Primary prevention of elder mistreatment is a healthcare goal. The nurse recognizes that one of the risk factors often present in elder mistreatment situations is:    

Caregiver independence.

  Home care dependency.

  Elder abandonment.

  Elder dependency.

A home care nurse found an elderly client with multiple bruises on both arms and the trunk. After the client denied the spouse was responsible, the rationale the nurse used for reporting the suspicion of abuse was:

    The nurse wanted to be identified as the one who was the “case finder.”

  Reporting suspected abuse is an ethical responsibility of the nurse.

  The nurse was concerned about being sued.

  The client was too afraid to report the spouse.

When a nurse determines with a high degree of confidence that an elderly homebound client has been mistreated, an appropriate intervention would be:

    Waiting until a social services agency completes an investigation before developing a plan.

  Consulting with the physician about admission to the hospital for a thorough assessment of the client.

  Arranging for police surveillance of the home.

  Suggesting that the family hire a new caregiver.

Which of the following situations could be the source of an ethical dilemma for the nurse with respect to elder mistreatment?

    The elderly person decides to return to the abusive setting.

  The elderly person was seriously injured due to physical abuse.

  The family sues the nurse for reporting abuse.

  The elderly person is not competent to make decisions.

An elderly person reports all of the following experiences to the nurse. Which of the reported experiences is the most likely indicator of exploitation of the elderly person?

    The client is forced to attend family events the individual doesn’t want to attend.

  Family members rarely visit.

  There isn’t any money available to make a weekly donation at church.

  The client is being threatened with admission to a nursing home.

The nurse suspects that a home health aide who comes into the home every day to provide basic hygiene care is abusing an elderly client. What is the best way to gather more information about the situation to confirm suspicions of abuse?

    Interview the client in private.

  Confront the caregiver about suspicions.

  Request a social services agency do an investigation.

  Ask the family what they think.

What data would help support a nursing diagnosis of elder mistreatment in the domestic setting?

    Caregiver will bathe the client only once a week.

  Client has a flat affect.

  An adult daughter, who is the primary caregiver, says that it is difficult to care for her elderly parent.

  Client states unhappiness with living arrangements and lack of privacy in a small home with young children present.

Mistreatment that occurs in nursing homes and is directed toward the elderly often is due to:

    Inability to use restraints with physically challenging residents.

  Low wages and heavy workloads of the nursing assistants.

  Staff’s lack of interest in the elderly as individuals.

  Nurses who feel their talent is not being used appropriately in a nursing home setting.

A nurse who plans to do research on caregiver strain in spouses of homebound elderly with cognitive impairment due to dementia is most likely to choose which theory of elder mistreatment to guide the study?

    Social isolation theory

  Exploitation theory

  Situational theory

  Transgenerational violence theory

Which of the following observations is indicative of physical mistreatment?

    Downcast eyes

  Agitation

  Withdrawing from soft touch

  Dislocated shoulder

Primary prevention of elder mistreatment is a healthcare goal.

The nurse recognizes that one of the risk factors often present in elder mistreatment situations is:

Your Answer:

Elder dependency.

  Rationale: One of the primary characteristics in elders who have been mistreated is dependency on others for performance of activities of daily living. Dependence can lead to caregiver strain and then mistreatment. Home care is not a risk factor for mistreatment. Caregiver independence is not related to

mistreatment of the elderly. Elders who have minimal family support can feel abandoned.Nursing Process: AnalysisCognitive Level: ComprehensionNCLEX-RN Test Plan: Psychosocial Integrity

2. A home care nurse found an elderly client with multiple bruises on both arms and the trunk. After the client denied the spouse was responsible, the rationale the nurse used for reporting the suspicion of abuse was:

Your Answer:

The nurse wanted to be

identified as the one who was the “case finder.”

Correct Answer:

Reporting suspected abuse is an ethical responsibility of the nurse.

  Rationale: The nurse has an ethical and legal responsibility to report suspected abuse to designated authorities for investigation. Because the nurse has this responsibility, legal liability is not an issue, nor are the denials by the client grounds for not

reporting the suspicion of abuse.Nursing Process: AnalysisCognitive Level: ApplicationNCLEX-RN Test Plan: Safe, Effective Care Environment

3. When a nurse determines with a high degree of confidence that an elderly homebound client has been mistreated, an appropriate intervention would be:

Your Answer:

Waiting until a social services agency completes an investig

ation before developing a plan.

Correct Answer:

Consulting with the physician about admission to the hospital for a thorough assessment of the client.

