Claudia, a CMA, is working with Mr. Harrington in the examination room. Mr. Harrington is 73 years old and does not have any living immediate family members. His closest relative is a cousin who lives more than five hours away. Within the medical practice, Mr. Harrington has the reputation of being grouchy at times and has been known to lose his temper easily. Claudia is completing his vital signs and measurements, a required component of the physical examination document that must be returned to his life insurance company. Since his last visit five months ago, Mr. Harrington has gained 16 pounds. As Claudia is exiting the room, Mr. Harrington calls out, "Be sure to mark my weight on my physical form the same as it was on my last visit. They don't need to know I've gained any weight." Claudia replies, " I'm not sure I can do that, Mr. Harrington. I'll see what I can do."

Mr. Harrington responds by saying, "Nurse, I'm asking you politely. I don't want to get upset. Who cares about a mere 16 pounds? Just make that change, okay?"

Feeling pressured, Claudia exclaims, "First of all, I am a medical assistant and not a nurse. And secondly, I am not going to lie on your medical records. If you're concerned about your weight, you will need to talk with the doctor when he comes in to see you." With that, she turns out of the examination room and closes the door behind her.