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Justice is the ethical principle concerned with fairness, equity, and the impartial distribution of resources, risks, and benefits. In healthcare, justice guides decisions such as prioritizing care based on clinical need and ensuring equal access to services regardless of personal characteristics. It does not relate to client loyalty, which is not an ethical principle but rather a relational dynamic. Framing justice as loyalty misrepresents its core meaning and undermines its role in ethical decision-making, which centers on fairness and equitable treatment across individuals and populations.

Veracity is the ethical duty to tell the truth, primarily referring to the clinician’s obligation to be honest with clients, provide accurate information, and support informed decision-making. While clients may also be truthful, the ethical principle of veracity is anchored in professional conduct—ensuring transparency, avoiding deception, and maintaining trust through honest communication. Defining veracity as the client’s ability to provide truthful information shifts responsibility away from the clinician and distorts the principle’s intent, which is to uphold truthfulness in the delivery of care.

Beneficence is the duty to promote the well-being of clients by acting in their best interests, supporting positive outcomes, and balancing benefits against risks. It does not mean causing an “intentional outcome,” which implies a focus on intent rather than the ethical quality of the outcome. Ethical beneficence emphasizes compassionate, evidence-based actions that enhance health and quality of life, while avoiding paternalism and ensuring respect for autonomy. The phrasing here is misleading because beneficence is about promoting good, not merely producing outcomes through intention without regard to benefit, risk, or consent.
 

Referring the client to a community support group is an important intervention because it provides emotional support, resources, and connection with others who have experienced similar situations. However, this is not the immediate priority when abuse is reported. Before referral, the nurse must ensure that the client and any children are safe from imminent harm. Support groups are valuable for long-term coping and recovery but do not address urgent safety needs.

Instructing the client on how to leave the relationship may be helpful, but it is not the priority. Leaving an abusive relationship can be dangerous if not carefully planned, and the nurse must first assess whether there is immediate risk of harm. Without this assessment, advising the client to leave could inadvertently increase danger, as abusers often escalate violence when they perceive loss of control.

Implementing the safety plan is a critical step in protecting the client, but it comes after assessing the level of immediate danger. A safety plan includes strategies such as identifying safe places, emergency contacts, and escape routes. However, the nurse must first determine whether the client or children are currently at risk of harm before deciding which safety measures to activate.

Suggesting that the client avoid making their partner angry places responsibility for the abuse on the victim rather than the perpetrator. This approach perpetuates victim-blaming and does not address the underlying issue of violence. It is not an appropriate or ethical nursing intervention, as it fails to empower the client or provide them with resources for safety and support.

Offering strategies for interacting in social situations does not address the immediate issue of intimate partner violence. While social support can be beneficial, this option is not directly relevant to the client’s safety or access to resources. It may be useful in general wellness care but is not a priority intervention in the context of abuse.

Instructing the client on how to behave to prevent anger from their partner reinforces the abusive dynamic and suggests that the victim can control the perpetrator’s behavior. This is harmful and unethical, as it shifts responsibility away from the abuser and onto the victim. Nurses must avoid interventions that perpetuate abuse or minimize the seriousness of the situation.

Struggling with a test or academic performance is common among children and does not directly indicate risk for abuse or violence. Academic difficulties can result from many factors such as learning challenges, stress, or lack of study time, but they are not a strong predictor of abuse.

A parent starting a new job is not inherently linked to abuse risk. While changes in family dynamics or stressors can affect children, this statement does not suggest neglect or violence. Employment changes are normal life events and do not directly indicate abuse.

Not feeling hungry in the morning is a common occurrence and does not necessarily indicate abuse. Appetite variations can be normal in children and are not a reliable marker of violence or neglect. Unless paired with other concerning signs such as malnutrition or food insecurity, this statement alone does not suggest abuse.

Requesting the police to gather evidence is not the role of the SANE. SANEs are trained to perform forensic medical examinations, collect and preserve evidence, document findings, and maintain chain of custody. While collaboration with law enforcement may occur, evidence collection is conducted by the SANE within the healthcare setting, ensuring integrity and admissibility. Delegating evidence collection to police at this stage would bypass established forensic protocols and compromise the quality and reliability of the evidence.

Requiring the client to call the police violates trauma-informed, patient-centered care principles. Clients have the right to choose whether to involve law enforcement, and coercion can exacerbate trauma and undermine trust. SANEs provide information about options, support informed decision-making, and respect autonomy. Mandating police contact disregards consent and may deter clients from seeking care or disclosing details essential for medical and forensic evaluation.

Protecting the client from further harm is a core nursing responsibility and a component of trauma-informed care, but it is not the defining role of the SANE. While SANEs ensure a safe environment during the exam and minimize retraumatization, their specialized role centers on forensic assessment, evidence collection, documentation, and coordination with legal processes. Safety is integral to care, yet the unique function of the SANE extends beyond general protection to expert forensic practice.

The notion that meeting the abuser’s needs would stop the violence is a classic example of victim-blaming and ignores the dynamics of power and control inherent in abuse. Violence is not caused by the victim’s behavior but by the perpetrator’s choice to exert control through harm. Encouraging victims to modify their behavior to prevent abuse perpetuates harmful myths, increases guilt and shame, and fails to address the perpetrator’s responsibility and the structural risks involved.

Suggesting that victims provoke violent episodes misattributes responsibility and reinforces dangerous stereotypes. Abuse is not a reaction to provocation but a deliberate pattern of coercion and control. Framing violence as provoked minimizes the seriousness of the abuse, discourages disclosure, and can lead to inadequate safety planning. Effective care requires rejecting narratives that blame victims and focusing on accountability and protection.

Believing that no one else would tolerate a victim’s “dependent clinging behavior” pathologizes normal trauma responses and undermines self-worth. Dependence and attachment behaviors can arise from fear, isolation, and survival strategies in abusive contexts. This belief is invalid and harmful, as it discourages seeking help and reinforces isolation. Supportive networks and trauma-informed services exist to assist survivors, and recovery is possible with appropriate care and resources.

Doing well in school is generally a positive indicator of resilience and adjustment. Children who are performing academically may not show overt signs of trauma in this domain. While abuse can affect school performance, success in academics is not typically considered a sign of negative impact. Instead, it suggests the child may be coping effectively in this area.

Talking about best friends at school reflects healthy social development and peer relationships. Positive friendships are protective factors against the effects of trauma and abuse. This statement does not indicate a negative impact of violence but rather shows that the child is engaging socially and building supportive connections.

Participation in school activities is a positive behavior that demonstrates engagement, socialization, and resilience. Involvement in extracurricular activities often supports emotional healing and provides structure. This does not indicate a negative impact of violence but rather shows adaptive functioning.