The Older Adult

Mr. Ashton's doctor prescribes anti-hypertensive medication that the elder is to take daily. Mr. Ashton, who is alert and oriented, says that he is not sick and will not waste money taking pills that he doesn't need. He refuses to take them despite his doctor's warnings that his blood pressure is seriously high and his family's pleas that he take the medicine. What category of abuse describes Mr. Ashton's behavior? a. self-neglect b. domestic abuse c. institutional abuse d. dementia-related abuse

a. Rationale: Self-neglect occurs when elders deliberately fail to take care of themselves.

The majority of elder abuse cases involve a. a family member abusing the elder at home. b. a healthcare worker abusing residents in a long-term care facility. c. strangers attacking elders outside the home. d. a neighbor who commits financial abuse.

a. Rationale: The majority of documented elder abuse cases involve a family member abusing the elder at home.

Which of these patients is displaying signs of abuse? a. A woman who complains that increases in cost of living makes it difficult to pay bills. b. A man who habitually waits for long periods of time before seeking medical help for injuries. c. A woman who has a habit of criticizing the medical care she receives. d. A man who prefers to discuss his medical issues privately with his physician.

b. Rationale: Waiting for long periods of time before seeking help for injuries can be a sign of abuse.

People who abuse elders a. are generally in good health. b. often come from a family with a history of domestic violence. c. seldom display dysfunctional personality traits. d. encourage socialization with other family members and friends.

b. Rationale: A history of family violence and dysfunctional family dynamics increases the risk of abuse.

Which of the following persons exhibits a sign of possible physical abuse? a. Mark, who is bald over the crown of his head. b. Nancy, who has a series of small, circular burns on her back. c. David, who has a fractured ankle due to a fall. d. Marian, who was in an automobile accident and has a black eye.

b. Rationale: Burns deliberately made by a lit cigarette produce small, circular burns.

Mrs. Carson's sons and daughters constantly insult and humiliate her in public. Which of the following statements is correct about this situation? a. No abuse is taking place because there is no physical evidence of abuse. b. Mrs. Carson is probably the victim of emotional abuse. c. Mrs. Carson's children are not harming their mother in any way. d. Mrs. Carson is self-abusive because she does not defend herself against these comments.

b. Rationale: Emotional abuse includes teasing, insults, and humiliation.

All of the following statements about the incidence of elder abuse are true EXCEPT: a. Every year, 1 to 2 million elders are abused in this country. b. Geriatric experts believe that most cases of elder abuse are reported and investigated. c. The rate of abuse increases as the age of the elderly population increases. d. Falls are the leading cause of accidental death in persons over 65 years of age.

b. Rationale: Geriatric experts believe that most cases of elder abuse are never reported.

Mr. Wilson is 85 years old and lives alone. His home is in need of repair and there are missing shingles from the roof of his house. Two young men in a green pick-up truck stop and ask Mr. Wilson if he would like them to fix his roof. They say that they will do the work for $100 but need to be paid before they perform any work. This is an example of probable a. financial abuse. b. get-rich-quick schemes. c. emotional abuse. d. fiduciary schemes.

a.

Mrs. Brooke was left at a grocery store, alone and helpless for several hours. She has no way of getting home and suffers from the early stages of dementia. What is Mrs. Brooke experiencing? a. abandonment b. physical abuse c. emotional abuse d. self-neglect

a. Rationale: Abandonment occurs when the person who is responsible for the elder deliberately deserts or abandons him/her.

Mrs. Henry is 90 years old. She lives with her granddaughter, who has taken her to her doctor's office for a routine checkup. Mrs. Henry is dressed in a short-sleeved blouse and light-weight slacks. She is wearing a thin sweater. The temperature outside is 45 degrees and it is raining. This could be an example of a. neglect. b. financial abuse. c. abandonment. d. emotional abuse.

a. Rationale: Inadequate clothing is often a characteristic sign of neglect.

