# A nurse is reviewing actions related to the Patient Bill of Rights for a client newly admitted to the medical-surgical unit. Which actions are consistent with respecting client rights? Select all that apply. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=364705&lang=en > language: en > subject: Client Rights > category: MOC ## Question A nurse is reviewing actions related to the Patient Bill of Rights for a client newly admitted to the medical-surgical unit. Which actions are consistent with respecting client rights? Select all that apply. 1 Limit medical record access because the client has not yet paid the admission deposit 2 Discuss the prognosis with the spouse first before sharing the information with the client 3 Honor the client refusal of a recommended procedure after risks have been explained by the surgeon 4 Document the informed refusal and the teaching provided, following facility policy for any refusal form. 5 Provide a written copy of the Patient Bill of Rights at admission and review key points ## Explanation Clients have the right to receive information, participate in decisions, refuse treatment, obtain access to their records within applicable rules, and have privacy protected. The nurse should honor an informed refusal, document the decision and teaching, follow facility policy for any refusal form, and provide the written notice of rights. An Against Medical Advice discharge form is not automatically required for refusal of one procedure. Sharing prognosis with a spouse before the capable client authorizes it violates autonomy and confidentiality, and payment status does not erase record-access rights. ## In-depth explanation Clinical Judgment Patient Bill of Rights pillars: information, autonomy, confidentiality, privacy, refusal, complaint resolution. The right to refuse treatment is grounded in autonomy. Discussion of prognosis must center the client first. Payment status does not modify rights to care or records. Memory Tip Rights = Information + Autonomy + Confidentiality + Refusal — payment never gates rights KR vs US AHA Patient Bill of Rights (1973, updated as Patient Care Partnership 2003) and Korean Medical Service Act article 4-2 share the same core rights. Both jurisdictions prohibit conditioning emergency care on payment. ## Clinical scenario Clinical Practice Guide Joint Commission + AHA Patient Care Partnership: - Information: clear explanation of diagnosis, treatment, prognosis, alternatives - Choice: informed consent and the right to refuse - Privacy and confidentiality: per HIPAA and state law - Care planning: client and family involvement - Discharge planning: timely, with home services as needed - Complaint resolution: ethics committee, patient advocate, ombudsman - Billing transparency: separate from care delivery Caution Refusal of life-saving care by a competent adult must be honored even when the team disagrees. Document capacity assessment, risk-benefit discussion, AMA form, and follow-up plan. Continue to offer support and re-engage; do not abandon the client. ## Key concepts - **Patient Bill of Rights** — AHA-published statement of client rights including information, autonomy, refusal, confidentiality, complaint resolution. Required to be communicated at admission. Updated as the Patient Care Partnership in 2003. - **Right to refuse treatment** — Competent adult right grounded in autonomy and the doctrine of informed consent. Includes the right to leave Against Medical Advice. Requires capacity assessment, full risk-benefit explanation, signed AMA form, and continued offer of support. - **Confidentiality** — HIPAA (US) and Korean Personal Information Protection Act protected client right. Information may be shared only for treatment, payment, operations, or with explicit authorization. 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