Which approach would be most appropriate when counseling a client who is a suspected victim of intimate partner violence?

Ask, "Have you ever been physically hurt by your partner?"

Offer the client a pamphlet about the local shelter for victims of intimate partner violence.

Call the client at home to ask some questions about the marriage.

Wait until the client comes in a few more times to make a better assessment.

Answer and Explanation

The Correct Answer is A

A. Ask, "Have you ever been physically hurt by your partner?":

This approach involves directly asking the client about their experience with intimate partner violence. While it's crucial to address the issue openly and directly, some clients may feel uncomfortable or unsafe disclosing abuse, especially during an initial encounter. However, for many clients, this direct approach can be empowering and may facilitate disclosure.

B. Offer the client a pamphlet about the local shelter for victims of intimate partner violence:

Providing informational resources about local shelters and support services can be a supportive and non-confrontational way to offer assistance to a client who may be experiencing intimate partner violence. It allows the client to access resources privately and at their own pace. However, it may not lead to immediate disclosure or intervention.

C. Call the client at home to ask some questions about the marriage:

Calling the client at home to inquire about their relationship may inadvertently escalate the situation and put the client at risk if the abusive partner overhears the conversation. It can also violate the client's privacy and autonomy, as they may not be comfortable discussing sensitive issues over the phone, especially if the abusive partner is present.

D. Wait until the client comes in a few more times to make a better assessment:

Delaying assessment and intervention can potentially prolong the client's exposure to abuse and increase their risk of harm. Intimate partner violence often escalates over time, so it's essential to address suspected abuse as soon as possible to ensure the client's safety and well-being.

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Correct Answer is B

Explanation

A. "You'll probably have a cesarean birth to prevent exposing your newborn."

This statement suggests a specific intervention without addressing the broader context of HIV management during pregnancy. While a cesarean birth may be recommended in certain cases to reduce the risk of vertical transmission of HIV, it is not the only or primary measure taken. Antiretroviral therapy (ART) is typically the mainstay of treatment during pregnancy to suppress viral load and reduce transmission risk.

B. "Antiretroviral medications are available to help reduce the risk of transmission."

This response provides accurate information about the use of antiretroviral medications during pregnancy to reduce the risk of mother-to-child transmission of HIV. ART is a critical component of HIV management in pregnant women and has been shown to significantly decrease the risk of vertical transmission when used appropriately.

C. "Wait until after the infant is born, and then something can be done."

This statement is not appropriate because it suggests delaying action until after the infant is born, which may increase the risk of HIV transmission during childbirth. Prompt initiation of antiretroviral therapy during pregnancy is essential to maximize the chances of preventing vertical transmission.

D. "Antibodies cross the placenta and provide immunity to the newborn."

While it is true that antibodies can cross the placenta and provide passive immunity to the newborn for certain infections, including some viral illnesses, this statement is not directly relevant to preventing HIV transmission from an HIV-positive mother to her newborn. Unlike some infections where maternal antibodies can confer protection to the infant, HIV transmission is not prevented solely by passive immunity. Instead, active measures such as antiretroviral therapy are necessary to reduce transmission risk.

A. alcohol B. heroin C. marijuana D. cocaine

Correct Answer is D

Explanation

A. Alcohol:

Alcohol consumption during pregnancy can lead to a range of adverse effects on the fetus, collectively known as fetal alcohol spectrum disorders (FASDs). However, the symptoms described in the scenario—tachycardia, hypertension, and evidence suggesting vasoconstriction—are not typical of alcohol use. While alcohol can lead to hypertension in chronic heavy drinkers, it is not commonly associated with tachycardia and vasoconstriction in the same way that stimulant drugs like cocaine are.

B. Heroin:

Heroin is an opioid drug that depresses the central nervous system, leading to effects such as respiratory depression, sedation, and decreased heart rate. While heroin use during pregnancy can have serious consequences for both the mother and the fetus, including neonatal withdrawal syndrome (neonatal abstinence syndrome), it is not typically associated with tachycardia, hypertension, and vasoconstriction. Therefore, heroin is less likely to be the substance causing the symptoms described in the scenario.

C. Marijuana:

Marijuana use during pregnancy has been associated with various adverse outcomes, including low birth weight and neurodevelopmental issues in children. However, the symptoms described—tachycardia, hypertension, and evidence suggesting vasoconstriction—are not typical of marijuana use. Marijuana is more commonly associated with effects such as relaxation, increased heart rate (tachycardia), and vasodilation (not vasoconstriction). Therefore, marijuana is less likely to be the substance causing the symptoms described in the scenario.

D. Cocaine:

Cocaine is a potent stimulant drug that acts on the central nervous system and cardiovascular system, leading to effects such as tachycardia, hypertension, and vasoconstriction. These symptoms are consistent with acute cocaine intoxication. Cocaine use during pregnancy can have serious adverse effects on both the mother and the fetus, including increased risk of miscarriage, preterm labor, placental abruption, and fetal growth restriction. Therefore, given the symptoms described in the scenario, cocaine is the substance that the nurse would question the woman about.

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Which approach would be most appropriate when counseling a client who is a suspected victim of intimate partner violence?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?

Correct Answer is D

Explanation

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