Exhibits
Which intervention(s) should the practical nurse (PN) initiate if elder mistreatment is suspected? Select all that apply.
Throw away soiled clothing.
Report findings to Adult Protective Services.
Complete a comprehensive history.
Perform a thorough physical assessment.
Question the client in front of the suspected abuser.
Develop a safety plan.
Take photographs to document the abuse or neglect.
Confront the abuser about concerning actions.
Correct Answer : B,C,D,F,G
A. Throw away soiled clothing.
Not Applicable
Throwing away soiled clothing does not address the issue of elder mistreatment and may not be relevant to the investigation of abuse or neglect. Instead, the focus should be on assessing the situation, documenting evidence, and ensuring the client’s safety. The PN’s role includes observing signs of mistreatment and reporting them, not managing personal items.
B. Report findings to Adult Protective Services.
Applicable
Reporting to Adult Protective Services is crucial for initiating a formal investigation into suspected elder mistreatment. These agencies are equipped to handle allegations of abuse and neglect through professional investigation and intervention. This step ensures that the client receives the appropriate protection and that any mistreatment is addressed legally.
C. Complete a comprehensive history.
Applicable
A comprehensive history helps the PN understand the client’s background, current living conditions, and any potential patterns of mistreatment. This information is essential for identifying signs of abuse or neglect and for making an informed report to the appropriate authorities. It also assists in documenting the client’s experiences and concerns.
D. Perform a thorough physical assessment.
Applicable
A thorough physical assessment allows the PN to identify and document signs of physical abuse or neglect, such as injuries or unsanitary conditions. This documentation is important for supporting the findings in the report to Adult Protective Services and for planning further interventions. The assessment provides evidence of mistreatment and helps in evaluating the client’s overall well-being.
E. Question the client in front of the suspected abuser.
Not Applicable
Questioning the client in front of the suspected abuser can be unsafe and may lead to further mistreatment of the client. It is important to conduct these discussions privately to protect the client and obtain accurate information. The PN should gather information discreetly and report findings to the authorities without risking the client’s safety.
F. Develop a safety plan.
Applicable
Developing a safety plan is essential for ensuring the client’s immediate safety and preparing for any potential risks of mistreatment. This plan addresses how the client can be protected from further harm and outlines steps for seeking help if needed. It is a proactive measure to safeguard the client’s well-being.
G. Take photographs to document the abuse or neglect.
Applicable
Photographs serve as objective evidence of abuse or neglect, which is valuable for investigations by Adult Protective Services. Documenting visual evidence helps in assessing the severity of the mistreatment and supports the report made to authorities. It provides a clear record of conditions that might otherwise be subjective or difficult to convey.
H. Confront the abuser about concerning actions.
Not Applicable
Confronting the abuser can escalate the situation and put the client at further risk of mistreatment. This action should be handled by professionals trained to manage such situations. The PN’s role is to observe, document, and report findings rather than directly addressing the suspected abuser
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A, C, B, D
Explanation
A. Informing the client of the purpose of the medication is the first step. This action ensures that the client understands why they are receiving the medication and what it is intended to do.
C. Putting on a clean pair of gloves is the next step to maintain hygiene and prevent contamination while handling the medication and applying the patch.
B. Placing the patch on a new area of cleansed skin follows glove application. Ensuring that the skin is clean and that a new site is used prevents irritation and ensures the effectiveness of the medication.
D. Documenting the application in the electronic medication record is the final step to complete the medication administration process. This ensures that the medication administration is recorded accurately for future reference and compliance.
Correct Answer is D
Explanation
A. Skin turgor is important for assessing hydration status, but it is not the most critical factor when preparing for a safe transfer. For an unresponsive client, ensuring stable hemodynamic conditions is more urgent. Blood pressure provides essential information about the client’s circulatory status, which is crucial for assessing the risks associated with the transfer.
B. Body weight is generally used for dosing medications or assessing nutritional status and is not immediately relevant for ensuring a safe transfer of an unresponsive client. Although body weight might be useful in planning the transfer logistics, it does not impact immediate safety concerns.
C. Temperature can indicate infection or other issues but does not directly affect the immediate safety of the transfer process. While monitoring temperature is part of overall care, it is not the most pressing concern during the transfer.
D. Blood pressure is essential to check before the transfer because it reflects the client’s cardiovascular stability. Low or unstable blood pressure might increase the risk of complications during the transfer, such as a sudden drop in blood pressure that could lead to a fall or injury.
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