  Rationale: It is appropriate to admit a client to the hospital for a thorough assessment in a safe environment, and it serves as an immediate way to remove the client

from the situation. Social Services will conduct an investigation, but the nurse has a responsibility to formulate a plan of care for the client. The caregiver might not be responsible for the abuse, so it would not be appropriate to suggest a new caregiver. Police surveillance is not done for suspected mistreatment.Nursing Process: ImplementationCognitive Level: AnalysisNCLEX-RN Test Plan: Safe, Effective Care Environment

4. Which of the following situations could be

the source of an ethical dilemma for the nurse with respect to elder mistreatment?

Your Answer:

The elderly person is not competent to make decisions.

Correct Answer:

The elderly person decides to return to the abusive setting.

  Rationale: The nurse recognizes an ethical dilemma is posed when a competent adult chooses to

return to the setting in which abuse occurred, because there is a high likelihood of abuse being repeated. The elderly person who is not competent will not be allowed to make decisions about the living situation. Injury is not a source of an ethical dilemma, nor is legal action taken against a nurse.Nursing Process: AssessmentCognitive Level: ApplicationNCLEX-RN Test Plan: Safe, Effective Care Environment 

5. An elderly person reports all of the following experiences to the nurse. Which of

the reported experiences is the most likely indicator of exploitation of the elderly person?

Your Answer:

The client is forced to attend family events the individual doesn’t want to attend.

Correct Answer:

There isn’t any money available to make a weekly donati

on at church.

  Rationale: When the elderly are exploited, others take advantage of them, almost always with respect to money matters. The exploiters might not be family members. Failure of family to visit and forced attendance of family events are not exploitation. Threats can be attempts at coercion but are not exploitation.Nursing Process: AnalysisCognitive Level: AnalysisNCLEX-RN Test Plan: Psychosocial Integrity

6. The nurse suspects that a home health aide who comes into the home every day to provide basic hygiene care is abusing an elderly client. What is the best way to gather more information about the situation to confirm suspicions of abuse?

Your Answer:

Request a social services agency do an investigation.

Correct Answer:

Interview the client in private.

  Rationale: The best method of getting information is to interview the client in

a private setting. Depending on the responses of the client, the nurse can develop a plan for how to proceed. The nurse then can consult the family or involve a social services agency.Nursing Process: AssessmentCognitive Level: ApplicationNCLEX-RN Test Plan: Health Promotion and Maintenance

7. What data would help support a nursing diagnosis of elder mistreatment in the domestic setting?

Your Answer:

An adult daughter, who

is the primary caregiver, says that it is difficult to care for her elderly parent.

Correct Answer:

Caregiver will bathe the client only once a week.

  Rationale: For the elderly, some hygiene measures might not be needed or desirable in the same frequency as for younger adults. However, bathing only

once weekly is not likely to be sufficient. Unhappiness with living arrangements and a flat affect are not evidence of mistreatment. Recognition of challenges with care giving does not mean mistreatment has occurred.Nursing Process: AssessmentCognitive Level: AnalysisNCLEX-RN Test Plan: Safe, Effective Care Environment

8. Mistreatment that occurs in nursing homes and is directed toward the elderly often is due to:

Your Inability to use

Answer:restraints with physically challenging residents.

Correct Answer:

Low wages and heavy workloads of the nursing assistants.

  Rationale: Individuals who have few skills and inadequate education in the complex care needs of the elderly, along with accompanying low wages and heavy workloads, might mistreat the elderly out of simple

frustration.Nursing Process: EvaluationCognitive Level: AnalysisNCLEX-RN Test Plan: Safe, Effective Care Environment

9. A nurse who plans to do research on caregiver strain in spouses of homebound elderly with cognitive impairment due to dementia is most likely to choose which theory of elder mistreatment to guide the study?

Your Answer:

Social isolation theory

Correct Situational

Answer: theory  Rationale: Situational

theory examines the burdens of caregiving and the ability of the caregiver to meet the needs and demands of the elderly individual. Mistreatment can result when the situation becomes overwhelming for the caregiver. The other theories do not relate to caregiver strain.Nursing Process: PlanningCognitive Level: ApplicationNCLEX-RN Test Plan: Health Promotion and Maintenance

10. Which of the following observations is indicative of physical

mistreatment?

Your Answer:

Downcast eyes

Correct Answer:

Dislocated shoulder

  Rationale: This is the only listed physical sign. A dislocated shoulder can occur with a violent jerk on the arm. Nursing Process: AssessmentCognitive Level: AnalysisNCLEX-RN Test Plan: Psychosocial Integrity