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 doesnt want to
attend.

Family members rarely visit.

There isnt 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.

Staffs 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
depende
ncy.

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:
Analysis
Cognitive Level:
Comprehension
NCLEX-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:
Reportin
g
suspecte
d abuse
is an
ethical
responsi
bility 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:
Analysis
Cognitive Level:
Application
NCLEX-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
complete
s an
investiga
tion
before
developi
ng a
plan.

Correct
Answer:
Consulti
ng with
the
physicia
n about
admissio
n to the
hospital
for a
thorough
assessm
ent 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:
Implementation
Cognitive Level:
Analysis
NCLEX-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
compet
ent to
make
decision
s.

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:
Assessment
Cognitive Level:
Application
NCLEX-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
individ
ual
doesnt
want to
attend.

Correct
Answer:
There
isnt
any

money
availabl
e to
make a
weekly
donatio
n 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:
Analysis
Cognitive Level:
Analysis
NCLEX-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
investiga
tion.

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:
Assessment
Cognitive Level:
Application
NCLEX-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
daught
er, who
is the
primary
caregiv
er, says
that it
is
difficult
to care
for her
elderly
parent.

Correct
Answer:
Caregiv
er 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:
Assessment
Cognitive Level:
Analysis
NCLEX-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
Answer:
Inability
to use
restraint
s with
physical
ly
challeng
ing
resident
s.

Correct
Answer:
Low
wages
and
heavy
workloa
ds of
the
nursing
assistan
ts.



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:
Evaluation
Cognitive Level:
Analysis
NCLEX-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
isolatio

n
theory
Correct
Answer:
Situatio
nal
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:
Planning
Cognitive Level:
Application
NCLEX-RN Test Plan:
Health Promotion and
Maintenance

10.

Which of the following
observations is
indicative of physical
mistreatment?
Your
Answer:
Downca
st eyes

Correct
Answer:
Dislocat
ed
shoulde
r



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