A nurse is caring for a group of older adult clients who receive home care.
Which of the following clients should the nurse interview about the possibility of caregiver abuse or neglect?
A client who has a bruise on their shin.
A client who is 9 kg (20 lb) over their recommended weight.
A client whose caregiver pays the client's bills.
A client who is wearing soiled clothing.
The Correct Answer is D
Choice A rationale
While a bruise on the shin could indicate abuse, it could also result from an accidental bump or fall, which are common in older adults due to factors like impaired balance or decreased bone density. A single bruise alone is not definitive evidence of caregiver abuse or neglect and requires further assessment to determine the cause.
Choice B rationale
Being 9 kg (20 lb) over the recommended weight is indicative of potential overeating or a sedentary lifestyle, both of which are health concerns but not direct indicators of caregiver abuse or neglect. Weight management is related to dietary habits and physical activity levels, not necessarily the actions of a caregiver.
Choice C rationale
A caregiver paying a client's bills is not necessarily indicative of abuse or neglect. It could be a sign of assistance and support, especially if the client has difficulty managing their finances. Financial arrangements between a client and caregiver need to be assessed within the context of their relationship and the client's capacity.
Choice D rationale
Wearing soiled clothing suggests a lack of proper hygiene and care, which could be a sign of neglect by the caregiver. Inadequate attention to basic needs like cleanliness can lead to skin breakdown, infections, and a decline in the client's overall health and well-being. This warrants further investigation into the care provided.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E"]
Explanation
Choice A rationale
Access to firearms in the home significantly increases the risk of suicide because firearms are highly lethal and provide a quick and often impulsive means of ending one's life. The availability of a firearm reduces the time between suicidal ideation and action, making intervention more difficult.
Choice B rationale
A sibling history of suicide can increase an individual's risk due to potential genetic predispositions to mental health disorders or learned behaviors and coping mechanisms within the family. However, it is not as direct or immediate a risk factor as other factors.
Choice C rationale
Being currently unmarried can be a contributing factor to social isolation and lack of support, which are risk factors for suicide. However, marital status alone is not a strong predictor of suicide risk, as many unmarried individuals have strong social networks, and married individuals can still experience isolation.
Choice D rationale
Expressing feelings of hopelessness is a critical warning sign for suicide. Hopelessness is a state of despair where an individual believes their situation will never improve, leading to a sense of futility and a higher likelihood of considering suicide as an escape.
Choice E rationale
A recent significant loss, such as the death of a loved one, a job loss, or the end of a significant relationship, can trigger intense emotional distress and increase vulnerability to suicidal ideation, especially if the individual lacks adequate coping mechanisms or social support. .
Correct Answer is A
Explanation
Choice A rationale
Liver function tests, such as alanine aminotransferase (ALT) with a normal range of 7 to 56 U/L for females and 10 to 70 U/L for males, and aspartate aminotransferase (AST) with a normal range of 5 to 40 U/L for both sexes, should be reviewed before administering valproic acid. Valproic acid can cause hepatotoxicity, and pre-existing liver dysfunction is a contraindication or requires careful monitoring.
Choice B rationale
A chest x-ray is primarily used to assess the lungs and heart. It is not directly relevant to the potential side effects or contraindications of valproic acid therapy.
Choice C rationale
A prostate-specific antigen (PSA) test is used to screen for prostate cancer in men. It is not related to the potential adverse effects of valproic acid. The normal range for PSA is generally less than 4 ng/mL, but this can vary with age.
Choice D rationale
A urine culture is used to detect urinary tract infections. While important for overall health assessment, it does not directly assess for contraindications or potential organ-specific side effects associated with valproic acid administration. .
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