A nurse in an emergency department is caring for a client who recently experienced partner violence.

Exhibits

The nurse is reviewing the client’s medical record at discharge. For each finding, specify whether the finding indicates a potential improvement in or a worsening of the client’s physical or psychological status.

Client states that the partner will not be violent in the future.

Client agrees to an appointment with a social worker.

Client’s reported pain level of the left wrist.

Client requests help developing a safety plan.

Client claims responsibility for the physical altercation.

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}

Choice A Reason: The belief that a partner will not be violent in the future can be a form of denial or wishful thinking, especially without any evidence of change or intervention. It is not uncommon for individuals in abusive relationships to hope for change, but without concrete actions, such as therapy or other interventions, this hope does not indicate an improvement in the client’s situation.

Choice B Reason: Agreeing to an appointment with a social worker is a positive step towards addressing the situation and seeking help. Social workers can provide support, resources, and guidance, which can be crucial for someone experiencing partner violence. This choice indicates a potential improvement in the client’s psychological status as it shows a willingness to engage with support services.

Choice C Reason: A decrease in reported pain levels can indicate physical improvement. Pain scales are subjective but provide a measure of the client’s comfort and can reflect healing or the effectiveness of pain management strategies.

Choice D Reason: Requesting help to develop a safety plan is a proactive step in ensuring personal safety and preparing for potential future incidents of violence. It shows the client’s awareness of the risks and a desire to protect themselves, which is a positive indicator of psychological improvement.

Choice E Reason: While claiming responsibility for the physical altercation may seem negative, it can also be seen as the client’s attempt to make sense of the situation. It is important to note that responsibility for violence lies with the perpetrator, not the victim. However, recognizing the dynamics of the relationship and the events leading up to the violence can be part of the healing process and taking control of one’s life.

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Correct Answer is B

Explanation

Choice A reason: Watching television before bedtime can be stimulating and interfere with the ability to fall asleep. The blue light emitted by screens can also disrupt the body's natural sleep-wake cycle.

Choice B reason: Regular exercise, particularly when done earlier in the day, can help reduce anxiety and improve sleep quality. However, it's important to avoid vigorous exercise close to bedtime as it can be too stimulating.

Choice C reason: Consuming the evening meal too close to bedtime can cause indigestion and interfere with sleep. It's better to finish eating at least 2-3 hours before going to bed.

Choice D reason: Taking long naps, especially later in the day, can make it more difficult to fall asleep at night. If naps are necessary, they should be short and not too close to bedtime.

A. Encourage the client to internalize their feelings related to the loss. B. Change the subject when the client expresses anger about their situation. C. Allow the client to be alone during times of spiritual inadequacy. D. Offer to contact the client's spiritual advisor if they have one.

Correct Answer is D

Explanation

Choice A reason: Encouraging the client to internalize their feelings related to the loss is not advisable. Grief is a personal experience, and expressing emotions is a healthy part of the grieving process. Internalizing feelings can lead to unresolved grief and potential mental health issues.

Choice B reason: Changing the subject when the client expresses anger about their situation is not supportive. Anger is a natural stage of the grieving process, and it's important for the nurse to acknowledge the client's feelings and provide a safe space for them to express their emotions.

Choice C reason: Allowing the client to be alone during times of spiritual inadequacy may not be beneficial. While respecting the client's need for solitude is important, it's also crucial to offer support and presence, as isolation can exacerbate feelings of loneliness and despair.

Choice D reason: Offering to contact the client's spiritual advisor is a supportive action that can help meet the client's spiritual needs. Spiritual care is an integral part of holistic nursing care, and connecting the client with their spiritual support system can provide comfort and aid in the grieving process.

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Correct Answer is B

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Correct Answer is D

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