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","D","E"]
Explanation
Rationale:
A. Telling the client she should leave is not supportive and may not be appropriate; decisions about leaving should be made by the client.
B. Helping the client get her partner into a treatment program is not within the nurse's immediate role and does not address the client’s immediate safety needs.
C. Helping the client to develop a safety plan and providing emergency contact information is crucial for the client’s immediate safety and is an appropriate intervention.
D. Assisting the client to explore resources such as shelters and legal protection supports her in making informed decisions and accessing necessary help.
E. Communicating acceptance of the client's decision and avoiding blame helps build trust and ensures the client feels supported in a non-judgmental environment.
Correct Answer is C
Explanation
Rationale:
A. Asking the client if they are comfortable calling 9-1-1 is an appropriate action. It involves assessing the client's readiness and comfort level in seeking emergency help.
B. A nurse-client dialogue about specific steps the client can take to stay safe is important for empowering the client with knowledge and strategies for protection.
C. Insisting that the client act on the plan the next time their safety is threatened may be inappropriate as it can impose undue pressure on the client, who might feel trapped or fearful. The nurse should support the client's choices and provide options rather than insist on actions.
D. A nurse-client dialogue about the potential barriers to safety is crucial for understanding and addressing obstacles that might prevent the client from seeking help or staying safe.