Patient Advocacy: Suspicion of Abuse

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The registered nurse is planning assignments for patients on a short-stay observation unit. Which activity should be assigned to the licensed practical nurse/licensed vocational nurse (LPN/LVN)? A. Provide patient teaching about routine wound care B. Obtain a urine specimen from a patient reporting hematuria and frequency C. Irrigate and apply a sterile dressing to a leg wound D. Admit a patient transferred from the emergency room

C. Irrigate and apply a sterile dressing to a leg wound

As a new graduate nurse is transitioning into her first pediatric nursing job, which statement suggests that this new nurse needs additional training, as identified by her preceptor and nurse manager? A. I'm so glad we have a CPS case worker in our hospital to deal with all this. I could never do that job! B. I'd like to watch some videos and maybe attend some classes on advanced physical assessment. I'm not sure I could detect potential abuse when assessing patients. C. I am glad to know that we receive ongoing training about what to do when we suspect some sort of abuse. This is all so new to me! D. Could I spend some time with the CPS case worker so I understand their role on our unit?

A. I'm so glad we have a CPS case worker in our hospital to deal with all this. I could never do that job!

Staff development activities on a nursing unit occur for a variety of reasons, including to establish or improve competence in an area, or to provide annual training for mandatory competencies. Which topics would be covered in an annual in-service of the mandatory child abuse reporting process for all nursing staff? (Select all that apply.) A. Review of the state statute on mandatory child abuse reporting. B. Discussion of actual case studies of child abuse to review obvious and concealed circumstances. C. Review and discussion of recent journal articles on child abuse detection and prevention. D. Role-playing how to discuss concerns of child abuse with parents or guardians. E. Demonstration of the electronic Child Protective Services (CPS) form that must be completed by a CPS staff member on every report made.

A. Review of the state statute on mandatory child abuse reporting. B. Discussion of actual case studies of child abuse to review obvious and concealed circumstances. C. Review and discussion of recent journal articles on child abuse detection and prevention. E. Demonstration of the electronic Child Protective Services (CPS) form that must be completed by a CPS staff member on every report made.

In a leadership class discussing the role of advocacy in nursing, the student nurse learns that these are patient advocacy nursing values when caring for a pediatric patient who may be a victim of child abuse? (Select all that apply.) A. Healing B. Autonomy C. Respect D. Caring E. Empowerment

B. Autonomy C. Respect D. Caring E. Empowerment

A 12-year-old child visits the school nurse about tiredness. While assessing the child, the nurse notices a black eye, which the child says occurred during a fall on the playground. This is the third school nurse visit in one month for vague, nonspecific complaints. What is the school nurse's priority action? A. Contact the child's parents and ask about the child's injury. B. Report suspicion of abuse to the local Child Protective Services (CPS) agency. C. Question the teacher about the parents' behavior and attendance at parents' night. D. Encourage the child to be truthful about the injury.

B. Report suspicion of abuse to the local Child Protective Services (CPS) agency.

During a home visit to a family of three—a mother, father, and child—the mother shares with the community health nurse that the father (who is not present) has hit the child on several occasions when he was drinking. The mother further explains that she has talked her husband into attending Alcoholics Anonymous and asks the nurse not to interfere, so her husband won't get angry and refuse treatment. What is the best response by the nurse? A. The nurse agrees not to interfere if the husband attends an Alcoholics Anonymous meeting that evening. B. The nurse commends the mother's efforts and also contacts Child Protective Services. C. The nurse commends the mother's efforts and agrees to let her handle things. D. The nurse makes plans to meet with the father to address these allegations with him.

B. The nurse commends the mother's efforts and also contacts Child Protective Services.

Which document addresses the role of the nurse in taking appropriate action regarding instances of illegal, unethical, and/or inappropriate behavior when caring for a patient population of any age? A. Health Insurance Portability and Accountability Act (HIPAA) B. Affordable Health Care Act C. Patient's Bill of Rights D. American Nurses Association (ANA) Scope and Standards of Practice

D. American Nurses Association (ANA) Scope and Standards of Practice

The pediatric nurse is admitting an 8-year-old child with cellulitis of both hands and arms from multiple infected bug bites in various stages of healing. The child has not received care for these infected bug bites. The nurse is upset and angry when she becomes aware that other unit staff have previously made several referrals to the local CPS agency about this family for issues related to neglect of care. Which ethical issue may be used to describe this situation? A. Moral uncertainty B. Moral distress C. Moral indifference D. Moral outrage

D. Moral outrage

When discussing the role of mandated reporting for suspected child abuse, the student nurse understands that not reporting suspected abuse could result in which legal action? A. Joint liability B. Defamation C. Intentional tort D. Professional negligence

D. Professional negligence

A 94-year-old patient with end-stage renal disease is refusing to take any prescribed medications, saying, "They make me feel sick, and I want to enjoy the rest of my short life." Which of the following responses by the nurse is best? A. I will have to notify your family. B. The doctor would not have ordered the medications if you didn't need them. C. I will call the doctor to ask for a different medication, like a shot. D. You can certainly decide not to take these medications, but first I want to make sure you know why they were prescribed.

D. You can certainly decide not to take these medications, but first I want to make sure you know why they were prescribed.


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