NSG 4067: ELDER ABUSE AND NEGLECT
1. An 80-year-old is seen in the emergency department for a fall. The client has bruises on the
upper arms and appears depressed. The client is accompanied by a grandchild, who is unkempt,
glassy-eyed, and whose breath smells of alcohol. Which of the following should be a priority
with the nurse?
A) Assess whether the older adult is safe in the home environment.
B) Determine whether legal interventions are appropriate.
C) Assess the client's degree of frailty and chronic health problems.
D) Determine the mental capacity of the older adult.
Ans: A
Feedback:
The first priority should be to see whether the older adult is safe and then determine his
competency. Legal intervention can be pursued after safety and competency are determined. The
degree of frailty and chronic health problems is assessed with safety issues and determination of
competency.
2. Which 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.
Ans: D
Feedback:
When the older adult denies cognitive impairment, the risk for abuse increases. Older adults who
are cognitively impaired are not able to meet minimal standards of care. Older adults who live
alone may be afraid to acknowledge their impairments.
3. A 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.
Ans: A
Feedback:
Because the older adult is not in immediate danger, the first step is to determine her competency
and the ability to make decisions for herself.
4. Which 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.
Ans: D
Feedback:
In all states within the United States, individual nurses are responsible for reporting abuse.
Mandatory reporters are required to report the suspicion of abuse or neglect. Protocols do not
replace individual responsibility. Protocols clarify individual roles and enhance the credibility of
the abuse report.
5. A 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.
Ans: B
Feedback:
Physical neglect can arise from the caregiver's lack of knowledge. It is important to assess the
caregiver's understanding of the dependent person's needs before drawing other conclusions.
1. An 80-year-old is seen in the emergency department for a fall. The client has bruises on the
upper arms and appears depressed. The client is accompanied by a grandchild, who is unkempt,
glassy-eyed, and whose breath smells of alcohol. Which of the following should be a priority
with the nurse?
A) Assess whether the older adult is safe in the home environment.
B) Determine whether legal interventions are appropriate.
C) Assess the client's degree of frailty and chronic health problems.
D) Determine the mental capacity of the older adult.
Ans: A
Feedback:
The first priority should be to see whether the older adult is safe and then determine his
competency. Legal intervention can be pursued after safety and competency are determined. The
degree of frailty and chronic health problems is assessed with safety issues and determination of
competency.
2. Which 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.
Ans: D
Feedback:
When the older adult denies cognitive impairment, the risk for abuse increases. Older adults who
are cognitively impaired are not able to meet minimal standards of care. Older adults who live
alone may be afraid to acknowledge their impairments.
3. A 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.
Ans: A
Feedback:
Because the older adult is not in immediate danger, the first step is to determine her competency
and the ability to make decisions for herself.
4. Which 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.
Ans: D
Feedback:
In all states within the United States, individual nurses are responsible for reporting abuse.
Mandatory reporters are required to report the suspicion of abuse or neglect. Protocols do not
replace individual responsibility. Protocols clarify individual roles and enhance the credibility of
the abuse report.
5. A 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.
Ans: B
Feedback:
Physical neglect can arise from the caregiver's lack of knowledge. It is important to assess the
caregiver's understanding of the dependent person's needs before drawing other conclusions.
