A public health nurse is assessing an older adult client who lives with a family member.
The nurse identifies several bruises in various stages of healing. The client and family members explain that the bruises are a result of clumsiness. However, based on the distribution of the bruises, the nurse suspects abuse.
Which of the following actions should the nurse take first?
Investigate further to confirm the suspicion.
Report the findings.
Provide the client with a crisis hotline number.
Discuss respite care with the client’s family.
The Correct Answer is B
The nurse has a legal and ethical obligation to report any suspected abuse of a vulnerable client, such as an older adult. Reporting the findings is the first action the nurse should take to protect the client and initiate an investigation by the appropriate authorities.
Choice A is wrong because investigating further to confirm the suspicion is not within the nurse’s scope of practice and could delay the reporting process.
Choice C is wrong because providing the client with a crisis hotline number is not enough to ensure the client’s safety and well-being.
The client might not be able to access the hotline or might be afraid to use it.
Choice D is wrong because discussing respite care with the client’s family is not appropriate at this stage.
The nurse should not assume that the family member is willing or able to provide adequate care for the client.
Respite care might be an option after the abuse is reported and investigated.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D","E"]
Explanation
These are some of the criteria used to assist in making the diagnosis of chronic fatigue syndrome (CFS) according to the Institute of Medicine (IOM) 2015 report.
Choice B is wrong because recent exposure to influenza is not a criterion for CFS diagnosis. Although some cases of CFS may be triggered by viral infections, such as Epstein-Barr virus or human herpes virus 6, there is no specific evidence that influenza causes CFS.
Choice A is correct because CFS is not caused by a primary condition. CFS is a diagnosis of exclusion, meaning that other possible causes of fatigue, such as sleep disorders, anemia, diabetes, thyroid problems, or mental health issues, must be ruled out before making the diagnosis.
Choice C is correct because unrefreshing sleep is one of the required symptoms for CFS diagnosis. Patients with CFS may not feel better or less tired even after a full night of sleep despite the absence of specific objective sleep alterations. Choice D is correct because fatigue that is not relieved by stress reduction is another required symptom for CFS diagnosis. Patients with CFS experience post-exertional malaise (PEM), which means that their symptoms worsen after physical, mental, or emotional exertion that would not have caused a problem before the illness.
Choice E is correct because severe tiredness for 2 months or more is one of the additional manifestations that must be present for CFS diagnosis. The IOM 2015 report states that the fatigue associated with CFS must last for more than 6 months and occur at least half the time at moderate, substantial or severe intensity.
Correct Answer is A
Explanation
This helps increase the oxygen-carrying capacity of the blood and corrects anemia.
Choice B is wrong because erythropoietin is not given to all people with anemia. It is only used for certain types of anemia, such as those caused by chronic kidney disease or chemotherapy.
Choice C is wrong because erythropoietin is not given for iron deficiency anemia. Iron deficiency anemia is treated with iron supplements and dietary changes.
Choice D is wrong because erythropoietin does not stimulate bone marrow production of white blood cells. White blood cells are involved in immune responses and are produced by different growth factors.
Question 22.
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