A discharge planning nurse works with a wide variety of families when organizing care for older adults after their discharge from the hospital. Which of the following relationship structures would the nurse consider to be a family? Select all that apply.
- A. Mr. E and his partner, Mr. S, who live together in an apartment
- B. Mr. R and his new 'lady friend,' who began cohabiting 2 months ago
- C. Mrs. B and her daughter, son-in-law, and widowed sister, all of whom share a house
- D. Mr. R, who is estranged from his children and has lived with his brother, a bachelor, for several years
Correct Answer: A
Rationale: The correct answer is A. While not traditional nuclear family structures, all of the given relationships and living arrangements constitute family units. Mr. E and his partner, Mr. S, who live together in an apartment, form a family unit. Choice B is not considered a family as it describes a relatively new and non-committal relationship. Choice C describes a traditional family structure with Mrs. B, her daughter, son-in-law, and widowed sister sharing a house, which also constitutes a family unit. Choice D describes a situation where Mr. R is estranged from his children and living with his bachelor brother, which can also be considered a family unit but is not as inclusive as the relationship described in choice A.
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What might a nurse suggest to help the grown children make the most of their limited incomes and time with their parents?
- A. Help them find nearby spots for picnics or other free outings
- B. Refer the family to a more appropriate practitioner
- C. Suggest they take out a second mortgage on the family house
- D. Encourage the entire family to participate in activities at Haven
Correct Answer: A
Rationale: A nurse, as a caring worker, may suggest helping the grown children find nearby spots for picnics or other free outings. This suggestion would allow the parents to get out of the facility and enjoy quality time with their children without any financial burden. While the family may also want to participate in activities at the facility, a picnic would provide a change of scenery. Referring the family to a more appropriate practitioner is not relevant to improving the limited incomes and time spent with the parents. Suggesting to take out a second mortgage on the family house could provide temporary financial relief but may not be the most suitable solution for maximizing time spent with the parents.
During a busy shift, a registered nurse directed an unlicensed care provider to change the dressing and perform wound care on an older adult client's surgical incision, an act that exists outside of the unlicensed care provider's scope of practice. Which of the following statements best captures the legal context of this event?
- A. The unlicensed care provider is solely responsible for the inappropriate practice.
- B. The nurse can be held liable for the actions of the unlicensed care provider.
- C. Liability rests with the nurse manager of the unit.
- D. In the absence of documented harm to the client, the action is legally permissible.
Correct Answer: B
Rationale: The correct answer is B. Under the doctrine of respondent superior, nurses can be held liable for the actions of individuals under their supervision. In this scenario, the registered nurse directed the unlicensed care provider to perform a task outside their scope of practice, making the nurse accountable for the consequences. Choice A is incorrect because the responsibility is shared between the nurse and the unlicensed care provider. Choice C is incorrect as the nurse manager may not be directly responsible for the actions of the registered nurse. Choice D is incorrect because legality is not determined solely by the absence of harm; acting within one's legal scope of practice is essential to ensure patient safety.
An 81-year-old female client has presented to the emergency department accompanied by her daughter with whom she lives. The daughter states that her mother has experienced a recent series of falls, which have resulted in her facial and arm bruises. The client smells of urine and is noticeably emaciated, unkempt, and anxious while the daughter berates her during the nurse's assessment. What is the nurse's responsibility in this situation?
- A. Determine the daughter's legal status with regard to her mother's financial affairs
- B. Report suspected elder abuse
- C. Establish whether the client has a durable power of attorney in place
- D. Obtain medical records regarding prior admissions for similar problems
Correct Answer: B
Rationale: In cases of suspected elder abuse, the nurse is responsible for reporting his or her suspicions to the relevant authorities. In this scenario, the signs of elder abuse are evident, such as the client's bruises, unkempt appearance, and the daughter's behavior. Determining the daughter's legal status or the client's power of attorney are not immediate priorities when abuse is suspected. Obtaining medical records for prior admissions is also not the primary concern in this situation.
Based on the information provided, what can be inferred about the nurse who has been working for several years in a long-term care facility with many Middle Eastern residents?
- A. The nurse's knowledge and skills provide expected care for clients in this demographic.
- B. The nurse is knowledgeable about Middle Eastern culture and respects and values providing culturally competent care.
- C. The nurse is attempting to overcompensate for cultural blindness and ethnocentrism within the community.
- D. This employment has allowed the nurse to demonstrate ethnic identity and cultural bias to a specific group of people.
Correct Answer: B
Rationale: The nurse in the scenario is likely knowledgeable about Middle Eastern culture and values providing culturally competent care to the residents. This inference can be made based on the nurse being well-respected and effective in providing care to this population. Choice A is incorrect because it only focuses on the nurse's knowledge and skills, not specifically about cultural competence. Choice C is incorrect as there is no indication of overcompensation; the nurse is described as effective and well-respected. Choice D is incorrect as there is no evidence to suggest that the nurse is demonstrating ethnic identity or cultural bias, but rather respecting and providing care tailored to the cultural needs of the residents.
What is the most important advantage of an advance directive?
- A. Such a directive indicates how medical decisions are to be made in case a patient is unable to communicate their wishes.
- B. It spares the family the burden of making significant decisions for a patient regarding terminal care.
- C. It ensures that a person's property is distributed according to their wishes after death, avoiding legal complications.
- D. It allows individuals to appoint a guardian for themselves in case of incapacity, without involving the court system.
Correct Answer: B
Rationale: An advance directive, or living will, is a legal document that specifies an individual's preferences for medical treatment if they are unable to communicate their wishes. The most important advantage of an advance directive is that it spares the family from having to make challenging decisions about terminal care on behalf of the patient. Choice A is incorrect because advance directives pertain to healthcare decisions, not property matters. Choice C is incorrect as it refers to a will for property distribution, which is a different legal document. Choice D is incorrect as advance directives are not related to appointing guardians but rather focus on healthcare decision-making.