Which step should a nurse prioritize when managing a client suspected of experiencing elder abuse?

A. "I am newly divorced and a single parent" describes situational stress. While these circumstances can contribute to emotional strain, they do not indicate abuse by another person. Emotional abuse requires deliberate behaviors aimed at controlling, belittling, or harming the client psychologically. Simply being a single parent or divorced does not meet this criterion.

B. "I recently was promoted at work but now I'm unable to work with the same coworkers I was used to working with" reflects workplace adjustment challenges or difficulty with social interactions. Although stress from these changes may affect the client’s mood or anxiety levels, there is no indication of intentional manipulation, humiliation, or coercion by another person. This statement is related to environmental or situational stress rather than abuse.

C. "My ex-partner tells me that I can't do anything right" is a direct example of emotional abuse. The ex-partner’s consistent verbal belittlement undermines the client’s confidence and self-esteem. This type of criticism is designed to create feelings of incompetence and self-doubt. Over time, such behavior can contribute to depression, anxiety, and learned helplessness, which may manifest as the client feeling “like they are going crazy.”

D. "My ex-partner constantly makes fun of my weight" also represents emotional abuse. Mocking or shaming someone about personal characteristics, such as appearance or body size, targets their self-worth and can lead to shame, poor self-image, and increased vulnerability to depression or anxiety. This behavior is intentional and repetitive, fulfilling the criteria for emotional abuse.

E. "I suppose I really do need to be on medication, like my ex-partner said" demonstrates coercion and manipulation, a form of emotional abuse. Here, the ex-partner is attempting to control how the client perceives their mental health and influence their decisions regarding treatment. This undermines the client’s autonomy, self-confidence, and ability to trust their own judgment, which can exacerbate depressive symptoms or feelings of helplessness.

F. "My friend recently passed away" expresses grief, which is a normal emotional reaction to loss. There is no evidence of another person exerting control, manipulation, or psychological harm, so this statement does not indicate emotional abuse.

A. Blood pressure is a vital sign and does not reflect negative symptoms. While monitoring vitals is important for overall health and detecting complications, blood pressure readings do not indicate motivational, social, or emotional deficits.

B. Lack of motivation (avolition) is a core negative symptom. In this scenario, the client refuses to attend therapy, eat, or engage in self-care activities. Avolition is characterized by decreased initiation and persistence in goal-directed activities and can manifest as inactivity or neglect of personal hygiene, nutrition, and social responsibilities.

C. Change in behavior is a nonspecific finding. While the client has behavioral changes, such as withdrawal and slowed movements, the term itself does not clearly identify negative symptoms. Behavior can change for many reasons, including environmental stressors or medical conditions. To link to negative symptoms, the specific behaviors must reflect diminished functioning (e.g., lack of motivation, energy, or social engagement).

D. Lack of energy (anergia) reflects diminished physical and mental activity. The client’s slowed movements, desire to sleep, and reluctance to participate in therapy demonstrate reduced energy levels, which are characteristic of negative symptoms. Anergia contributes to difficulty completing tasks and engaging in daily activities.

E. Withdrawn indicates social withdrawal, reduced social interaction, and avoidance of contact with others. The client’s refusal to engage in conversation or participate in therapy sessions reflects this hallmark negative symptom. Social withdrawal can lead to isolation and further functional decline if not addressed.