08-18-2006, 10:16 AM
A 26-year-old Spanish-speaking woman presents to your clinic for a bruised left arm. The patient is a local woman who speaks no English and has recently moved to this area from overseas. She works at the local telephone company and has moved in with her fiancee. This is her fourth visit to the clinic for various bruises and injuries. On this visit she has a diffuse ecchymoses and purpura over her entire left arm and forearm in the shape of œhand prints. She claims that she fell while walking down the stairs. On her previous visits, she has had similar bruises on her chest, abdomen, and back, all of which she attributed to various œfalls. She is otherwise healthy, denies tobacco or alcohol. She does report that he fiancee drinks ethanol to intoxication quite frequently and has recently lost his job. She is somewhat tearful when mentioning him. Her physical examination is remarkable for the left arm bruising as above, various bruises in her back and abdomen is various stages of healing, and a valgus deformity of her left leg. The remainder of her examination is unremarkable. The most appropriate course of action is to
A. ask the patient in simple, direct language if she has been hit by her fiancee
B. contact the police for intervention
C. no action is indicated as the patient has no active medical issues
D. no action is indicated as the patient will be offended and leave the clinic
E. question the patient in the presence of other health care workers in the clinic
A. ask the patient in simple, direct language if she has been hit by her fiancee
B. contact the police for intervention
C. no action is indicated as the patient has no active medical issues
D. no action is indicated as the patient will be offended and leave the clinic
E. question the patient in the presence of other health care workers in the clinic
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