A woman who is 6 months pregnant has sought medical attention saying she fell down the stairs. What scenario would cause an emergency department nurse to suspect that the woman has been a victim of IPV?

Correct Answer: B

Rationale: The correct answer is B) The woman has injuries on various parts of her body that are in different stages of healing. This scenario raises suspicion of intimate partner violence (IPV) because the presence of injuries in different stages of healing indicates a pattern of ongoing abuse. This is a key red flag for healthcare providers to recognize and address potential IPV cases. Option A is incorrect because a loud and hostile argument alone may not necessarily indicate IPV, as arguments can occur in healthy relationships. Option C, avoiding eye contact and being hesitant to answer questions, may indicate anxiety or fear but does not specifically point to IPV. Option D, having a fractured arm and fresh bruises, may suggest recent trauma but does not provide evidence of a pattern of abuse over time, which is crucial in identifying IPV cases. In an educational context, it is vital for healthcare professionals to be able to recognize signs of IPV to provide appropriate support and intervention for pregnant women who may be experiencing abuse. Training on identifying IPV indicators and understanding the dynamics of abusive relationships is essential for nurses and other healthcare providers working in maternal health to ensure the safety and well-being of their patients.

Correct Answer: C

Rationale: The correct answer is C) Summary of information (e.g., 'The client is a battered woman.'). This option is the least helpful to the court because it lacks specific details and objective information that can be used as evidence in legal proceedings. Courts require concrete evidence to support claims of abuse, and a vague summary like this does not provide the necessary documentation to substantiate the client's experience. Option A) Clear and legible written documentation is crucial as it allows for a detailed account of the client's condition, interactions, and any relevant information. This type of documentation is essential for legal purposes as it provides a clear record of events. Option B) Photographs of injuries are highly valuable evidence in cases of abuse as they provide visual documentation that can be used to corroborate the client's account and demonstrate the extent of injuries. Option D) Accurate description of the client's demeanor is also important as it can help paint a picture of the client's emotional state and behavior, which can be relevant in court proceedings to support the client's claims of abuse. In an educational context, this question highlights the importance of accurate and detailed documentation in cases of abuse. Nurses play a critical role in documenting and reporting instances of abuse to ensure that appropriate interventions are implemented and legal actions can be pursued if necessary. Clear and thorough documentation is essential for supporting the client, ensuring accountability, and seeking justice in cases of abuse.

Correct Answer: C

Rationale: A moderately obese adolescent (20% to 30% above ideal weight) may have early onset menstruation. Girls who regularly exercise before menarche can have delayed onset of menstruation to age 18 years. Anatomic abnormalities and Type 1 diabetes mellitus are also possible causes but obesity is least likely.

Correct Answer: A

Rationale: The correct answer is A) "I feel irritable and moody a week before my period is supposed to start" because this symptom is characteristic of premenstrual syndrome (PMS). PMS typically manifests with emotional symptoms such as irritability, mood swings, and anxiety in the days leading up to menstruation. These emotional changes are often due to hormonal fluctuations during the menstrual cycle. Option B) "I have lower abdominal pain beginning on the third day of my menstrual period" describes dysmenorrhea, which is menstrual pain or cramps that occur during menstruation, not premenstrual symptoms. Option C) "I have nausea and headaches after my period starts and they last 2 to 3 days" could be indicative of other issues such as menstrual migraines or gastrointestinal disturbances, but are not typical symptoms of PMS. Option D) "I have abdominal bloating and breast pain after a couple days of my period" describes symptoms that may occur during menstruation, but are not specific to PMS. Educationally, understanding the symptoms of PMS is important for both individuals experiencing these symptoms and healthcare providers to provide appropriate management and support. Recognizing the distinction between PMS and other menstrual-related issues helps in accurate diagnosis and treatment planning.

Correct Answer: A

Rationale: The correct answer is A) Breast cancer. When discussing hormone therapy with a perimenopausal client, it is crucial to identify preexisting conditions that may impact the risks and benefits of treatment. Breast cancer is a significant concern because hormone therapy, particularly estrogen-progestin therapy, has been associated with an increased risk of breast cancer. Therefore, in a client with a history of breast cancer, hormone therapy may not be recommended due to the potential for cancer recurrence or growth. Option B) Vaginal and urinary tract atrophy is a common symptom of menopause that can be effectively treated with hormone therapy. While it is important to address this issue in perimenopausal clients, it is not as critical to identify as a history of breast cancer. Option C) Osteoporosis is another condition that can benefit from hormone therapy as it helps maintain bone density. However, in the context of a perimenopausal client with a history of breast cancer, the focus should be on the potential risks associated with hormone therapy rather than its benefits for osteoporosis. Option D) Arteriosclerosis, or hardening of the arteries, is not directly related to the discussion of hormone therapy in a perimenopausal client. While cardiovascular health is an important consideration in hormone therapy, a history of breast cancer takes precedence in this scenario. In an educational context, understanding the importance of individualized care and considering a client's medical history when discussing treatment options is crucial in providing safe and effective care. It highlights the need for healthcare providers to assess risks and benefits carefully, especially with hormone therapy, which can have significant implications for certain preexisting conditions.