The RN is caring for James, an elderly man, in his home. The client’s son, Brad, is visiting and he plans to take James to the bank so that he can sign a Power of Attorney (POA) for his finances over to Brad. James tells the nurse that he is not ready for his son to take over as POA, but he doesn’t want to make him angry.
What should the nurse do next?
Assure the patient that his son has his best interest in mind.
The nurse has no accountability for this situation since it is not a clinical issue.
Notify the primary care physician that the patient can no longer care for himself.
Contact the department of aging to report suspected financial abuse.
The Correct Answer is D
The nurse has a duty to protect the patient’s rights and well-being, and to report any signs of abuse or neglect. Financial abuse is defined as someone illegally or improperly using an elder’s money or belongings for their own personal use. It is a common form of elder abuse and can have serious consequences for the victim’s physical and mental health.
The nurse should not assume that the son has the patient’s best interest in mind (choice A), as this may not be the case.
The nurse should not ignore the situation or dismiss it as a non-clinical issue (choice B), as this would violate the nurse’s ethical and legal obligations. The nurse should not notify the primary care physician that the patient can no longer care for himself (choice C), as this may not be true and may infringe on the patient’s autonomy and dignity.
The nurse should respect the patient’s wishes and help him to exercise his rights and choices.
The nurse should also provide support and resources to the patient, such as counselling, legal aid, or social services.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
McBurney’s point is located one-third of the distance from the right anterior superior iliac spine to the umbilicus. This is where the base of the appendix is attached to the cecum, which is part of the large intestine. When the appendix becomes inflamed or infected, it causes pain in this area.
Choice A is wrong because the left lower quadrant is where the sigmoid colon and part of the small intestine are located.
These organs are not related to appendicitis.
Choice B is wrong because the left upper quadrant is where the stomach, spleen, and part of the pancreas are located.
These organs are also not related to appendicitis.
Choice C is wrong because the right upper quadrant is where the liver, gallbladder, and part of the small intestine are located. These organs can cause pain in this area if they have problems, but not appendicitis
Correct Answer is C
Explanation
This nursing diagnosis is typically not associated with anemia because anemia does not cause dehydration or loss of body fluids. Anemia is a condition in which the hemoglobin concentration or the number of red blood cells is lower than normal, resulting in decreased oxygen delivery to the tissues.
Choice A. Ineffective tissue perfusion is wrong because anemia can impair tissue perfusion by reducing the oxygen-carrying capacity of the blood.
Choice B. Activity intolerance is wrong because anemia can cause fatigue, weakness, and dyspnea on exertion due to inadequate oxygen supply to the muscles.
Choice D. Risk for decreased cardiac output is wrong because anemia can increase the risk of cardiac complications such as tachycardia, palpitations, angina, and heart failure due to increased cardiac workload and demand for oxygen.
Normal ranges for hemoglobin are 13.5 to 17.5 g/dL for men and 12 to 15.5 g/dL for women; normal ranges for hematocrit are 38.8 to 50% for men and 34.9 to 44.5% for women; normal ranges for red blood cell count are 4.7 to 6.1 million/mm3 for men and 4.2 to 5.4 million/mm3 for women; normal ranges for reticulocyte count are 0.5 to 1.5% of red blood cells.
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