Nursing Elites

1. An elderly man has relied on one of his sons for his care. Now the son has become very involved with a religion other than the one in which he was raised. As a result, he now refuses to help his father. What can a nurse do to help in this family situation?

• A. Set up a family conference that includes the son
• B. Bring in help from other family members or outside
• C. Insist that the son help, along with other family members
• D. Ask the family's own spiritual adviser to intervene

Correct answer: A

Rationale: In this complex family situation, it is essential to approach the issue with sensitivity and understanding. Setting up a family conference that includes the son is the most appropriate action for the nurse to take. While it may seem challenging, there is a possibility that involving the son in a family discussion can help him understand the impact of his actions on his father and the rest of the family. By including him in the conversation, the son may realize the importance of his role in caring for his father. Insisting that the son help, along with other family members, could lead to resistance and further alienation. Asking the family's spiritual adviser to intervene may not be effective if the son is rebelling against the family's religion. If the family conference does not yield positive results, then bringing in help from other family members or an outside caregiver may become necessary to ensure the elderly man receives the care he needs.

2. What is a standard of care?

• A. A relationship in which a nurse has assumed responsibility for the care of a patient
• B. A policy or procedure established by a health care agency or professional association
• C. The norm for what a reasonable individual would do in a similar circumstance
• D. A public law that, if violated, can result in liability for the nurse

Correct answer: C

Rationale: A standard of care is the level of care that a reasonably prudent person with similar training and experience would provide in a similar circumstance. Choice A is incorrect because it describes the nurse-patient relationship. Choice B is incorrect as it refers to specific policies or procedures. Choice D is incorrect as it describes a law rather than the expected level of care.

3. Which of the following family interactions would the nurse most likely interpret as being atypical?

• A. Mr. R states that he and his brother always had a cordial, though somewhat distant, relationship but that they are now quite close.
• B. Mrs. D describes being a grandparent as 'having all the benefits of having children without the headaches and responsibilities.'
• C. Mr. and Mrs. N had a tumultuous relationship for decades but now appear more at ease with one another.
• D. Mr. A states that his ideal living situation would be himself and his adult son and daughter all under the same roof.

Correct answer: D

Rationale: The correct answer is D. While marital reconciliation, rekindled relationships with siblings, and satisfaction in the role of grandparent are common phenomena among older adults, it is less common for parents and children to see cohabitation as an ideal situation or first preference. Choices A, B, and C reflect common positive family dynamics experienced by older adults, such as improved relationships with siblings, contentment in the grandparent role, and easing of marital tensions over time. On the other hand, choice D stands out as atypical as it suggests an unconventional living arrangement where adult children live with their parent, which is less commonly preferred by older adults.

4. Which of the following statements most accurately captures an aspect of contemporary family caregiving in the United States?

• A. Women typically spend more time caring for aging parents than they did for their own children.
• B. The most common pattern of care involves an older man providing in-home care for his wife.
• C. The majority of care is now provided by public and private agencies rather than family members.
• D. A residential or institutional environment is now the most common venue for caregiving.

Correct answer: A

Rationale: The correct answer is A. Today, on average, women spend more time providing care for their aging parents than they did for their own children. While some men provide care for their wives, it is not the most common pattern. Family members, rather than public or private agencies, still provide the majority of care in a non-institutional environment, making option C incorrect. Also, caregiving in a residential or institutional environment is not the most common venue, thus choice D is inaccurate.

5. An 81-year-old female client has presented to the emergency department accompanied by her daughter with whom she lives. The daughter states that her mother has experienced a recent series of falls, which have resulted in her facial and arm bruises. The client smells of urine and is noticeably emaciated, unkempt, and anxious while the daughter berates her during the nurse's assessment. What is the nurse's responsibility in this situation?

• A. Determine the daughter's legal status with regard to her mother's financial affairs
• B. Report suspected elder abuse
• C. Establish whether the client has a durable power of attorney in place
• D. Obtain medical records regarding prior admissions for similar problems

Correct answer: B

Rationale: In cases of suspected elder abuse, the nurse is responsible for reporting his or her suspicions to the relevant authorities. In this scenario, the signs of elder abuse are evident, such as the client's bruises, unkempt appearance, and the daughter's behavior. Determining the daughter's legal status or the client's power of attorney are not immediate priorities when abuse is suspected. Obtaining medical records for prior admissions is also not the primary concern in this situation.

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