CNM Certified Nurse Midwife

Category - Professional Issues

A 43-year-old female client who is about to get married comes to the clinic with her boyfriend for a series of fertility tests. The client’s boyfriend used to be the nurse midwife’s patient from another facility, and the nurse midwife is certain that he tested positive for HIV. The client is unaware of her boyfriend’s diagnosis. The nurse midwife talks to the boyfriend in private, and, although he acknowledges that that he used to be her patient, he denies that he tested positive for HIV and refuses to talk to his girlfriend about his diagnosis. What should the nurse midwife’s next action be?
  1. Decide not to inform the client but document that an attempt was made to convince the boyfriend to reveal the diagnosis to the female client.
  2. Inform the female client that her boyfriend has HIV.
  3. Obtain information from the boyfriend’s past medical record without his permission.
  4. Urge the female client to persuade her boyfriend to get an HIV test with her.
Explanation
Answer: D - The next action of the nurse is to urge the female client to persuade her boyfriend to have an HIV test with her. This action may be supported by educating the client about the effects, risks and treatment options of HIV. The nurse midwife has the duty to protect the health of the female client, but she also has to respect the boyfriend’s privacy. Urging the client to persuade her boyfriend to take the test with her is ethical. There are certain situations in which the nurse midwife has the legal duty to report cases that threaten public safety. The nurse may inform the female client about the boyfriend’s diagnosis if she has attempted to resolve this issue through all other possible means.
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