NU472 Week 6 HESI Case Study Evolve Elsevier
Intimate Partner Violence and PTSD - 29 Questions
And Answers Latest Update
A nurse is working in the family medicine clinic in a large community health care center. The first client is a young adult
woman who arrives at the center with her two children, ages 4 and 6, and an advocate from the local domestic violence
shelter. Because the shelter is near the center, many women and children who are living there have also been clients of
the clinic. The nurse overhears the advocate tell the front desk staff that client came to the shelter the previous week and
asked to be taken to the clinic because she was having trouble sleeping and had several severe headaches. The front desk
staff alert the nurse to the fact that client is a new client at the clinic and has not provided prior medical records. The
nurse is ready to take a health history and to assess the client, so the nurse takes client to a private room. The children
stay with the advocate in the waiting area.
Which is the best reason for the nurse to screen this client for intimate partner violence?
o All women of childbearing age should be screened for intimate partner violence.
o All clients should be screened for intimate partner violence in a primary care setting.
o The nurse is worried that children might be abused and asking their mom about intimate partner violence is a good
way to start the conversation.
o The nurse overheard that she came from a domestic violence shelter.
o All women of childbearing age should be screened for intimate partner violence.
· Screening for intimate partner violence is recommended by the U.S. Preventive Service Task Force for all women of
childbearing age.
Which is the best way for the nurse to screen for intimate partner violence?
o Ask client is she has any specific injuries related to violence.
o Ask many, specific questions about types of violence so that you can document her history of abuse in the chart in case
of legal action.
o Tell client that she can trust the nurse and then give her the opportunity to disclose abuse if she wants to.
o Use an evidence-based tool such as the Abuse Assessment Screen.
o Use an evidence-based tool such as the Abuse Assessment Screen.
· Evidence-based tools like the Abuse Assessment Screen are the best way to screen for intimate partner violence because
they have been tested for reliability and validity. They also limit interviewer bias.
Which behavior should the nurse avoid because it could make client less likely to disclose violence to you?
o Waiting in silence for her to answer the questions.
, o Telling her that the nurse is legally required to contact the authorities if she discloses violence against her children.
o Using probing language to press for a response.
o Interviewing her alone without her children or the advocate.
o Using probing language to press for a response.
· Using probing language or pressing for more information than the client is ready to disclose will decrease the likelihood
of disclosure.
The nurse asks client to have a seat, and then sits in a chair across from her. Client is visibly uncomfortable and seems
reticent to talk about why she is seeking medical attention at the clinic. During the health history portion of the
assessment, client tells the nurse that she was treated for postpartum depression after her youngest child was born, but
she is currently not on any medications. She also discloses that she has been physically and sexually abused by her
husband since her first pregnancy and that this is the first time she has disclosed the abuse to a healthcare provider.
Describing the abuse, client states that months would go by without any problems, but then her husband would suddenly
become violent. She states that her husband was constantly and often violently jealous. Client tells the nurse that she
decided to leave her husband last week because her oldest child was having frequent nightmares about his mother being
murdered by his father. Her husband knows where all of her friends and family live, so she was not sure where to go. She
called a crisis hotline, and they told her a bed was available at the local shelter for her and her two children. At that
point, she decided to go to the shelter. Before the child’s nightmares started, she said she coped with the violence by
going somewhere else and checking out emotionally. Seeing her child’s pain, though, was enough to motivate her to
leave the relationship. She had been experiencing headaches and trouble sleeping for several months, but the symptoms
seemed to get worse after her first night at the shelter. She says that she is hopeful now that she has started receiving
services at the shelter but that she also wants to forget the abuse ever happened and erase it from her mind.
What risk factors for depression and anxiety are evident in the client’s health history?
o Marital status and recent move to a shelter.
o Number and age of children.
o Headaches and trouble sleeping.
o Female gender and history of physical abuse.
o Female gender and history of physical abuse.
· Female gender and history of physical abuse are risk factors for depression and anxiety.
What is the nurse most concerned about for this client, knowing her history of depression and intimate partner
violence?
o Body image issues and eating disorders.
o Possibility of suicide or self-harm.
o An increase in a chronic disease like hypertension.
o Potential for substance abuse.
o Possibility of suicide or self-harm.
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