Question

The new nursing supervisor for several units in the hospital surveys the physical structure of each setting. Which observations MOST concern the nurse?

  • 1. An open trashcan is next to the copier on each unit.
  • 2. Computer monitor screens face into the nursing station on each unit.
  • 3. There is a computer printer on each unit.
  • 4. Computer terminals at point-of-care have key locks.

Answer

The wording, "MOST concerned" is typical of the NCLEX-RN® examination and indicates an incorrect action. You have to read the answers to determine what the question is asking and determine what is an incorrect action regarding client confidentiality and the use computers.

We teach the Decision Tree which is based on clinical judgment. Critical thinking is used in clinical judgment. Critical thinking requires the nurse to identifying patterns. What pattern do you see in the answer choices? All of these answers are implementations. Since the question refers to confidentiality and computers, Maslow and the ABCs do not fit. You must evaluate the outcome of each answer choice.

The new nursing supervisor for several units in the hospital surveys the physical structure of each setting. Which observations MOST concern the nurse?

1. An open trashcan is next to the copier on each unit.

CORRECT – copies of patient health information can be discarded into these trash cans and easily read by unauthorized persons, thus breaking confidentiality; secure disposal containers or shredders should be adjacent to copiers; these containers could be used for all papers containing patient health information, whether photocopied, printed from a computer, or even written on a nursing activities work list from daily assignments.

2. Computer monitor screens face into the nursing station on each unit.

Not of concern; helps prevent breaches in patient confidentiality.

3. There is a computer printer on each unit.

Not of concern; if printers are shared by units, unauthorized persons might read printouts; open trash can next to copier is priority

4. Computer terminals at point-of-care have key locks.

Not of concern; key locks provide an extra measure of security to provide unauthorized persons from accessing data; individual passwords and identification codes are other basic safeguards, as is a computer system that 'times out' after a certain period of time when it is not being used.

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