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Difficulty: MediumClient Rights and Advocacy

A practical nurse is preparing an older adult client for discharge to a family member's home. During a final skin assessment, the nurse observes multiple unexplained bruises in various stages of healing on the client's torso. The client becomes visibly withdrawn and flinches when the family member enters the room. When questioned privately, the client whispers, "I am just clumsy and fall sometimes." Which action should the practical nurse take to best advocate for this client's right to safety?

  1. A
    Wait to file an official report until concrete proof of physical harm is obtained from interviewing the family member.
  2. B
    Discuss the client's bruising and suspected abuse with other staff members in the hallway to gather opinions on whether to report.
  3. Notify the nursing supervisor and initiate a formal report to adult protective services based on the suspicion of abuse.Answer
  4. D
    Comfort the client by stating, "Do not worry, we will make sure nobody hurts you after you leave the facility."

Answer

Notify the nursing supervisor and initiate a formal report to adult protective services based on the suspicion of abuse.
The practical nurse acts as a client advocate by prioritizing the client's right to a safe environment. Because nurses are mandated reporters, recognizing the combination of physical signs (bruising in various stages of healing) and behavioral cues (flinching, withdrawal) creates a legal and ethical obligation to report the suspicion of abuse. Intervening before discharge is critical to prevent further harm.

Step-by-Step Solution

1
Assess the physical findings and behavioral cues of the client.
The nurse identifies multiple unexplained bruises and observes fearful behavior around the family member.
Recognizing signs of potential elder abuse is the first crucial step in client advocacy.
2
Correlate the assessment findings with mandated reporting laws and facility protocols.
The nurse determines that there is a reasonable, clinical suspicion of abuse.
Nurses are legally required to report suspected abuse to protect vulnerable populations, even without concrete proof.
3
Report the suspicion to the appropriate authorities immediately.
The nurse notifies the nursing supervisor and contacts adult protective services.
Immediate reporting ensures the client's safety is prioritized and investigated before a potentially unsafe discharge occurs.

Key Concept

Client Advocacy and Mandated Reporting of Suspected Abuse
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Topics

Client Rights and Advocacy

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