. NR548 Week 8
John's sister calls the PMHNP to discuss her concerns that John is under a lot of stress
and may be showing signs of psychosis. John has not permitted the PMHNP to speak
with his sister as they are estranged, and John has asked the PMHNP not to share
information.
Is it acceptable for the PMHNP to share information about John's status with his sister?
- CORRECT ANSWER-No
Rationale: The HIPAA Privacy Rule permits a health care provider to disclose
information to the family members of an adult client who has the capacity and indicates
that he or she does not want the disclosure made, only to the extent that the provider
perceives a serious and imminent threat to the health or safety of the client or others
and the family members are in a position to lessen the threat. Otherwise, under HIPAA,
the provider must respect the wishes of the adult client who objects to the disclosure.
Is it permissible for the PMHNP to listen to the sister's concerns without sharing
information? - CORRECT ANSWER-Yes
Rationale: HIPAA in no way prevents health care providers from listening to family
members or other caregivers who may have concerns about the health.
John's mother recently had a stroke and is in the neuro intensive care unit (ICU). With
his mother out of the home, John has forgotten to take his medications for over a week.
He begins to experience hallucinations and paranoia. At his appointment with the
PMHNP, he threatens to harm his sister.
To whom should the PMHNP disclose this information (select all that apply):
-John's sister
-John's mother's nurse in the neuro ICU
-Law enforcement near the sister's home
-A social worker from the Board of Developmental Disabilities who has been working
with the family - CORRECT ANSWER--John's sister
-Law enforcement near the sister's home
-A social worker from the Board of Developmental Disabilities who has been working
with the family
Rationale: The Privacy Rule permits a health care provider to disclose necessary
information about a client to law enforcement, family members of the client, or other
persons when the provider believes the client presents a serious and imminent threat to
self or others. Specifically, when a health care provider believes in good faith that such
a warning is necessary to prevent or lessen a serious and imminent threat to the health
or safety of the client or others, the Privacy Rule allows the provider, consistent with
, applicable law and standards of ethical conduct, to alert those persons whom the
provider believes are reasonably able to prevent or lessen the threat.
Informed Consent - CORRECT ANSWER-for care and treatment is a fundamental
ethical and legal principle
-respects the client's autonomy in medical decision-making
-Clients have the right to receive information and ask questions about recommended
treatments so they can make decisions about their care that are consistent with their
beliefs, values, and goals of treatment
-Clients have the right to knowledge about their treatment under "reasonable
practitioner" or "reasonable person" standards under U. S. law.
-may change over time and in different circumstances
• is an ongoing process
Health Insurance Portability and Accountability Act (HIPAA) - CORRECT ANSWER-
provides a legal framework for handling client information
-HIPAA rules help protect the privacy of the client's identifiable health information while
facilitating communication among providers and other entities
• ensure information is available for treatment and other purposes such as insurance
benefits
-health professionals may be held legally liable by state and federal law for breaching
confidentiality
Release of Information - CORRECT ANSWER--HIPAA guides the PMHNP in making
decisions about when to share information based on their professional judgment to
prevent harm
• may be necessary for providers to share mental and behavioral health information to
enhance treatment or ensure the health and safety of the client and others
-PMHNPs are mandatory reporters in cases of suspected child abuse
Duty to Warn - CORRECT ANSWER-exception to requirements for confidentiality
-Most states have laws that allow mental health professionals to share information
about clients who may become violent
-several states, it is even mandatory for providers to report when clients may pose a
danger to themselves or others
John is a 36-year-old with a diagnosis of schizophrenia. He lives with his mother. His
symptoms are currently well managed by medications; however, he sometimes forgets
to take them. At the visit with the PMHNP, John asks the PMHNP to go over his
medication regimen with his mother.
