A mother confides to the nurse that her live-in boyfriend knocked down her 2-year-old child because he was crying too much.
She begs the nurse not to tell anyone because her boyfriend has agreed to take anger management classes.
Which of the following actions should be taken by the nurse?

Choice A rationale

While improving self-esteem can benefit the client, it does not address the immediate danger posed by an abusive relationship. Self-esteem-focused interventions are long-term and secondary to ensuring the client’s physical safety and security in abusive situations.

Choice B rationale

Teaching the client to avoid conflict places the burden of change on the victim, which is inappropriate in cases of domestic abuse. It does not reduce the risk of harm or address the perpetrator’s behavior, nor does it prioritize the client’s safety.

Choice C rationale

Couples counseling is contraindicated in cases of domestic violence as it can increase the risk of harm to the victim. Addressing abuse requires individual interventions and prioritizing the safety of the victim rather than joint sessions that might escalate tension or conflict.

Choice D rationale

Developing a safety plan is the first priority when dealing with cases of domestic violence. This plan includes identifying safe spaces, emergency contacts, and strategies to leave the abusive environment if necessary. It addresses the immediate risk and ensures the client’s physical safety.

Choice A rationale

Counseling for the boyfriend does not address the immediate safety risks to the child, who may remain vulnerable to further harm in the current environment.

Choice B rationale

While alternate housing might protect the child, it delays mandatory reporting, which is a legal obligation for healthcare providers in suspected abuse cases to ensure child welfare.

Choice C rationale

Reporting to child protective services is legally required and ensures the safety of the child while allowing investigation into the abuse for appropriate intervention and support.

Choice D rationale

Maintaining confidentiality is not applicable in cases of suspected child abuse, as healthcare providers are mandated reporters and must prioritize the child's safety over privacy.