# The charge nurse reviews communication events from the shift. Which events require follow-up to protect client confidentiality? Highlight the events that do not use appropriate privacy safeguards.

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> subject: Assignment/Delegation/Supervision  
> category: MOC

## Question

The charge nurse reviews communication events from the shift. Which events require follow-up to protect client confidentiality? Highlight the events that do not use appropriate privacy safeguards.

| Communication setting | Documented event |
| --- | --- |
| Bedside report | The outgoing nurse reports current treatment details to the receiving nurse. |
| Health information office | The client requests an electronic copy of the client's own record. |
| Unit hallway | A staff member posts a celebration photo with the client name board visible. |
| Public health report | The nurse sends required disease data through the approved reporting portal. |
| Telephone handoff | The nurse verifies the receiving clinician before discussing the care plan. |
| Electronic record | A nurse opens a neighbor's chart out of curiosity while off duty. |
| Interpreter visit | An authorized interpreter receives the details needed for today's teaching. |
| Public elevator | A nurse tells a friend about the client's diagnosis and room number. |
| Quality review | The committee reviews limited case data through the protected quality system. |

## Explanation

Follow up on unnecessary chart access, a photo that exposes identifiers, and a public conversation with a friend. Treatment communication and permitted reporting use protected information for an authorized purpose.

## In-depth explanation

Quick answer
Follow up on the hallway photo with a visible name board, the nurse opening a neighbor's chart out of curiosity, and the elevator discussion with a friend. Each event exposes protected information without a care-related or authorized purpose.

Why this is correct
Privacy protection depends on both purpose and safeguards. Workforce access should match job duties, and conversations or images should not expose identifiable health information to people who are not involved in care or otherwise authorized. Treatment handoffs, a client's own record request, and disclosures required by law follow different permitted pathways.[2]

Easy analogy or mental picture
Think of the health record as a keycard-controlled room. A care role or valid permission opens only the door needed for the task; curiosity or a casual conversation does not create a key. The analogy is about access control, not about withholding information needed for treatment.

Memory hook
Purpose, permission, protection: all three must fit before information moves.

NCLEX decision rule
When health information is shared, first identify the recipient and purpose, then ask whether access is authorized and reasonable safeguards are present. Do not label necessary treatment communication as a breach merely because clinical details are discussed.

Why the other choices are wrong
The other events involve the client, a clinician receiving information for treatment, a required public-health report, an interpreter participating in care, or a quality process using limited data. Those events still require facility safeguards, but the displayed facts do not show the same unauthorized access or public disclosure.References

- [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

- [2]HHS: Summary of the HIPAA Privacy RuleU.S. Department of Health and Human Services

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