A woman and her live-in significant other come in the emergency department following a motor vehicle collision. Which finding should alert the nurse to assess for the possibility of domestic violence?

The woman is timid and speaks softly when asked about the accident.

spiral fracture on the woman's arm and wrist.

The woman is hyperventilating and appears to be in pain.

Fresh bruises on the woman's shoulder and chest.

Answer and Explanation

The Correct Answer is B

A. The woman is timid and speaks softly when asked about the accident: Timid behavior may suggest fear or anxiety, but it's nonspecific and may be due to trauma or emotional distress, not necessarily abuse.

B. Spiral fracture on the woman's arm and wrist: Spiral fractures occur from twisting injuries and are often associated with non-accidental trauma, especially when the injury doesn't match the reported mechanism.

C. The woman is hyperventilating and appears to be in pain: Hyperventilation and visible pain may indicate anxiety or physical injury, but they are expected after trauma and not unique to domestic violence.

D. Fresh bruises on the woman's shoulder and chest: Bruising is a possible sign of abuse, but bruises alone can result from a car accident. The type and location must be assessed in context.

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Correct Answer is B

Explanation

A. "You didn't do anything wrong.” This statement is well-intended, but may minimize the parent’s emotional experience. It’s important to acknowledge the parent’s feelings rather than just reassuring them. This response does not invite further expression of their emotions.

B. "This must be a very difficult time for you." This response acknowledges the parent's emotional distress and validates their feelings, creating an opportunity for them to express their concerns. It provides emotional support and opens the door for further discussion.

C. "Is there any particular reason why you think this is your fault?" While it may be important to understand the parent’s concerns, this response is confrontational. It may inadvertently make the parent feel blamed, which could worsen their state instead of comfort.

D. "With surgery, your baby should have a full recovery." This response may give false hope and oversimplifies the complexities of myelomeningocele. Recovery outcomes depend on various factors. The focus should be on providing emotional support rather than making promises.

A. The client with a small bowel obstruction who has a nasogastric tube that is draining greenish fluid. B. The client with a bowel obstruction due to a volvulus who is experiencing abdominal rigidity. C. The client who had surgery yesterday and is experiencing a paralytic ileus with absent bowel sounds. D. The client with an obstruction of the large intestine who is experiencing abdominal distention.

Correct Answer is B

Explanation

A. While the presence of greenish fluid in a nasogastric tube can indicate a small bowel obstruction, this finding alone does not necessarily indicate an immediate life-threatening condition. The client should be monitored, but this is not the priority.

B. Abdominal rigidity in the context of a volvulus (twisting of the bowel) can indicate bowel ischemia or perforation, which is a surgical emergency. Immediate intervention is needed to prevent further complications such as sepsis or peritonitis.

C. A paralytic ileus is a common postoperative complication and often resolves with time. While the absence of bowel sounds is concerning, it is a routine finding in this situation and does not require immediate attention unless there are signs of further complications.

D. Abdominal distention in a large bowel obstruction can indicate a need for further assessment and treatment. However, compared to a volvulus with abdominal rigidity, this situation is less urgent and does not represent an immediate life-threatening emergency.

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A woman and her live-in significant other come in the emergency department following a motor vehicle collision. Which finding should alert the nurse to assess for the possibility of domestic violence?

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Naxlex Comprehensive Predictor Exams

The parent of a child born with a myelomeningocele asks the nurse, "What did I do to deserve this?" Which response is most helpful?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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