Nokea
Which of the following aspects of gerontological nursing would be most likely classified under private law?
- A. The regulation of who may call himself or herself a 'nurse'
- B. The contract between an older adult resident of a care facility and the owners of the facility
- C. The legal criteria for declaring an individual mentally incompetent
- D. The criminal consequences for instances of elder abuse
Correct Answer: B
Rationale: The correct answer is B because private law deals with relationships between individuals and organizations, such as the contract between an individual and the care facility. Choices A, C, and D are not classified under private law. Choice A pertains to professional regulation and is a matter of public law. Choice C involves legal criteria and decision-making related to mental competence, falling under public law. Choice D concerns criminal consequences, which are also part of public law.
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An investigation into reports of substandard care on the subacute geriatric unit of a hospital has been undertaken. Which of the following events is representative of malpractice on the part of the nursing staff?
- A. A client with a documented history of seizures was left with his bed raised and with bedrails not in place, resulting in a fall and head injury
- B. A client was sent for a colonoscopy, after which it was learned that the client had never given written consent for the procedure
- C. A client with a diagnosis of vascular dementia was found wandering in the hall outside the unit
- D. An immobile client was not turned over the course of a night shift and developed a pressure ulcer on her coccyx
Correct Answer: A
Rationale: Answer A is correct as it includes all the components of malpractice: duty, negligence, and injury. The nursing staff failed in their duty by leaving a client with a documented history of seizures unattended with bedrails not in place, resulting in a fall and head injury. Answer B involves an issue related to consent, which is the responsibility of the physician, not the nursing staff. Answer C does not demonstrate negligence or harm caused by the nursing staff. Answer D also shows negligence by failing to turn an immobile client, leading to a pressure ulcer, but it lacks a direct connection to the duty of the nursing staff in preventing harm.
An elderly man has relied on one of his sons for his care. Now the son has become very involved with a religion other than the one in which he was raised. As a result, he now refuses to help his father. What can a nurse do to help in this family situation?
- A. Set up a family conference that includes the son
- B. Bring in help from other family members or outside
- C. Insist that the son help, along with other family members
- D. Ask the family's own spiritual adviser to intervene
Correct Answer: A
Rationale: In this complex family situation, it is essential to approach the issue with sensitivity and understanding. Setting up a family conference that includes the son is the most appropriate action for the nurse to take. While it may seem challenging, there is a possibility that involving the son in a family discussion can help him understand the impact of his actions on his father and the rest of the family. By including him in the conversation, the son may realize the importance of his role in caring for his father. Insisting that the son help, along with other family members, could lead to resistance and further alienation. Asking the family's spiritual adviser to intervene may not be effective if the son is rebelling against the family's religion. If the family conference does not yield positive results, then bringing in help from other family members or an outside caregiver may become necessary to ensure the elderly man receives the care he needs.
During a home visit, a nurse notes that an 80-year-old female patient's blood pressure is 166/99 despite the recent introduction of a diuretic to her medication regimen. The patient admits that her son refuses to give her the diuretic because it has precipitated incontinence episodes and states, 'He gets so furious when I soil myself.' What action should the nurse prioritize in this potential case of elder abuse?
- A. Improving or salvaging the family dynamics
- B. Teaching the son why his actions are inappropriate
- C. Initiating legal action
- D. Taking measures to protect the patient's safety
Correct Answer: D
Rationale: In this potential case of elder abuse, the nurse's priority should be taking measures to protect the patient's safety. The patient's health and well-being are at risk due to the son's refusal to administer the diuretic, which can lead to serious health complications. While improving family dynamics (choice A), educating the son (choice B), and legal actions (choice C) may be necessary in the long run, the immediate concern is ensuring the patient's safety and well-being.
How does guardianship differ from power of attorney?
- A. The court appoints a guardian; an individual grants a power of attorney to someone else to make decisions on his or her behalf.
- B. Guardianship is legally binding whether or not an individual is competent; power of attorney applies only to the incompetent.
- C. Courts monitor the actions of those executing a power of attorney, but guardians are free to act on behalf of another as long as standards of 'reasonable prudence' are met.
- D. Guardianship stays in effect for one calendar year and must be renewed annually; power of attorney stays in effect until one or both parties choose to revoke it.
Correct Answer: A
Rationale: The correct answer is A. The key difference between guardianship and power of attorney is that the court appoints a guardian to make decisions on behalf of an individual who is deemed incompetent, while an individual grants a power of attorney to someone else to make decisions on their behalf when they are competent. Choice B is incorrect because both guardianship and power of attorney can apply to individuals who are competent or incompetent. Choice C is incorrect as guardians, like those with power of attorney, must act in the best interest of the individual they represent, and the level of oversight can vary. Choice D is incorrect as guardianship and power of attorney do not have fixed time limits; they remain in effect until revoked or ended by the appropriate legal process.
During a family meeting that the nurse organized during an older adult's discharge planning from the hospital, there is visible animosity between the son and daughter of the patient. What should the nurse's initial response be to the apparent family dysfunction?
- A. Teach the patient's children alternative methods of interaction.
- B. Encourage the family to choose one spokesperson to represent all the children.
- C. Organize separate meetings with the son and with the daughter.
- D. Assess the family history and the nature of the son and daughter's relationship.
Correct Answer: D
Rationale: The correct initial response for the nurse in this situation is to assess the family history and the nature of the son and daughter's relationship. By gathering data and identifying factors contributing to the dysfunction, the nurse can better understand the underlying issues and dynamics at play. Teaching alternative methods of interaction (Choice A) may not address the root cause of the animosity. Encouraging one spokesperson for the family (Choice B) may overlook individual concerns. Organizing separate meetings (Choice C) may not provide a holistic view of the family dynamics and may not address the issues affecting the family unit as a whole. Therefore, assessing the family history and relationship dynamics is essential for effective intervention and resolution of the family dysfunction.