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Difficulty: MediumHealth Screening

A clinic nurse is preparing to conduct an intimate partner violence (IPV) screening for a young adult client who arrived at the healthcare facility with their spouse. Arrange the following nursing actions in the correct sequence to safely and effectively perform the screening.

  1. 1Escort the client to a private examination room separate from any accompanying partners.
  2. 2Explain to the client that safety screening is a routine practice provided to everyone.
  3. 3Ask direct, objective questions about experiences of physical, emotional, or sexual abuse.
  4. 4Offer an affirming statement validating that any disclosed abuse is not the client's fault.
  5. 5Evaluate the client for immediate danger and determine the risk of imminent harm or lethality.

Answer

The correct sequence is: Ensure privacy, explain universal screening, ask direct questions, validate disclosure, and evaluate immediate safety.
The priority in IPV screening is client safety, meaning the nurse must first establish a secure, private environment away from any accompanying individuals. Next, introducing the screening as a universal, routine practice reduces stigma and defensiveness. The nurse then asks direct, objective screening questions. If the client discloses abuse, the immediate psychosocial priority is to therapeutically validate their experience. Finally, the nurse must assess for immediate danger and lethality to determine if an urgent safety plan is needed before the client leaves the facility.

Step-by-Step Solution

1
Ensure privacy
The client is separated from their spouse in a secure room.
Screening must never occur with a partner present due to the high risk of retaliation and compromised confidentiality.
2
Introduce universal screening
The nurse explains that IPV screening is routinely done for all clients.
Normalizing the assessment prevents the client from feeling singled out and reduces defensiveness.
3
Conduct the screening assessment
Direct, non-judgmental questions about abuse are asked.
Clear and specific questions are necessary to accurately identify experiences of violence.
4
Validate the client's disclosure
The nurse provides an affirming statement that the abuse is not the client's fault.
Therapeutic validation builds trust and provides crucial emotional support immediately following disclosure.
5
Assess immediate safety
The nurse evaluates the risk for imminent lethality or harm.
Once the client's experience is validated, determining immediate danger dictates the urgency and type of safety planning required before the client leaves.

Key Concept

Intimate Partner Violence (IPV) Screening Sequence
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Topics

Health Screening

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