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. The Domestic Violence Screening Tool is used to screen for domestic violence but may not be as specifically validated for assessing immediate safety and lethality.
B. The Intimate Partner Assessment is a general tool for assessing relationships but lacks specific validation for safety concerns in abuse cases.
C. The Lethality Tool is specifically designed to assess the risk of harm or death in situations of intimate partner violence. It is widely validated and focuses on assessing immediate safety and risk.
D. The Mini Mental Status Exam is used to assess cognitive function and mental status, not specifically for abuse or safety assessment.
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.