A pregnant woman has just tested HIV-positive. She asks how she should tell her boyfriend. What is the most appropriate response by the practical nurse?

• A. Is there a chance you got HIV from your boyfriend?
• B. You do not have AIDS; let's talk about being HIV-positive.
• C. It is more important at this time to think about protecting your baby from HIV.
• D. He will have to know you are HIV-positive; let's talk about how to tell him.

Answer: (D)

The main idea is to support the patient in disclosing her HIV status to her partner in a way that protects her safety and autonomy while giving the partner the information they need. The best response recognizes that the partner has a right to know and offers to help her plan how to tell him, rather than making the disclosure for her or withholding information.

This approach respects confidentiality and patient empowerment. The nurse’s role is to guide and support, not to decide or disclose on the patient’s behalf. By offering to discuss how to tell him, the nurse helps the patient choose a respectful, honest, and practical approach, and can include topics like what to say, when and where to talk, and what information to share (such as the fact of HIV-positive status, treatment, and how this affects transmission risk). It also opens the door to discussing safety, emotional support, and steps to protect both partner and baby, such as adherence to antiretroviral therapy to reduce transmission risk.

Context that helps understanding: informing partners enables informed decisions about testing and safer practices, and it allows the partner to seek testing and care promptly. The nurse should acknowledge the patient’s concerns, assess any safety considerations, and provide resources for counseling and support.

If you’re comparing with other ideas, those options don’t focus on planning a patient-led disclosure or on providing supportive guidance for telling a partner, and some could undermine autonomy or confidentiality.