Nursing Elites

1. Which of the following aspects of gerontological nursing would be most likely classified under private law?

• A. The regulation of who may call himself or herself a 'nurse'
• B. The contract between an older adult resident of a care facility and the owners of the facility
• C. The legal criteria for declaring an individual mentally incompetent
• D. The criminal consequences for instances of elder abuse

Correct answer: B

Rationale: The correct answer is B because private law deals with relationships between individuals and organizations, such as the contract between an individual and the care facility. Choices A, C, and D are not classified under private law. Choice A pertains to professional regulation and is a matter of public law. Choice C involves legal criteria and decision-making related to mental competence, falling under public law. Choice D concerns criminal consequences, which are also part of public law.

2. Mrs. W, aged 82, resides with her son and daughter-in-law who are finding it challenging to provide adequate care while maintaining their careers and home life. During a homecare visit, Mrs. W tells the nurse that, 'My children's generation doesn't know how good they've got it; when I was younger we all had to take care of our parents, and for a lot longer than most people do now.' Which of the following statements most accurately underlies the response that the nurse will provide to Mrs. W?

• A. The increasing prevalence of chronic illnesses means that there are indeed fewer old-old adults than there were in earlier generations.
• B. The increasing acceptance of long-term care means that the caregiving burden of the son and daughter-in-law's generation is lighter than that of Mrs. W's generation.
• C. More older people are living longer and receiving care in the community than when Mrs. W was in her middle-adult years.
• D. The caregiving needs of the old-old are increasing but these needs are more commonly met in institutional settings rather than in the community.

Correct answer: C

Rationale: The correct answer is C because people are living longer and receiving more of their care in the community than in years past. This reflects the current trend where older individuals tend to receive care in community settings rather than institutional ones. Choices A, B, and D are incorrect because they do not align with the reality that more older people today are living longer and being cared for in the community.

3. Nurse B arrives for his regular night shift at a care facility for the aged. Due to a family emergency, he has only slept for 3 hours since his last shift. One of Nurse B's aides calls in sick, and there is no one available to replace the aide that night. With no help accessible, Nurse B lifts an obese patient from a wheelchair into a bed alone. Short on time and assistance, Nurse B decides to forgo the patient's evening bath. Legally, what does Nurse B most likely face?

• A. Little risk of liability because he is doing his best under difficult circumstances
• B. Immediate termination for dereliction of duty
• C. Liability if a pattern of negligence is identified in his performance evaluation
• D. A high risk of liability for his actions

Correct answer: D

Rationale: In this scenario, Nurse B faces a high risk of liability for his actions due to several factors. Working with insufficient resources, failing to adhere to policies and procedures, taking shortcuts, and working while highly stressed are all situations that increase the risk of liability. Nurse B's decision to lift an obese patient without assistance and skip the patient's evening bath due to time constraints and lack of help are clear examples of actions that can lead to legal consequences. Choices A, B, and C are incorrect because the circumstances described in the scenario indicate a higher likelihood of liability due to the factors mentioned above.

4. 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.

5. Based on the information provided, what can be inferred about the nurse who has been working for several years in a long-term care facility with many Middle Eastern residents?

• A. The nurse's knowledge and skills provide expected care for clients in this demographic.
• B. The nurse is knowledgeable about Middle Eastern culture and respects and values providing culturally competent care.
• C. The nurse is attempting to overcompensate for cultural blindness and ethnocentrism within the community.
• D. This employment has allowed the nurse to demonstrate ethnic identity and cultural bias to a specific group of people.

Correct answer: B

Rationale: The nurse in the scenario is likely knowledgeable about Middle Eastern culture and values providing culturally competent care to the residents. This inference can be made based on the nurse being well-respected and effective in providing care to this population. Choice A is incorrect because it only focuses on the nurse's knowledge and skills, not specifically about cultural competence. Choice C is incorrect as there is no indication of overcompensation; the nurse is described as effective and well-respected. Choice D is incorrect as there is no evidence to suggest that the nurse is demonstrating ethnic identity or cultural bias, but rather respecting and providing care tailored to the cultural needs of the residents.

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