The nurse working in emergency triage is evaluating a client with injuries frequently associated with physical abuse. Which of the following questions if answered yes by the client would indicate a higher risk of mortality?
"Do you have a gun in your home?"
"Have you ever tried to leave?"
"How many times have you been hospitalized for abuse?"
"Do you have a plan if things go too far?"
The Correct Answer is A
Rationale:
A. The presence of a gun in the home is associated with a higher risk of severe injury or death in cases of domestic violence.
B. While trying to leave can be risky, it does not directly indicate a higher risk of mortality compared to other factors.
C. Repeated hospitalizations indicate ongoing abuse but are not as directly related to immediate risk of mortality as the presence of a gun.
D. Having a plan could indicate awareness and preparation, which may not directly correlate with immediate risk of mortality.
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Correct Answer is C
Explanation
Rationale:
A. Appendicitis is a common condition and does not inherently increase the risk of fatal abuse.
B. A fractured humerus may be concerning but is not as high-risk for fatal abuse as younger children with significant disabilities.
C. A child with cerebral palsy, especially at a young age, is at higher risk of fatal abuse due to increased dependency and vulnerability.
D. Varicella (chickenpox) is a contagious disease but does not significantly increase the risk of fatal abuse.
Correct Answer is A
Explanation
Rationale:
A. Checking with the doctor ensures that the herbal tea does not interact with the client's medications and is safe for their specific health condition. This response shows concern for the client's safety and adheres to clinical guidelines.
B. Filling out forms is not relevant or necessary for this situation; ensuring safety and medical compatibility is more appropriate.
C. Prohibiting herbal tea without considering the client’s preferences or potential benefits is not patient-centered care.
D. Questioning the client's choice without a valid reason dismisses their preferences and does not address potential safety concerns.