The nurse is assisting with patient data collection in a clinic. The nurse is assigned to a young female patient who has an older male friend present at her bedside. The patient is nervous, timid, very thin, and with poor hygiene and lets the friend answer all of the nurse's questions. What actions should the nurse take?
Whisper to patient that she will be saved.
Confront the family friend to allow the patient to ask questions.
Consult the health care team about the suspicions and call local authorities to investigate.
Ask the patient if she feels safe, while the friend is in the room.
The Correct Answer is D
Explanation:
A. Whisper to the patient that she will be saved.
This action is inappropriate and does not address the underlying issues of the patient's condition or the presence of the family friend. Whispering such a statement may also be confusing or alarming to the patient.
B. Confront the family friend to allow the patient to ask questions.
While it's important to facilitate open communication with the patient, confronting the family friend directly may not be the most effective approach initially. It's crucial to first assess the patient's comfort level and safety before addressing the situation with the friend.
C. Consult the healthcare team about the suspicions and call local authorities to investigate.
Jumping to conclusions and involving authorities without gathering more information or assessing the patient's feelings directly could escalate the situation unnecessarily. It's important to handle such concerns with sensitivity and professionalism, involving appropriate resources only when needed.
D. Ask the patient if she feels safe, while the friend is in the room.
This is the most appropriate action initially. By directly asking the patient about her feelings of safety, the nurse can gauge the patient's comfort level and assess any potential concerns or risks. This approach allows the nurse to gather information and address any issues in a supportive and patient-centered manner. If the patient expresses concerns or discomfort, further assessment and appropriate interventions can be implemented, which may include involving other members of the healthcare team or authorities if necessary.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Explanation:
A. Expert opinions:
Expert opinions are valuable in clinical practice and decision-making, but they are considered a lower level of evidence compared to systematic reviews and meta-analyses. Expert opinions are often classified as Level V evidence in the hierarchy.
B. Systematic review
A systematic review is a comprehensive and rigorous synthesis of multiple studies on a particular topic, and it often includes a meta-analysis that statistically combines the results of these studies to provide a high level of evidence. This type of evidence is considered Level I because it provides a strong foundation for making clinical decisions due to its methodological rigor and ability to summarize findings from multiple studies.
C. Credible websites:
Credible websites can provide valuable information, but they are not classified as Level I evidence. The evidence hierarchy typically places systematic reviews and meta-analyses at the highest level due to their methodological rigor and synthesis of multiple studies.
D. Qualitative studies:
Qualitative studies are valuable for exploring complex phenomena and understanding individuals' experiences, beliefs, and perspectives. However, they are generally considered lower in the hierarchy of evidence compared to systematic reviews and RCTs, which are categorized as Level I evidence.
Correct Answer is D
Explanation
Explanation:
A. "Reporting is voluntary for health care workers."
This statement is incorrect. Reporting child abuse is not voluntary for healthcare workers; it is a legal requirement in many jurisdictions. Failure to report suspected abuse can lead to legal and professional consequences.
B. "Civil liability can result if the abuse can't be proven."
While civil liability may be a concern in some situations, it is not the primary reason for reporting child abuse. The main purpose of reporting is to ensure the safety and well-being of the child, not to prove abuse in a legal sense.
C. "Evidence of abuse must be collected prior to reporting."
This statement is incorrect. While collecting evidence can be important in legal proceedings, it is not the responsibility of healthcare workers to collect evidence of abuse before reporting. Suspected cases of abuse should be reported promptly to the appropriate authorities, who are responsible for investigating and gathering evidence.
D. "If suspicion of abuse exists then reporting is mandatory."
This statement correctly reflects the legal and ethical obligation of healthcare workers to report suspected cases of child abuse. Healthcare professionals are mandated reporters, which means they are required by law to report any suspicion of child abuse or neglect, even if there is no concrete evidence. Reporting is not voluntary for healthcare workers, and failure to report suspected abuse can result in serious consequences, including legal penalties and professional sanctions.
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