A 70-year-old client in clinic with caregiver and signs of bruising; abuse is suspected. Which action should the nurse take first?

• A. Provide the client with a 24-hour hotline number
• B. Ask the caregiver to wait in the waiting room
• C. Document concerns and notify appropriate authorities
• D. Interview the client privately in a safe environment

Answer: (D)

The main idea is to protect the patient and obtain an accurate report by talking with the patient privately before involving others or taking actions that depend on the patient’s statements. Interviewing the client alone in a safe, private setting removes potential pressure from the caregiver and helps the nurse assess whether abuse is occurring, how it may be affecting the patient, and whether there is immediate risk. This private conversation allows the patient to speak openly about injuries, the sequence of events, and any threats or coercion, which is essential for an accurate assessment and safe planning. After establishing private communication and assessing safety, the nurse should follow protocol to document concerns and notify the appropriate authorities, while offering resources such as a hotline. Asking the caregiver to wait in the waiting room or providing a hotline without first securing a private interview may prevent the patient from sharing truthfully and could delay protection for the patient. If the patient cannot communicate, follow applicable procedures and involve the appropriate supports.