A nurse is assessing an 80-year-old client who has multiple bruises on their arms and back in various stages of healing. The client's adult child and primary caregiver states, "They've always been clumsy and fall frequently." The client is quiet and avoids making eye contact. What is the nurse's primary legal responsibility in this situation?
Obtain a definitive confirmation of abuse from the client before reporting.
Report the suspicion of abuse to the appropriate state authorities.
Ask the caregiver to leave the room so the client can be interviewed alone.
Document the findings and continue to monitor for any new injuries.
The correct answer is to report the suspicion of abuse to the appropriate state authorities. Nurses are mandated reporters and are legally required to report any suspicion of abuse or neglect involving vulnerable populations, such as the elderly. The report should be made based on a reasonable suspicion; proof is not required. Delaying the report to monitor for new injuries or waiting for the client to confirm the abuse could place the client at further risk. While confronting the caregiver may be part of a broader intervention, it is not the primary legal responsibility, which is to ensure the safety of the client by reporting to the designated authorities.
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