Is this allowed under HIPAA? - CORRECT ANSWER-Yes
Rationale: In situations where the client is given the opportunity and does not object,
HIPAA allows the provider to share or discuss the client's mental health information with
family members or other persons involved in the client's care or payment for care
John's sister calls the PMHNP to discuss her concerns that John is under a lot of stress
and may be showing signs of psychosis. John has not permitted the PMHNP to speak
with his sister as they are estranged, and John has asked the PMHNP not to share
information.
Is it acceptable for the PMHNP to share information about John's status with his sister?
- CORRECT ANSWER-No
Rationale: The HIPAA Privacy Rule permits a health care provider to disclose
information to the family members of an adult client who has the capacity and indicates
that he or she does not want the disclosure made, only to the extent that the provider
perceives a serious and imminent threat to the health or safety of the client or others
and the family members are in a position to lessen the threat. Otherwise, under HIPAA,
the provider must respect the wishes of the adult client who objects to the disclosure.
Is it permissible for the PMHNP to listen to the sister's concerns without sharing
information? - CORRECT ANSWER-Yes
Rationale: HIPAA in no way prevents health care providers from listening to family
members or other caregivers who may have concerns about the health.
John's mother recently had a stroke and is in the neuro intensive care unit (ICU). With
his mother out of the home, John has forgotten to take his medications for over a week.
He begins to experience hallucinations and paranoia. At his appointment with the
PMHNP, he threatens to harm his sister.
To whom should the PMHNP disclose this information (select all that apply):
-John's sister
-John's mother's nurse in the neuro ICU
-Law enforcement near the sister's home
-A social worker from the Board of Developmental Disabilities who has been working
with the family - CORRECT ANSWER--John's sister
-Law enforcement near the sister's home
-A social worker from the Board of Developmental Disabilities who has been working
with the family
Rationale: The Privacy Rule permits a health care provider to disclose necessary
information about a client to law enforcement, family members of the client, or other
persons when the provider believes the client presents a serious and imminent threat to
self or others. Specifically, when a health care provider believes in good faith that such
a warning is necessary to prevent or lessen a serious and imminent threat to the health
or safety of the client or others, the Privacy Rule allows the provider, consistent with
, applicable law and standards of ethical conduct, to alert those persons whom the
provider believes are reasonably able to prevent or lessen the threat.
Informed Consent - CORRECT ANSWER-for care and treatment is a fundamental
ethical and legal principle
-respects the client's autonomy in medical decision-making
-Clients have the right to receive information and ask questions about recommended
treatments so they can make decisions about their care that are consistent with their
beliefs, values, and goals of treatment
-Clients have the right to knowledge about their treatment under "reasonable
practitioner" or "reasonable person" standards under U. S. law.
-may change over time and in different circumstances
• is an ongoing process
Health Insurance Portability and Accountability Act (HIPAA) - CORRECT ANSWER-
provides a legal framework for handling client information
-HIPAA rules help protect the privacy of the client's identifiable health information while
facilitating communication among providers and other entities
• ensure information is available for treatment and other purposes such as insurance
benefits
-health professionals may be held legally liable by state and federal law for breaching
confidentiality
Release of Information - CORRECT ANSWER--HIPAA guides the PMHNP in making
decisions about when to share information based on their professional judgment to
prevent harm
• may be necessary for providers to share mental and behavioral health information to
enhance treatment or ensure the health and safety of the client and others
-PMHNPs are mandatory reporters in cases of suspected child abuse
Duty to Warn - CORRECT ANSWER-exception to requirements for confidentiality
-Most states have laws that allow mental health professionals to share information
about clients who may become violent
-several states, it is even mandatory for providers to report when clients may pose a
danger to themselves or others
John is a 36-year-old with a diagnosis of schizophrenia. He lives with his mother. His
symptoms are currently well managed by medications; however, he sometimes forgets
to take them. At the visit with the PMHNP, John asks the PMHNP to go over his
medication regimen with his mother.
Is this allowed under HIPAA? - CORRECT ANSWER-Yes
Rationale: In situations where the client is given the opportunity and does not object,
HIPAA allows the provider to share or discuss the client's mental health information with
family members or other persons involved in the client's care or payment for care
