During a bath, the nurse notes findings on a resident. Which findings raise concern for possible abuse?
Select all that apply.
Bruises in various stages of healing on the inner upper arms
One small bruise on the shin after documented contact with a walker
Flinching and fear when a particular caregiver approaches
Mild forgetfulness consistent with the diagnosis
Asking for a different roommate after an argument
Show the answers and explanation
Answers: A and C.
A – Bruises in various stages of healing on the inner upper arms
C – Flinching and fear when a particular caregiver approaches
Topic: Recognizing elder abuse
Patterned or hidden bruises at different stages of healing and fear of a specific caregiver are classic warning signs of abuse. A single explained injury, expected cognitive changes and a roommate complaint are not suspicious by themselves.
Why the others are wrong
B – A documented, consistent explanation makes this less suspicious.
D – Forgetfulness expected for the diagnosis is not a sign of abuse.
E – A roommate request after an argument is a routine concern.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
2Question
An adult client arrives at the emergency department two hours after a sexual assault. She is tearful and asks if she can shower. Which nursing actions are appropriate?
Select all that apply.
Explain that bathing, douching and changing clothes before the exam can destroy evidence, and ask her to wait if she is able
Place her damp clothing together in a sealed plastic bag so that nothing is lost
Stay with her or call an advocate, and offer a private, quiet space
Place each piece of clothing in its own paper bag
Tell her that she must file a police report before the exam can begin
Record her account in her own words in quotation marks and keep the chain of custody for every specimen
Show the answers and explanation
Answers: A, C, D and F.
A – Explain that bathing, douching and changing clothes before the exam can destroy evidence, and ask her to wait if she is able
C – Stay with her or call an advocate, and offer a private, quiet space
D – Place each piece of clothing in its own paper bag
F – Record her account in her own words in quotation marks and keep the chain of custody for every specimen
Topic: forensic evidence after sexual assault
Evidence is best preserved when the client does not bathe, douche or change before the exam, but the choice stays hers and she is not pressured. Each item of clothing goes in its own paper bag, because plastic traps moisture and damages evidence. Presence of an advocate, privacy, careful quoted documentation and chain of custody protect both the client and the evidence. A police report is not required for the exam.
Why the others are wrong
B – Plastic traps moisture and promotes mold and bacterial growth; evidence is kept in paper.
E – A report is the client's choice; in many places the exam and evidence collection can be done without one.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
3Question
A clinic nurse sees a teenage girl who is brought in by an older man who answers every question for her and will not leave the room. Which findings increase the concern for human trafficking?
Select all that apply.
She looks to the man before answering each question and avoids eye contact
She says that someone else keeps her identification and travel papers
She says she lives with her parents and goes to high school each day
She has bruises in different stages of healing and an account of the injuries that keeps changing
She asks her own questions about the visit and is comfortable being alone with the nurse
Show the answers and explanation
Answers: A, B and D.
A – She looks to the man before answering each question and avoids eye contact
B – She says that someone else keeps her identification and travel papers
D – She has bruises in different stages of healing and an account of the injuries that keeps changing
Topic: recognizing indicators of trafficking
Indicators of trafficking include a controlling companion, deference to him, someone else holding identification, signs of repeated injury and a history that changes. No single finding is proof, so the nurse looks for a pattern, interviews the client alone using a professional interpreter if needed, and follows the facility protocol and reporting duties. Stable housing, school attendance and independence argue against it.
Why the others are wrong
C – Stable family housing and regular school attendance point away from control by another person.
E – Independence and ease when alone with staff argue against control by another person.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
4Question
A home health nurse visits an 82-year-old widow who lives alone. In two months she has lost 6 kg, her clothing is soiled, mail is piled by the door and the refrigerator holds spoiled food. She is alert and oriented and says, 'I manage just fine.' Which action is most appropriate?
Accept her statement, because she is alert and oriented, lives independently and is entitled to decide how she wants to live her life at home
Arrange with her relatives to move her into a nursing home as soon as possible
Assess her cognition, mood, nutrition and function, and report to the provider and Adult Protective Services as the state requires
Leave a pamphlet about community meal programs and revisit in three months
Show the answer and explanation
Answer: C. Assess her cognition, mood, nutrition and function, and report to the provider and Adult Protective Services as the state requires
Topic: self-neglect in an older adult
These findings describe self-neglect, which is a form of elder neglect and is reportable to Adult Protective Services in many states. A competent adult may refuse help, but the nurse must still look for treatable causes such as depression, dementia, illness or medication effects and let the right agency evaluate safety. Alertness alone does not show that she is safe.
Why the others are wrong
A – Her orientation does not explain the weight loss and spoiled food; accepting the statement leaves a likely serious problem unevaluated.
B – A forced move without assessment ignores her rights and the cause of the decline; autonomy is limited only through the proper process.
D – A pamphlet and a three-month gap is too weak a response to a client who is losing weight now.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
5Question
A school nurse examines an 8-year-old who has patterned bruises on the back and says she is afraid to go home. The nurse suspects physical abuse. To whom is the nurse legally required to make a report?
The state or local child protective services agency
The child's parents, so they can explain the injuries first
Only the school principal, who then decides whether to report
The child's pediatrician, with a note in the school record
Show the answer and explanation
Answer: A. The state or local child protective services agency
Topic: mandated reporting of child abuse
Nurses are mandated reporters. When they have reasonable suspicion of child abuse or neglect, they must report to the child protective services agency or, depending on state law, law enforcement. Proof is not required, and the report cannot be delegated to a supervisor or delayed to confront the family.
Why the others are wrong
B – Confronting the parents first can endanger the child and compromise any investigation.
C – Facility policy may require telling a supervisor, but the nurse's own legal duty is not met by passing the decision on.
D – A note to the physician is not a report to the agency that investigates and protects children.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
6Question
During a home visit, a nurse sees unexplained bruising on an older adult's arms. The caregiver answers all questions for the client, and the client flinches when the caregiver moves near. What should the nurse do?
Confront the caregiver about the bruises and ask whether the caregiver is hurting the client
Report the suspicion to Adult Protective Services and document the objective findings
Wait until the next visit to see whether more evidence of mistreatment appears
Ask the client to sign a statement that the bruises came from a fall and then close the matter
Show the answer and explanation
Answer: B. Report the suspicion to Adult Protective Services and document the objective findings
Topic: reporting suspected elder abuse
Nurses are mandated or expected reporters of suspected elder abuse in most states. A reasonable suspicion is enough, and the report goes to Adult Protective Services with objective documentation.
Why the others are wrong
A – Direct confrontation can endanger the client and is not the nurse's role.
C – Delay leaves the client at risk, and reporting does not require proof.
D – Obtaining such a statement does not address the suspected abuse.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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