A nurse is conducting a home visit for a client who has a newborn baby. The nurse observes that the client's partner is verbally abusive and controlling towards the client. The partner does not allow the client to leave the house or talk to anyone without their permission. The partner also refuses to let the nurse talk to the client privately. What is the most appropriate action by the nurse?

Confront the partner and tell them that their behavior is unacceptable and abusive.

Ignore the partner and focus on providing education and care to the client and the baby.

Report the partner to the authorities for domestic violence and child abuse.

Give the client a phone number for a domestic violence hotline and ask them to call when they are safe.

Answer and Explanation

The Correct Answer is D

Rationale: The nurse should recognize that the client is in an abusive relationship and may be at risk of harm or retaliation if they try to leave or seek help. The nurse should provide discreet and confidential support to the client, without alerting or provoking the partner. The nurse should also give the client information and resources that may help them escape or cope with their situation.

Incorrect options:

A) Confront the partner and tell them that their behavior is unacceptable and abusive. - This action may be dangerous or counterproductive, as it may escalate the partner's anger or violence towards the client or the nurse. The nurse should avoid confronting or challenging the partner, as this may jeopardize their safety or trust.

B) Ignore the partner and focus on providing education and care to the client and the baby. - This action may be ineffective or unethical, as it may ignore or enable the partner's abuse towards the client. The nurse should not overlook or disregard signs of domestic violence, as this can put the client and the baby at further risk.

C) Report the partner to the authorities for domestic violence and child abuse. - While reporting the partner to the authorities may be necessary in some cases, it is not the most appropriate immediate action for the nurse in this situation. The nurse should prioritize the safety and well-being of the client and the baby and provide them with resources to seek help and support.

The nurse's primary responsibility is to ensure the safety and well-being of the client and the baby. By giving the client a phone number for a domestic violence hotline and asking them to call when they are safe, the nurse provides them with a confidential resource that can offer guidance, support, and help in planning a safe exit from the abusive situation. It allows the client to reach out for assistance when they feel ready and secure enough to do so.

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Correct Answer is B

Explanation

Rationale: The nurse should use active listening and empathy skills to acknowledge and validate the family members' feelings, without judging or dismissing them. The nurse should also avoid giving advice or opinions that may conflict with the client's wishes.

Incorrect options:

A) "I understand how you feel, but you have to respect your loved one's wishes." - This statement may sound patronizing or insensitive, as it implies that the nurse knows how the family members feel and that they are not respecting the client's wishes. The nurse should avoid using "but" statements, as they can negate or minimize the previous statement.

C) "Why are you angry? Don't you want your loved one to be comfortable?" - This statement may sound accusatory or defensive, as it questions the family members' motives and emotions. The nurse should avoid using "why" questions, as they can sound confrontational or judgmental.

D) "You should talk to your loved one and try to change their mind." - This statement may sound disrespectful or inappropriate, as it suggests that the nurse does not support the client's decision and that the family members should persuade the client otherwise. The nurse should avoid giving unsolicited advice or opinions that may interfere with the client's autonomy and dignity.

A. "You are suffering from post-traumatic stress disorder (PTSD). You need to see a psychiatrist as soon as possible." B. "You have been through a lot of trauma. It is normal to have these symptoms. They will go away with time." C. "You are not alone. There are many people who have similar experiences and can support you. Would you like me to connect you with some resources?" D. "You are in denial. You have to face your past and deal with it. Otherwise, you will never heal."

Correct Answer is C

Explanation

Rationale: The nurse should use a trauma-informed approach, which involves providing safety, trust, choice, collaboration, and empowerment to the client. The nurse should express empathy and compassion, without assuming or labeling the client's diagnosis or condition. The nurse should also offer options and resources, without imposing or forcing them on the client.

Incorrect options:

A) "You are suffering from post-traumatic stress disorder (PTSD). You need to see a psychiatrist as soon as possible." - This statement may sound alarming or stigmatizing, as it labels the client's condition and prescribes a specific treatment without involving the client in the decision-making process. The nurse should avoid making assumptions or diagnoses based on limited information.

B) "You have been through a lot of trauma. It is normal to have these symptoms. They will go away with time." - This statement may sound dismissive or minimizing, as it normalizes the client's symptoms and does not acknowledge the impact or severity of their trauma. The nurse should avoid making generalizations or predictions about the client's recovery.

D) "You are in denial. You have to face your past and deal with it. Otherwise, you will never heal." - This statement may sound harsh or blaming, as it criticizes the client's coping mechanism and implies that they are responsible for their own healing. The nurse should avoid using guilt-tripping or shaming tactics that may damage the therapeutic relationship.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has terminal cancer and has decided to stop treatment and enter hospice care. The client's family members express anger and disbelief at the client's decision. How should the nurse respond?

Correct Answer is B

Explanation

A client who is a refugee from a war-torn country tells the nurse that they have nightmares, flashbacks, and difficulty sleeping. The client says that they do not want to talk about their past experiences or seek any help. What is the best response by the nurse?

Correct Answer is C

Explanation

A client who is a single parent of three children tells the nurse that they have been feeling stressed and overwhelmed lately. The client says that they have no one to help them with childcare or household chores. Which of the following statements by the nurse is most appropriate?

A nurse is assessing a client who is a caregiver for his spouse with Alzheimer's disease. The nurse notices that the client has lost weight, appears fatigued, and reports feeling overwhelmed. What is the priority nursing intervention for this client?