A nurse is performing a routine assessment on an elderly client admitted for a hip fracture. The client avoids eye contact, flinches when touched, and has multiple healed bruises in various stages on the arms and back. When asked about the bruises, the client hesitates and says, 'I fall a lot at home.' What is the nurse's most appropriate action?:
Document the findings and reassess the client at the next scheduled shift.
Provide the client with education about reducing home safety risks to prevent falls.
Ask the client more specific questions to gather further information about their injuries.
Notify the appropriate authorities or social services about the suspicion of abuse.
The correct action in this situation is to notify the proper authorities or social services as required by law. The combination of the client's behavioral indicators (e.g., avoiding eye contact, flinching when touched), physical findings (e.g., bruises in various stages of healing), and an inconsistent explanation are hallmarks of potential abuse or neglect. Reporting initiates a formal investigation and ensures the client’s safety. While documentation and gathering additional information are important steps, they do not replace the legal obligation to report. Similarly, providing home safety education is inappropriate when abuse is suspected, as it overlooks the immediate risk to the client.
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NCLEX RN
Psychosocial Integrity
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