A nurse is caring for an older adult client who states, "I can't pay for my care because my kid took all my money." Which of the following actions should the nurse take?
Instruct the client to report the theft to the police.
Report the possible abuse to adult protective services.
Ask the client if there is another family member they can call for financial help.
Restrict visitation for the client's family until discharge.
The Correct Answer is B
A. Instruct the client to report the theft to the police: While reporting theft to the police may be necessary, the immediate concern is the safety and well-being of the client, especially if financial exploitation or abuse is suspected.
B. Report the possible abuse to adult protective services: Suspected financial exploitation or abuse of an older adult should be reported to the appropriate authorities, such as adult protective services, for investigation and intervention.
C. Ask the client if there is another family member they can call for financial help: While involving other family members may be appropriate in some situations, suspected abuse or exploitation requires intervention from trained professionals.
D. Restrict visitation for the client's family until discharge: Restricting visitation should only be done if there is a clear risk to the client's safety, and it should not be the first action taken in response to suspected abuse.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. The Sims position is lying on the left side with the right knee and thigh drawn up with the left arm placed along the back. This position is typically used for rectal examinations and enemas, not for administering nasal drops.
B. The prone position is lying face down. This position is not suitable for administering nasal drops as it can be uncomfortable and may obstruct proper administration.
C. The supine position is lying flat on the back with the face upward. This position is ideal for administering nasal drops as it allows for easy access to the nostrils and facilitates proper instillation of the medication.
D. The orthopneic position is sitting upright and leaning forward, often with the arms supported on a table or pillows. This position is sometimes used by patients with respiratory distress but is not typically recommended for administering nasal drops.
Correct Answer is ["A","B","C","E","F"]
Explanation
A. Chest x-ray: Essential for visualizing the heart and lungs, which is critical in a patient with symptoms of heart failure and respiratory issues.
B. Basic metabolic profile (BMP): Important to assess electrolytes, renal function, and glucose levels, especially given the patient's history of diabetes and hypertension.
C. 12-lead ECG: Necessary for evaluating heart rhythm, rate, and to look for any ischemic changes, especially since the patient is experiencing tachycardia.
D. Doppler studies of lower extremities: While useful for assessing peripheral vascular disease, it is not as immediately relevant as the other tests for a direct diagnosis of heart failure.
E. Brain natriuretic peptide (BNP) level: A key diagnostic test for heart failure as elevated levels are indicative of cardiac stress.
F. Echocardiogram: Provides critical information on heart function and structure, which is essential for diagnosing and managing heart failure.
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