The nurse is in a maternal/child unit and is caring for a new parent. The new parent expresses concern about their safety in the home. The nurse provides the client with an intimate partner violence crisis center number. Which of the following is a way the nurse can evaluate the client's response to the safety plan?

The client explains they are not planning to leave their home.

The client thinks their home will be safer now that there is a baby in the house

The client thanks the nurse for the information.

The client puts the number of the crisis center into their phone.

Answer and Explanation

The Correct Answer is D

It indicates that the client acknowledges the importance of having a safety plan and is willing to take proactive measures to ensure their well-being and that of their child. This response suggests a positive engagement with the safety plan provided by the nurse.
A.   This response indicates that the client may not perceive their current situation as unsafe or may not be ready to take action to address potential safety concerns.
B.   This response suggests that the client may have misconceptions about how the presence of a baby in the home affects safety, especially in the context of intimate partner violence.
C.   While expressing gratitude for the information provided is a positive response, it does not necessarily indicate whether the client understands the seriousness of the situation or plans to utilize the resources provided.

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Correct Answer is D

Explanation

Given the traumatic nature of sexual assault and the potential for re-traumatization, the assessment of the genitalia and rectum should be conducted last. This allows the nurse to build rapport with the client, establish trust, and address any immediate concerns or needs before proceeding with a potentially distressing examination.

A. Assess the child without their caregiver present. B. Have toys or drawing materials available for the child. C. Focus on the physical domain of health. D. Have the child carefully repeat the events of the trauma.

Correct Answer is B

Explanation

B. Providing toys or drawing materials can help the child express their thoughts, feelings, and experiences in a nonverbal and developmentally appropriate manner. Play-based activities allow children to communicate and process their emotions more comfortably than verbal communication alone.

For young children, especially those who have experienced trauma, the presence of a caregiver can provide comfort, reassurance, and support during the assessment process.

C. Neglecting the child's emotional needs can result in overlooking important aspects of their experience and hinder their recovery.

D. Asking the child to repeat the events of the trauma can be retraumatizing and overwhelming for them. It may increase their distress and hinder their ability to cope with the experience.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is completing an assessment of a client who was sexually assaulted. What assessment should the nurse conduct last?

Correct Answer is D

Explanation

A nurse is assessing a 6-year-old child who has experienced violence at school. Which of the following strategies should the nurse use during their assessment of this client?

Correct Answer is B

Explanation

A nurse on an inpatient mental health unit is caring for a client who has major depressive disorder and malnutrition. Which of the following actions should the nurse take to improve the client's nutritional status?

A nurse is precepting a student nurse interviewing a client with a different cultural background. Which nonverbal behavior by the student indicates that the nurse should intervene? (Select all that apply)

During an assessment, the nurse determines that a client sees more than one primary care provider and has obtained prescriptions from each provider. Which method would be most appropriate to determine a client's current medication regimen?

A nurse is interviewing a client who is contemplating a behavior change. According to the processes of Motivational Interviewing, which of the following client behaviors indicates that the nurse has successfully engaged with the client?

A nurse is admitting a client who speaks a different language than the nurse. Which of the following actions should the nurse take?

A nurse is caring for a client who has limited hand movement. Which of the following actions should the nurse take to assist the client with feeding?

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