A nurse who works with the older population is aware that elder abuse takes many forms. Which of the following examples most clearly constitutes elder abuse?
A) A paid caregiver cleans and assists with shopping for an older adult who lives alone.
B) An older adult assists with child care in exchange for room and board at her niece's house.
C) A daughter manages her mother's finances after the older adult granted her power of attorney.
D) A daughter changes her mother's incontinence brief only after the urine has soaked through all her clothing because she wants to save money.
Question 2An 81-year-old has been living for the past 2 years in a long-term care facility. However, financial pressures have required that the resident move in with the oldest child and spouse.
Which of the following statements if made by the child's spouse should signal a potential risk for elder abuse?
A) I sure hope that we'll qualify for some home care because this seems pretty overwhelming.
B) This won't be easy for anyone. I think I might even end up having to juggle my work schedule.
C) He's used to being waited on here, but at our place he's going to have to fend for himself.
D) I'm probably going to even have to get some friends or neighbors to help out from time to time.
Question 3Which of the following statements is true about the laws of mandatory abuse reporting?
A) Government agencies, not individual nurses, are responsible for reporting abuse.
B) Mandatory reporting laws require reporters to know whether abuse or neglect has occurred, rather than just suspecting it has occurred.
C) The use of an abuse reporting protocol replaces individual responsibility for reporting.
D) A registered nurse is mandated to report abuse or neglect if it is suspected.
Question 4Which of the following is true about cognitive impairment and abuse of older adults?
A) Older adults who live alone are always willing to acknowledge their impairments.
B) Cognitively impaired older adults are usually able to meet minimum standards of care.
C) When the older adult denies cognitive impairment, the risk for abuse declines.
D) Older adults become more vulnerable to abuse because of cognitive impairment.
Question 5A 30-year-old grandchild lives with and provides care for the 75-year-old grandparent. The grandparent has congestive heart failure, hypothyroidism, and chronic pain from a compression fracture and osteoporosis.
The grandchild supervises the older adult's medications. The home health nurse notes that the older adult has extra diuretic pills and that the pain medications for a month have been used and cannot be refilled for 2 more weeks. The older adult tells the nurse: Those pain pills don't work, my back is always hurting. The nurse notes that the older adult's ankles are very swollen. Which of the following things should the nurse do first?
A) Call adult protective services and ask for an immediate evaluation.
B) Assess the grandchild's understanding of her grandmother's needs.
C) Take the grandmother to the emergency department immediately.
D) Tell the older adult that her grandchild is probably taking her pain medications.
Question 6A neighbor notices an 81-year-old getting water from someone's outside faucet. The neighbor notices that this person's ankles are very swollen and there is an open wound on her left leg.
The older adult says, I stopped taking my pills because the water department turned off my water and I can't use the bathroom. My daughter did not pay the water bill, and she never has time to take me to the doctor so my legs can be checked. The neighbor calls adult protective services. Which of the following interventions is the priority when the nurse visits for an evaluation and does not find any immediate danger?
A) The competency of the older adult in making decisions needs to be determined.
B) The daughter needs to be picked up by the police on a neglect charge.
C) The older adult needs to be involuntarily committed to a long-term care facility.
D) An involuntary legal intervention needs to be initiated immediately.
Question 7An older adult with heart failure and mild dementia states the intent to refuse low sodium diet and diuretics, stating: It's important to me to live free, without restrictions on what I eat. The family is supportive. Which action, by the nurse
should be done first?
A) Assure that the client understands the consequences of this decision.
B) Discuss this decision with the older adult's family to plan for the future.
C) Document the client's wishes in the plan of care.
D) Notify the primary health care provider of the client's wishes.
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