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.
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Related Questions
Correct Answer is C
Explanation
A. "I will apply cold compresses when my joints are painful." Cold compresses can provide temporary relief from pain and inflammation associated with osteoarthritis.
B. "I will limit purine intake in my diet." Limiting purine intake is more relevant for conditions like gout, not osteoarthritis.
C. "I plan to take water aerobics classes at the gym near my house." Water aerobics is a lowimpact exercise that can help improve joint mobility and reduce pain associated with osteoarthritis.
D. "I will avoid the use of ibuprofen for pain control." Ibuprofen is a common nonsteroidal antiinflammatory drug (NSAID) that can help relieve pain and inflammation in osteoarthritis. However, it's essential to consider potential side effects and consult with a healthcare provider before long-term use, especially in older adults.
Correct Answer is A
Explanation
A. Documenting in the client's medical record every 15 minutes is essential to monitor the client's status, including physical and psychological well-being, while in restraints. Accurate documentation ensures that any changes or responses to the intervention are recorded and communicated to other healthcare providers.
B. Offering toileting to the client every 4 hours may be necessary depending on the client's
individual needs, but it does not address the immediate need for monitoring the client's safety and well-being while restrained.
C. Removing the restraint when the client falls asleep is not appropriate without a healthcare provider's order. Restraints should only be removed based on a specific criteria set forth by
institutional policies or as directed by the healthcare provider.
D. Requesting an as-needed prescription for restraints is not appropriate. Restraints should only be used when necessary to ensure the safety of the client or others, and their use should be based on a healthcare provider's assessment and orders.
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