Nokea
Which of the following statements most accurately captures an aspect of contemporary family caregiving in the United States?
- A. Women typically spend more time caring for aging parents than they did for their own children.
- B. The most common pattern of care involves an older man providing in-home care for his wife.
- C. The majority of care is now provided by public and private agencies rather than family members.
- D. A residential or institutional environment is now the most common venue for caregiving.
Correct Answer: A
Rationale: The correct answer is A. Today, on average, women spend more time providing care for their aging parents than they did for their own children. While some men provide care for their wives, it is not the most common pattern. Family members, rather than public or private agencies, still provide the majority of care in a non-institutional environment, making option C incorrect. Also, caregiving in a residential or institutional environment is not the most common venue, thus choice D is inaccurate.
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A visiting nurse becomes concerned about a caregiver daughter. Although she does not seem overburdened, she may be drinking too much. The recycling bin contains many wine bottles, and visitors come to the home. What action should the nurse take?
- A. Direct the daughter to a local Alcoholics Anonymous chapter
- B. Ignore the signs unless they interfere with caregiving
- C. Find a new caregiver in the family or outside of it
- D. Assess the daughter's motivation and ability to provide care
Correct Answer: D
Rationale: The correct action for the nurse to take in this situation is to assess the daughter's motivation and ability to provide care. The nurse should not jump to conclusions based solely on the presence of wine bottles in the recycling bin. It is important to understand the daughter's overall capacity for caregiving and if her potential alcohol consumption is affecting her ability to provide care. Directing the daughter to Alcoholics Anonymous without a thorough assessment may not be appropriate at this stage. Ignoring the signs or immediately finding a new caregiver without understanding the daughter's situation may not address the underlying issue. Therefore, assessing the daughter's motivation and caregiving capabilities is the most appropriate initial step for the nurse.
Which of the following family interactions would the nurse most likely interpret as being atypical?
- A. Mr. R states that he and his brother always had a cordial, though somewhat distant, relationship but that they are now quite close.
- B. Mrs. D describes being a grandparent as 'having all the benefits of having children without the headaches and responsibilities.'
- C. Mr. and Mrs. N had a tumultuous relationship for decades but now appear more at ease with one another.
- D. Mr. A states that his ideal living situation would be himself and his adult son and daughter all under the same roof.
Correct Answer: D
Rationale: The correct answer is D. While marital reconciliation, rekindled relationships with siblings, and satisfaction in the role of grandparent are common phenomena among older adults, it is less common for parents and children to see cohabitation as an ideal situation or first preference. Choices A, B, and C reflect common positive family dynamics experienced by older adults, such as improved relationships with siblings, contentment in the grandparent role, and easing of marital tensions over time. On the other hand, choice D stands out as atypical as it suggests an unconventional living arrangement where adult children live with their parent, which is less commonly preferred by older adults.
As a daughter and mother are extremely close emotionally, they made a pact years ago never to put the mother in a nursing home. Now, the physical demands of caregiving are becoming too great. What is the best way a nurse can help the daughter?
- A. Persuade her to admit her mother to a nursing home
- B. Aid her in finding help with in-home care
- C. Praise her success in being a good daughter and keeping her promise
- D. Point out her mistaken altruism
Correct Answer: B
Rationale: In this situation, the best course of action for the nurse is to aid the daughter in finding help with in-home care. Persuading her to admit her mother to a nursing home would likely cause guilt and emotional distress due to their pact. Praise alone may not address the current physical caregiving challenges. Pointing out her 'mistaken altruism' could be seen as insensitive and unhelpful. Providing practical assistance in finding in-home care can alleviate the physical demands on the daughter while still honoring the emotional commitment they made.
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.
Why might nurses not be the best choice to obtain informed consent from patients?
- A. Nurses may be tempted to influence the patient's decision in subtle ways.
- B. Nurses may not be able to answer some of the medical questions the patient asks.
- C. A signature obtained by anyone other than a physician will not stand up in court.
- D. Under the law, nurses are only allowed to act as witnesses to informed consent signatures.
Correct Answer: B
Rationale: Nurses may not have the medical expertise to answer all the questions that patients may have regarding their treatment, which is a crucial aspect of obtaining informed consent. While nurses should not influence a patient's decision, it is not a major reason why they should not obtain informed consent. Signatures obtained by nurses are legally binding, and although nurses often act as witnesses, there is no legal restriction preventing them from obtaining informed consent itself.