An older adult client is brought to an urgent care clinic by her paid in-home caregiver for a suspected UTI. The client has bruising to the left side of her face and appears fearful when her caregiver makes sudden movements. Which priority action should the nurse take first?
Notify adult protective services about possible elder abuse by the caregiver.
Have the caregiver stay in the waiting area while the client is brought into a room for assessment.
Contact the caregiver's employment agency to report the suspicion of abuse.
Ask the patient how the injury occurred and observe the caregiver's reaction.
The Correct Answer is B
A. This action is crucial if there is a suspicion of elder abuse, as adult protective services (APS) can investigate the situation thoroughly and take necessary measures to protect the client. However, before making such a notification, it is important to assess the immediate safety of the client and gather preliminary information.
B. This is a prudent initial action to ensure that the client is in a safe environment away from the caregiver, who may be the suspected abuser. It allows the nurse to conduct a private and thorough assessment of the client without the potential influence or intimidation from the caregiver. This step is critical for ensuring the client's safety and obtaining unbiased information.
C. While reporting to the caregiver’s employment agency may be a step in the process, it is not the immediate priority. The primary focus should be on ensuring the client’s safety and assessing the situation before contacting external agencies.
D. While it is important to gather information about how the injury occurred, the immediate priority is to ensure the client's safety and provide an opportunity for a private assessment. The presence of the caregiver during this conversation could influence the client's responses or cause additional stress.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.4"]
Explanation
Volume to administer = (Desired Dose) / (Concentration of available medication). The desired dose is 2,000 units, and the concentration available is 5,000 units/mL. Using the formula, you get 2,000 units / 5,000 units/mL = 0.4 mL.
Therefore, the nurse should administer 0.4 mL of heparin injection to deliver a dose of 2,000 units.
Correct Answer is B
Explanation
A. Amlodipine is a calcium channel blocker used to manage hypertension. It is not associated with an increased risk of osteoarthritis. While hypertension itself is a health concern, amlodipine does not directly contribute to the development of OA.
B. Prednisone is a corticosteroid that can lead to various side effects, including bone loss and osteoporosis with long-term use. Although osteoporosis and OA are different conditions, long-term use of corticosteroids can potentially increase the risk of joint issues and contribute to the development or exacerbation of OA due to the impact on joint cartilage and bone density.
C. Warfarin is an anticoagulant used to prevent blood clots in atrial fibrillation. It is not directly associated with an increased risk of osteoarthritis. The primary concerns with warfarin involve bleeding risks rather than joint health.
D. Being Caucasian and having multiple children do not directly contribute to an increased risk of osteoarthritis.
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