Which of the following persons is most likely to be abused? a. Mr. Montgomery, a 75 year old with significant hearing loss. b. Mrs. Martin, an 85 year old who needs significant help with her activities of daily living. c. Mr. Brent, a 60 year old who is unable to walk and uses a wheelchair for mobility. Mrs. King, a 75-year old who has trouble speaking.

b. Rationale: Most victims of elder abuse are women. The older the elder, the more likely is the occurrence of abuse. Factors that increase the risk include physical and/or mental impairment. Mrs. Martin is the eldest of these people and needs significant help with her activities of daily living.

Which of the following is true? a. You must be able to prove elder abuse before you report it. b. Most states require nurses to report abuse. c. The laws concerning elder abuse are the same in all states. d. You have no obligation concerning abuse if you are a nursing student.

b. Rationale: The true statement is "Most states require nurses to report abuse." All other options are false.

In order to help stop abuse, elders should be taught to do all of the following EXCEPT: a. Keep in touch with family, friends, and neighbors. b. Ask a neighbor to deposit social security checks in a bank account. c. Receive regular health and dental care. d. Know how to contact help in the event they are abused.

b. Rationale: t is best to have checks directly deposited into a bank account. Unless the neighbor is a trusted, good friend, there is a danger of financial abuse. Question 7: Tremendous!

Sexual abuse of an elderly person a. seldom occurs because very elderly persons are not sexually active. b. is limited to actual physical contact. c. may be suspected if there is unusual bruising of the inner thighs. d. occurs only in women.

c.

Mrs. Banks is found shivering in the doorway to a community hospital's emergency department. When questioned, she says her granddaughter left her there hours ago and wasn't coming back. This is an example of a. self-neglect. b. financial abuse. c. abandonment. d. emotional abuse.

c. Rationale: Abandonment occurs when the person responsible for an elder deserts or abandons him/her.

Which of the following statements about elder abusers is CORRECT? a. Abusers usually have a good understanding of the behaviors that dementia can cause. b. Abusers usually readily admit that they are abusing elderly persons. c. Abusers often have many excuses to justify abusing elderly persons. d. Abusers seldom have a history of being abused themselves.

c. Rationale: Abusers often come up with a variety of excuses to justify or even deny the abuse.

Mrs. Ray is brought to the emergency room with a black eye and a fractured wrist. She insists that her son-in-law punched and shoved her. Mrs. Ray's daughter, Gloria, says that her mother is only trying to make trouble. Which of the following is an appropriate way to document this situation? a. Describe only the physical injuries and don't mention Mrs. Ray's and Gloria's comments. b. Document the following: Family members disagree about the nature of the injury and seem to dislike each other. c. Document the following: Patient states that "my son-in-law punched me and pushed me into the wall." Mrs. Gloria Mason, patient's daughter, states, "My mother is only trying to make trouble. She hates my husband." d. Document your opinions about the abuse since you are obligated to report any suspected abuse.

c. Rationale: Be objective in your charting. Put comments exactly as they were stated in quotes. Do not document your personal opinions.

Which of the following is an example of financial abuse? a. Mrs. Anderson establishes a joint bank account with her daughter. b. Mr. Bailey asks his son to sell the family home. c. Mrs. Larson notices that her daughter has withdrawn $1,000 from her savings account without her permission. d. Mr. Swanson is mentally incompetent and his son is responsible for his finances.

c. Rationale: Financial abuse includes taking money or other possessions from an elder without the elder's permission.

Mrs. Grey lives with her son and his family. She is well-provided for physically and enjoys living in the same house as her grandchildren. Her son and daughter-in-law drink alcohol quite heavily. When they are drunk they insist that she watch them while they are having sex. This disturbs Mrs. Grey terribly. Which of the following statements describes this situation? a. No abuse is taking place because Mrs. Grey is not being harmed. b. To qualify as sexual abuse, Mrs. Grey must experience unwanted physical contact. c. This situation qualified as sexual abuse. d. Unless Mrs. Grey has lacerations or bleeding in the genital or anal areas, no abuse has taken place.

c. Rationale: Sexual abuse includes forcing the elder to view sexual scenes without his or her consent. Sexual abuse is not limited to sexual contact.

