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.

Geria violencean dabuse

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 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:
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:
The
Your nurse
Answer: wanted
to be
identifie
d as the
one who
was the
case
finder.
Reportin
Correct g
Answer: 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:
Waiting
Your until a
Answer: social
services
agency
complet
es an
investig
ation
before
developi
ng a
plan.
Consulti
Correct ng with
Answer: the
physicia
n about
admissio
n to the
hospital
for a
thoroug

h
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?
The
Your elderly
Answer: person
is not
compet
ent to
make

decisio
ns.
The
Correct elderly
Answer: 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?
The
Your client
Answer: is
forced

to
attend
family
events
the
individ
ual
doesnt
want
to
attend.
There
Correct isnt
Answer: any
money
availab
le 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?
Request
Your a social
Answer: services
agency
do an
investiga
tion.
Intervie
Correct w the
Answer: 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?
An
Your adult
Answer: daught
er, who
is the
primar
y
caregiv
er, says

that it
is
difficult
to care
for her
elderly
parent.
Caregiv
Correct er will
Answer: 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:
Inability
Your to use
Answer: restrain
ts with

physical
ly
challeng
ing
resident
s.
Low
Correct wages
Answer: 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?
Social
Your isolatio
Answer: n
theory

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

10.

Which of the following

observations is
indicative of physical
mistreatment?
Downc
Your ast
Answer: eyes
Disloca
Correct ted
Answer: 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