An incapacitated older adult with dementia is brought to the emergency department by a rescue squad after falling and breaking an arm. When the patients children arrive, they are adamantly against the patient having any medical care and insist that prayer will heal the broken arm. What action by the nurse is most appropriate?

Check facility policies and contact the hospital social worker

Allow the family to pray with the patient then escort them to the waiting room

Call the police who can force the family to accept medical care

Call security to keep the family from interfering with medical care

Answer and Explanation

The Correct Answer is A

A.   When faced with a situation where a patient's family refuses medical care, it is important to follow the facility's policies and procedures. In many cases, the hospital social worker can be a valuable resource in helping to resolve such situations. The social worker can provide support to the family, help them understand the importance of medical care, and advocate for the patient's best interests.
B.   While it is important to respect the family's cultural and religious beliefs, it is also important to ensure that the patient receives the necessary medical care. Allowing the family to pray with the patient is appropriate, but the patient should still receive medical attention for their broken arm.
C.   This is not a appropriate course of action. While the patient has a right to receive medical care, it is important to approach the situation with respect and compassion, and to try to work with the family to find a solution that is in the best interests of the patient.
D.   This could escalate the situation and make it more difficult to resolve. It is important to approach the situation with empathy and understanding, and to try to work with the family to find a solution that is acceptable to all parties.

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Correct Answer is D

Explanation

A. While assessing the patient's functional limitations is important for determining the appropriate level of care needed, it does not directly address the competency of the UAP staff.
B. Arranging for UAP services is important, but it does not guarantee the quality of care provided. Evaluating the competency of the UAP staff is essential to ensure that the patient receives safe and effective care.
C. While the nurse may play a role in case management and advocacy, it's important to ensure that the UAP staff is competent to provide the necessary care.
D. To ensure the quality of care and safety of an older adult patient who requires in-home UAP assistance, it's crucial to evaluate the competency of the UAP staff. This involves assessing their skills, knowledge, and ability to provide safe and effective care.

A. controlling the interview by selecting the memories to be discussed B. encouraging the patient to relive his or her memories while maintaining focus C. scheduling several short interviews rather than one long one D. reminding the patient to share important memories of the past

Correct Answer is B

Explanation

A. controlling the interview by selecting the memories to be discussed: Guided reminiscence should be a collaborative process between the nurse and the patient. The nurse should facilitate the conversation and encourage the patient to share their own memories, rather than imposing specific topics.

B. Guided reminiscence is a therapeutic technique that involves helping individuals recall and reflect on past experiences. The goal is to promote positive emotions, improve cognitive function, and enhance a sense of well-being.
C. While it may be helpful to break up the reminiscence sessions into shorter intervals, the focus should be on creating a comfortable and supportive environment for the patient to share their memories.
D. While it may be helpful to prompt the patient to recall specific memories, the emphasis should be on allowing the patient to freely explore their own memories and experiences.

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Naxlex Comprehensive Predictor Exams

To best assure both the quality of care and the safety of the older adult patient who requires in home unlicensed assistive personal (UAP) assistance, the geriatric nurse:

Correct Answer is D

Explanation

The nurse most effectively implements guided reminiscence during a patient interview by

Correct Answer is B

Explanation

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To best minimize patient anxiety and help ensure a successful history assessment interview, the geriatric nurse first:

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