In most states, which group is responsible for investigating reports of elder abuse? a. The police b. Area Agency on Aging c. Adult Protective Services d. Nursing home administrators

c. Rationale: The Adult Protective Services Agency is responsible for investigating reports of elder abuse.

Which of these persons has the greatest risk of becoming an elder abuser? a. An RN who has worked on a dementia unit for 15 years. b. A man who visits his ailing mother twice a day. c. A teenager who abuses alcohol and occasionally visits his elderly grandmother. d. A woman who was verbally abused by her mother throughout her life.

d. Rationale: Victims of abuse are more likely to become abusers themselves.

All of the following statements about failure to report abuse are true EXCEPT: a. Elders may be afraid to report the abuse. b. Elders sometimes blame themselves for the abuse. c. Elders may be embarrassed to report the abuse. d. Elders do not report abuse because they encourage it.

d. Rationale: Although elders sometimes believe that they are to blame for the abuse, and abusers sometimes believe that the elder is responsible for the abuse, the victim is NOT responsible for abuse.

Which of these signs is suggestive of abuse? a. Bald spots over the crown of a man's head b. Brusing at the site of an injection c. Simple fracture of the leg d. Brush burns around the torso

d. Rationale: Brush burns in an unusual place such as the torso may suggest the inappropriate use of tight restraints

Roberta is a newly licensed registered nurse. Her patient, Mrs. Talbot, is a pale, thin elderly woman admitted with pneumonia. She tells Roberta that: "I am afraid to go home. My daughter and her husband make me stay in a cold room with no heat and no blankets." Roberta suspects neglect as a form of elder abuse and documents her findings by recording: a. Mrs. Talbot is confused and thinks she is being abused. b. Mrs. Talbot is a victim of neglect. c. Mrs. Talbot states that her family is neglecting her. d. Mrs. Talbot states that "my daughter and her husband make me stay in a cold room with no heat and no blankets."

d. Rationale: Documentation must be factual, and the best way to convey Mrs. Talbot's words is to quote her.

1. Victoria is an elderly resident in a long-term care facility. Recently, a new member of the staff begins to push Victoria roughly when she is helping the elder into a wheelchair. This staff member also twists Victoria's arm when the elder is incontinent. What category of abuse is this? a. neglect b. domestic abuse c. self-abuse d. institutional abuse

d. Rationale: Institutional abuse occurs when persons employed in homes for elders (such as long-term care facilities) commit abuse.

Stephanie is a senior nursing student working part-time as a nursing assistant. One weekend, in her role as a nursing assistant, Stephanie is assigned to take care of an elderly patient who has brush burns around both of his ankles and bald spots at the sides of his scalp. Stephanie suspects elder abuse. Her FIRST action should be: a. Do nothing since she is functioning as a nursing assistant and is not obligated to report suspected abuse. b. Call 911 immediately. c. Confront the man's son with her suspicions. d. Report her suspicions to the charge nurse.

d. Rationale: She should immediately report her suspicions to the charge nurse as a first step.

Which of the following injuries can be a sign of physical abuse? a. pattern baldness b. general bruising of the c. upper arm d. spiral fractures

d. Rationale: Spiral fractures are often the result of deliberately twisting the limb.

Stacey is a nursing assistant and suspects that one of her elderly patients is being abused. What should she do? a. Nothing. She is not a licensed professional and has no authority to pursue this matter. b. Confront the person she suspects is abusing the elder. c. Discuss the matter with her friends and family. d. Follow her hospital's policies and procedures for reporting elder abuse.

d. Rationale: Stacey may not be a mandated reporter, but she has an ethical and moral obligation to intervene.

The elder abuser is most often the victim's a. spouse. b. neighbor. c. siblings. d. adult child.

d. Rationale: The abuser is the victim's adult child in about 47% of documented cases.

Who commits financial abuse most frequently? a. lawyers b. stockbrokers c. financial advisers d. family members

d. Rationale: The persons who commit financial abuse most often are family members.