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NCLEX-RN Confidentiality and HIPAA practice questions

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These are original practice items written to the NCLEX-RN blueprint (4 options, no penalty for wrong answers), not actual exam questions. Try each one before you open the answer.

What this topic covers

Confidentiality and HIPAA sits inside the Management of Care category of the NCLEX-RN. Our bank holds 33 verified items tagged to it, and the 4 below are a fixed sample so the page stays the same every time you open it. Each one shows the reasoning, not just the letter.

The topic tag comes from our own items rather than from a published syllabus, so treat it as a map of what we cover. For the official category breakdown see the NCLEX-RN page.

Confidentiality and HIPAA sample questions

Question 1

A nurse is working at a clinic and receives a phone call from a person who identifies themselves as the spouse of a client. The caller asks for the client's laboratory results. The client has not signed a release of information form. Which response by the nurse is most appropriate?

  1. A Explain that the information cannot be disclosed without the client's written authorization.
  2. B Ask the caller to come to the clinic in person to receive the information.
  3. C Provide the results because the caller is the client's spouse and has a right to know.
  4. D Transfer the call to the client's healthcare provider for further discussion.
Show the answer and explanation

Correct answer: A

HIPAA prohibits releasing protected health information, even to a spouse, without the client's authorization. The nurse should explain that the results cannot be shared without the client's permission.

Why the other options are wrong:
B: Coming in person does not change the lack of authorization.
C: Being married does not give a spouse the right to the client's health information.
D: The provider is bound by the same privacy rules, so transferring the call does not solve the problem.

Question 2

A nurse is working on a surgical unit and receives a phone call from a person who states they are the client's spouse and asks for the client's laboratory results. The client's medical record lists the spouse as an emergency contact, but the client has not signed a release of information for the spouse. Which response by the nurse is most appropriate?

  1. A Ask for the spouse's name and date of birth, then provide the results if they match
  2. B Explain that the information cannot be disclosed without the client's written consent
  3. C Transfer the call to the client's room so the spouse can speak directly with the client
  4. D Provide the laboratory results since the caller is the emergency contact
Show the answer and explanation

Correct answer: B

The correct answer is to explain that the information cannot be disclosed without the client's written consent. HIPAA regulations require a specific authorization for release of protected health information, even to a spouse, unless the client has given explicit permission. Being an emergency contact does not give automatic access to clinical data. Providing the results (the option "Provide the laboratory results since the caller is the emergency contact" violates HIPAA. Asking for verification (the option "Ask for the spouse's name and date of birth, then provide the results if they match" is insufficient; identity verification does not override the need for consent. Transferring the call to the client's room (the option "Transfer the call to the client's room so the spouse can speak directly with the client" may be a courtesy, but it does not address the disclosure of laboratory results and could still involve the nurse in an unauthorized release if the client is unable to consent.

Question 3

A nurse receives a phone call from a person who identifies himself as the client's brother and asks about the client's diagnosis and treatment plan. The client has not authorized release of information to family members. What should the nurse do?

  1. A Tell the caller that information cannot be released without the client's authorization
  2. B Verify the caller's identity by asking for his date of birth before sharing details
  3. C Ask the client's assigned physician to speak with the caller about the diagnosis
  4. D Share only the client's general condition without giving specific diagnosis details
Show the answer and explanation

Correct answer: A

The client has not authorized release of information to family, so under HIPAA the nurse must not disclose the diagnosis or treatment plan to the caller. The nurse should tell the caller that information cannot be shared without the client's permission.

Why the other options are wrong:
B: Verifying identity does not create authorization; even a confirmed brother has no right to the information without consent.
C: The physician is bound by the same confidentiality rules, so referring the call does not solve the problem.
D: Sharing even general condition details without authorization is an unauthorized disclosure.

Question 4

A nurse is working at a long-term care facility and receives a telephone call from a person who identifies herself as the daughter of a resident. The caller asks for the resident's current medications and diagnosis. The nurse has not previously met this daughter and does not have the resident's consent on file to release information. Which response by the nurse is appropriate?

  1. A Ask the caller to provide the resident's date of birth and social security number to verify identity before giving information.
  2. B Provide the information because the caller claims to be the daughter and has a right to know the resident's health status.
  3. C Inform the caller that information cannot be disclosed without the resident's written authorization or documented consent.
  4. D Transfer the call to the facility's social worker who can determine whether to release the information over the phone.
Show the answer and explanation

Correct answer: C

Under HIPAA, a nurse cannot disclose protected health information to a family member without the client's written authorization or documented consent, even if the caller claims to be a relative. Providing the information based solely on the caller's claim (the option "Provide the information because the caller claims to be the daughter and has a right to kn..." violates HIPAA privacy rules. Asking for personal identifiers (the option "Ask the caller to provide the resident's date of birth and social security number to verif..." does not constitute valid authorization, as verification alone does not satisfy HIPAA's requirement for consent. Transferring the call to a social worker (the option "Transfer the call to the facility's social worker who can determine whether to release the..." still does not resolve the lack of consent and may inadvertently allow unauthorized disclosure. The correct response is to inform the caller that the information cannot be released without proper authorization, protecting the resident's confidentiality rights.

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