A married woman comes to the clinic for her annual well-woman physical examination. During the interview with the practical nurse (PN), the client makes minimal eye contact. The PN observes yellow bruising to the lower eye and purple bruising on the client's upper arm, which look like fingerprints. Which question is best for the PN to ask the client?

A. Is anyone hurting you?: This direct question addresses the possibility of abuse clearly and sensitively. Observed bruising patterns and minimal eye contact are potential indicators of intimate partner violence, making this the most appropriate and immediate inquiry. B. Do you want to see a social worker?: Offering support is important, but it assumes the client has already disclosed abuse. Without first assessing the situation, this approach may not elicit necessary information or provide immediate protection. C. How is your marital relationship?: Asking generally about the relationship may be too vague to uncover abuse. Clients experiencing violence may not recognize or disclose abusive behavior without direct questioning. D. Is there something you want to tell me?: While open-ended questions can encourage sharing, this phrasing may be too indirect given the clear physical signs of potential abuse. Direct questioning is needed to ensure the client’s safety.