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An older adult diagnosed with dementia lives with family and attends an adult day care center. A nurse at the center notices the adult has a disheveled appearance, a strong odor of urine, and bruises on the limbs and back. What type of abuse might be occurring?
- A. Psychological
- B. Financial
- C. Physical
- D. Sexual
Correct Answer: C
Rationale: The assessment of physical abuse is supported by the nurse's observation of bruises. Physical abuse includes evidence of improper care, as well as physical endangerment behaviors such as reckless behavior toward a vulnerable person that could lead to serious injury. No data substantiate the other options.
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An older adult diagnosed with dementia lives with family and attends day care. After observing poor hygiene, the nurse at the center talks with the patient's adult child. This caregiver becomes defensive and says, 'It takes all my time and energy to care for my mother. She's awake all night. I never get any sleep.' Which nursing intervention has priority?
- A. Teach the caregiver more about the effects of dementia.
- B. Secure additional resources for the mother's evening and night care.
- C. Support the caregiver to grieve the loss of the mother's ability to function.
- D. Teach the family how to give physical care more effectively and efficiently.
Correct Answer: B
Rationale: The patient's child and family were coping with care until the patient began to stay awake at night. The family needs assistance with evening and night care to resume their pre-crisis state of functioning. Secondary prevention calls for the nurse to mobilize community resources to relieve overwhelming stress. The other interventions may then be accomplished.
A patient has a history of physical violence against family members when frustrated and then experiences periods of remorse after each outburst. The patient attends anger management classes. Which finding indicates success in this plan of care?
- A. The patient expresses frustration verbally instead of physically.
- B. The patient explains the rationale for behaviors to the victim.
- C. The patient identifies three personal strengths.
- D. The patient agrees to seek counseling.
Correct Answer: A
Rationale: The patient will develop a healthier way of coping with frustration if it is expressed verbally instead of physically. The incorrect options do not confirm the achievement of outcomes.
A patient at the emergency department is diagnosed with a concussion. The patient is accompanied by a spouse who insists on staying in the room and answering all questions. The patient avoids eye contact and has a sad affect and slumped shoulders. Assessment of which additional problem has priority?
- A. Risk of intimate partner violence
- B. Phobia of crowded places
- C. Migraine headaches
- D. Depressive symptoms
Correct Answer: A
Rationale: The diagnosis of a concussion suggests violence as a possible cause. The patient is exhibiting indicators of abuse including fearfulness, depressed affect, poor eye contact, and a possessive spouse. The patient may be also experiencing depression, anxiety, and migraine headaches, but the nurse's advocacy role necessitates an assessment for intimate partner violence.
A patient tells the nurse, 'My husband is abusive only when he drinks too much. His family was like that when he was growing up. He always apologizes and regrets hurting me.' What risk factor was most predictive for the husband to become abusive?
- A. History of family violence
- B. Loss of employment
- C. Abuse of alcohol
- D. Poverty
Correct Answer: A
Rationale: An abuse-prone individual is an individual who has experienced family violence and was often abused as a child. This phenomenon is part of the cycle of violence. The other options may be present but are not as predictive.
An older adult diagnosed with Alzheimer's disease lives with family. During the week, the person attends a day care center while the family is at work. In the evenings, members of the family provide care. Which factor makes this patient most vulnerable to abuse?
- A. Dementia
- B. Living in a rural area
- C. Being part of a busy family
- D. Being home only in the evening
Correct Answer: A
Rationale: Older adults, particularly those with cognitive impairments, are at high risk for abuse. The other characteristics are not identified as placing an individual at high risk for abuse.