A clinic nurse interviews a patient who reports fatigue, back ...

[BrownTown3]

A clinic nurse interviews a patient who reports fatigue, back pain, headaches, and sleep disturbances. The patient seems tense, then becomes reluctant to provide more information, and is in a hurry to leave. How can the nurse best serve the patient?
 
  a. Explore the possibility of patient social isolation.
  b. Have the patient fill out an abuse assessment screen.
  c. Ask whether the patient has ever had psychiatric counseling.
  d. Ask the patient to disrobe; then assess for signs of physical abuse.

Question 2

A person at the emergency department is diagnosed with a concussion. The individual is accompanied by a spouse who insists on staying in the room and answering all questions. The patient avoids eye contact and has a sad affect and slumped shoulders.
 
  Assessment of which additional problem has priority?
 
  a. Phobia of crowded places
  b. Risk of domestic abuse
  c. Migraine headaches
  d. Major depression

[huda]

Answer to Question 1

ANS: B
In this situation, the nurse should consider the possibility that the patient is a victim of domestic violence. Although the patient is reluctant to discuss issues, he or she may be willing to fill out an abuse assessment screen, which would then open the door to discussion.

Answer to Question 2

ANS: B
The diagnosis of a concussion suggests violence as a cause. The patient is exhibiting indicators of abuse including fearfulness, depressed affect, poor eye contact, and a possessive spouse. The patient may be also experiencing depression, anxiety, and migraine headaches, but the nurse's advocacy role necessitates an assessment for domestic violence.

[BrownTown3]

TYSM

[epscape]

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