A nurse is developing an interdisciplinary care plan for an 86-year-old client who was recently admitted after reporting financial abuse by a family caregiver. The client lives alone, has early-stage dementia, and expresses reluctance to involve law enforcement. Which of the following actions best balances safety with respect for client autonomy?

Request that the facility's legal team initiate conservatorship to protect the client's assets

Recommend that the health care provider complete a capacity evaluation and assign a guardian if needed

Refer the client to adult protective services without consent, as mandated by elder abuse laws

Collaborate with a social worker to identify supportive resources and explore options for financial management and caregiving

Answer and Explanation

The Correct Answer is D

A. Request that the facility's legal team initiate conservatorship to protect the client's assets: Conservatorship is a restrictive legal measure that removes significant autonomy. It is pursued only after thorough evaluation of capacity and consideration of less invasive options.

B. Recommend that the health care provider complete a capacity evaluation and assign a guardian if needed: A capacity evaluation may become necessary if the client’s dementia progresses and financial decision-making is compromised. However, at this early stage, imposing guardianship without exploring other supports undermines the client’s autonomy.

C. Refer the client to adult protective services without consent, as mandated by elder abuse laws: While nurses are mandated reporters, immediate referral without the client’s engagement may erode trust. Involving APS is important, but it should be coupled with supportive strategies that respect the client’s expressed wishes.

D. Collaborate with a social worker to identify supportive resources and explore options for financial management and caregiving: This balances safety and autonomy by addressing the abuse while respecting the client’s reluctance to involve law enforcement. Social workers can connect the client with protective services, financial counseling, and community support.

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. "Do you have a history of congestive heart failure or sinusitis?": While COPD can strain the heart over time, congestive heart failure is not considered a directly related illness. Sinusitis is also more of a concurrent condition rather than a complication linked to COPD.

B. "Have you recently had influenza or pneumonia?": Clients with COPD are at high risk for respiratory infections like influenza and pneumonia because of impaired lung clearance and reduced immune defense. These infections often exacerbate COPD, worsen symptoms, and increase hospitalizations.

C. "Do you suffer from seasonal allergies or asthma?": Seasonal allergies and asthma involve airway inflammation but are distinct conditions. While they may overlap with COPD in symptoms, they are not the most likely illnesses directly related to COPD exacerbations.

D. "Have you ever been diagnosed with chronic bronchitis or emphysema?": Chronic bronchitis and emphysema are not related illnesses but are core conditions under the COPD umbrella itself. Asking this does not identify additional illnesses associated with COPD.

A. Give the client a dose of acetaminophen. B. Call 9-1-1. C. Determine if the client has a history of migraine headaches D. Assure the client the symptoms will resolve within 24 hours

Correct Answer is B

Explanation

A. Give the client a dose of acetaminophen: While acetaminophen can relieve mild headache, it does not address the urgent risk of stroke. Treating pain without evaluating for a cerebrovascular event could delay critical care.

B. Call 9-1-1: Sudden severe headache and new-onset numbness after a TIA may indicate progression to an acute stroke. Prompt emergency intervention is essential to prevent permanent neurological damage and improve outcomes.

C. Determine if the client has a history of migraine headaches: While a history of migraines may provide context, the acute presentation of neurological deficits cannot be assumed to be a migraine. Immediate action takes priority over history-taking.

D. Assure the client the symptoms will resolve within 24 hours: Providing reassurance without medical evaluation is unsafe. The client’s symptoms could indicate a serious cerebrovascular event requiring urgent intervention rather than waiting for spontaneous resolution.

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The nurse is completing an admission interview for a client with chronic obstructive pulmonary disease (COPD). Which question by the nurse provides additional information about related illnesses the client is likely to experience?

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