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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

Choice A rationale

While exploring the client's relationship with their partner is important for understanding their grief, immediately asking for details might feel intrusive or overwhelming shortly after a significant loss. The nurse should first acknowledge the client's feelings before delving into specifics of the relationship.

Choice B rationale

"Grief affects everyone differently; your feelings are valid" is an empathetic and validating response that acknowledges the client's unique experience and normalizes their emotions. It provides support and reassurance without minimizing their loss or telling them how they should feel, fostering trust and open communication.

Choice C rationale

Suggesting the client "stay busy to take your mind off things" can be dismissive of their grief and may prevent them from processing their emotions in a healthy way. While distraction can be helpful at times, avoiding grief entirely is not a constructive coping mechanism and can prolong the healing process.

Choice D rationale

Recommending a bereavement support group is a helpful suggestion for long-term support; however, immediately after the loss, the client may not be ready to engage in a group setting. The nurse should first focus on providing immediate emotional support and then suggest resources like support groups when the client is more ready.

A. "You are feeling like a failure.”. B. "I see many positive things about you.”. C. "You're not the only client who feels this way.”. D. "How can you feel that way when you have so much to live for?"

Correct Answer is A

Explanation

Choice A rationale

Reflecting the client's feeling back to them, such as "You are feeling like a failure," acknowledges their emotional state without judgment or dismissal. This therapeutic communication technique validates the client's feelings and encourages further exploration of their thoughts and emotions.

Choice B rationale

While intended to be positive, stating "I see many positive things about you" can minimize the client's current feelings and may not address the underlying reasons for their negative self-perception. It can also sound dismissive of their distress.

Choice C rationale

Saying "You're not the only client who feels this way" can minimize the client's individual experience and may make them feel that their feelings are not unique or important. It does not directly address their specific statement of wanting to be dead.

Choice D rationale

Asking "How can you feel that way when you have so much to live for?" invalidates the client's current feelings and can make them feel misunderstood or defensive. It does not address the depth of their despair and suicidal ideation.

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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?

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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?