HESI Registered Nurse EXIT Practice Exam

If a client states they have important information to share and asks for confidentiality, how should the nurse respond?

1. I must document and report any information disclosed.

2. I cannot make such a promise of confidentiality.

3. It depends on the nature of the information.

4. I must report all information to the treatment team.

The correct answer is: I cannot make such a promise of confidentiality.

When a client expresses the need for confidentiality while sharing important information, the nurse's response of indicating that they cannot guarantee confidentiality is grounded in the principles of ethical nursing practice and legal obligations. Nurses are required to maintain a professional boundary with clients, which includes understanding the limits of confidentiality. This response highlights that while nurses strive to create a safe environment for patients to share information, there are certain situations—such as when there is a risk of harm to the patient or others, or if there is evidence of abuse—where confidentiality cannot be upheld. Legally and ethically, nurses must balance a client's right to confidentiality with their duty to protect the client and others. This rule not only empowers clients to share their experiences but also informs them about potential limitations that may arise during their care. The other options imply different approaches that do not fully address the essential nature of patient confidentiality and the responsibility of the nurse to inform patients about the limitations of that confidentiality. Therefore, indicating the impossibility of making an absolute promise of confidentiality accurately reflects the complexities involved in the nurse-client relationship and ensures that patients are fully aware of how their information might be handled, especially in sensitive situations.