follow the existing DNR and notify the RN/charge nurse to address the family’s concerns, honoring the valid order. Option B concedes to family; option C destroys legal documents; and option D breaches confidentiality. This follows the ethical principle of fidelity to directives. Legally, DNRs are enforceable. A transferable strategy for advocating client rights is to educate families on directives and involve support for acceptance.
A 36-year-old client is admitted for observation after a seizure. The client’s employer calls and asks whether the client can return to work tomorrow. The client has not authorized release of information to the employer. How should the nurse respond to a request for confidential information?
State you cannot share any information without the client’s permission and refer the caller to the client for work-related updates
Provide the expected discharge date but not the diagnosis
Ask the employer to fax a request on company letterhead and then provide an update
Confirm the client had a seizure but is stable and being monitored
Explanation
This question tests understanding of client rights and advocacy. The primary client right involved is confidentiality. The nurse should state they cannot share any information without the client’s permission and refer the caller to the client for work-related updates, protecting health privacy from employers. Option A provides date; option C confirms details; and option D requires formal request that still breaches. This adheres to the ethical principle of confidentiality. Legally, HIPAA prevents employer disclosures. A transferable strategy for advocating client rights is to limit responses to non-medical referrals in professional inquiries.
A 77-year-old client has a POLST indicating DNR and no intubation. The client’s spouse states, "He didn’t mean it—put him on a ventilator if needed." The client is currently alert and nods when asked if the POLST still reflects their wishes. Which action should the nurse take to uphold client rights?
Avoid discussing the issue and wait until the client becomes unresponsive
Change the code status to full code because the spouse is the next of kin
Support the client’s expressed and documented wishes and notify the RN/charge nurse to address the spouse’s concerns
Tell the spouse the client is required to accept intubation in the hospital
Explanation
This question tests understanding of client rights and advocacy. The primary client right involved is autonomy through advance directives. The nurse should support the client’s expressed and documented wishes and notify the RN/charge nurse to address the spouse’s concerns, prioritizing the client's confirmation. Option B changes based on spouse; option C delays; and option D mandates treatment. This follows the ethical principle of autonomy. Legally, POLST forms are binding. A transferable strategy for advocating client rights is to confirm current wishes when conflicts arise.
A 55-year-old client is admitted for alcohol withdrawal monitoring. A friend calls and asks, "Is he detoxing again?" The client has not consented to release information. How should the nurse respond to a request for confidential information?
Ask the friend to verify the client’s date of birth, then provide an update
Confirm the client is on the unit but do not discuss the reason for admission
Tell the friend the client is stable and receiving medication for withdrawal
State you cannot confirm or deny the client’s presence or condition without permission and offer to take a message for the client
Explanation
This question tests understanding of client rights and advocacy. The primary client right involved is confidentiality. The nurse should state they cannot confirm or deny the client’s presence or condition without permission and offer to take a message for the client, fully upholding privacy. Option A confirms presence; option C discloses details; and option D requires verification that breaches. This upholds the ethical principle of confidentiality in sensitive cases. Legally, HIPAA protects substance-related information strictly. A transferable strategy for advocating client rights is to use neutral responses in unauthorized inquiries.
An 85-year-old hospice client has an advance directive stating comfort measures only and no hospitalization. The family insists on calling 911 for transfer to the hospital for IV antibiotics. The client is intermittently awake and appears uncomfortable. Which action should the nurse take to uphold client rights?
Tell the family they are not allowed to be present if they disagree with the plan
Review the advance directive and hospice plan with the family and notify the RN/hospice team to support care consistent with the client’s documented wishes
Arrange immediate transfer to the hospital because the family is requesting antibiotics
Ask the family to sign a new directive changing the plan to full treatment
Explanation
This question tests understanding of client rights and advocacy. The primary client right involved is autonomy through advance directives. The nurse should review the advance directive and hospice plan with the family and notify the RN/hospice team to support care consistent with the client’s documented wishes, prioritizing the plan. Option B overrides directives; option C excludes family; and option D seeks unauthorized changes. This aligns with the ethical principle of respecting end-of-life autonomy. Legally, hospice directives guide care. A transferable strategy for advocating client rights is to facilitate family discussions aligned with directives.
An 82-year-old client with a documented DNR order is admitted to a long-term care facility. The client’s adult son tells the nurse, "If Mom stops breathing, you must do CPR." The client is currently alert but fatigued. Which action should the nurse take to uphold client rights?
Ask the son to sign a form changing the code status to full code
Avoid discussing code status and refer the son to the billing office for paperwork questions
Tell the son you will do CPR because family wishes come first in emergencies
Explain that the facility will follow the client’s documented DNR and notify the RN/charge nurse of the family’s concerns
Explanation
This question tests understanding of client rights and advocacy. The primary client right involved is autonomy through advance directives. The nurse should explain that the facility will follow the client’s documented DNR and notify the RN/charge nurse of the family’s concerns, upholding the client's expressed wishes while addressing family dynamics. Option B prioritizes family over client wishes; option C allows unauthorized changes; and option D avoids the issue, neglecting advocacy. This follows the ethical principle of respecting autonomy via advance directives. Legally, DNR orders must be honored unless revoked by the client. A transferable strategy for advocating client rights is to honor documented directives and facilitate interdisciplinary discussions for family conflicts.
A 79-year-old client in a skilled nursing facility has an advance directive stating no feeding tube. The client’s daughter states, "You have to place a feeding tube—Dad would want to live." The client is now confused and cannot restate preferences. Which action should the nurse take to uphold client rights?
Tell the daughter the nurse will decide what is best for the client
Proceed with preparing the client for a feeding tube because the family is requesting it
Ask the daughter to sign consent for the feeding tube since the client is confused
Support the advance directive and report the conflict to the RN/charge nurse for care planning consistent with the documented wishes
Explanation
This question tests understanding of client rights and advocacy. The primary client right involved is autonomy through advance directives. The nurse should support the advance directive and report the conflict to the RN/charge nurse for care planning consistent with the documented wishes, prioritizing the client's prior instructions. Option B follows family over directive; option C allows unauthorized signing; and option D abdicates nursing judgment. This aligns with the ethical principle of fidelity to client wishes. Legally, advance directives are binding without client revocation. A transferable strategy for advocating client rights is to reference directives in conflicts and involve leadership for resolution.
A 28-year-old client is treated in an urgent care clinic for a sexually transmitted infection. The client’s parent arrives and demands, "I’m paying the bill—tell me what’s wrong." The client is an adult and has not consented to disclosure. How should the nurse respond to a request for confidential information?
Provide the diagnosis because the parent is financially responsible
Ask the parent to wait in the lobby while you discuss the diagnosis with other staff
State you cannot share information without the client’s permission and offer to bring the client in to decide what can be shared
Confirm the client was treated and prescribe information about the medication
Explanation
This question tests understanding of client rights and advocacy. The primary client right involved is confidentiality. The nurse should state they cannot share information without the client’s permission and offer to bring the client in to decide what can be shared, protecting adult privacy despite financial ties. Option A breaches based on payment; option C confirms treatment unauthorized; and option D delays inappropriately. This is based on the ethical principle of confidentiality for all competent adults. Legally, HIPAA applies regardless of payer. A transferable strategy for advocating client rights is to empower clients to direct information sharing in family inquiries.