The Nurse Has Administered the Apgar Screen Tool to Assess

The nurse has administered the Apgar screen tool to assess an older client's family function status.Upon determining that the family functions at a 4, the nurse:

A) prepares to administer a more detailed tool.
B) prepares to report reasonable suspicion of elder abuse.
C) asks the client to identify specific family members to include in care planning sessions.
D) notifies social services that the family is not likely to be of much support to the client.