Healthcare providers should be suspicious of injuries if the victim:

• A. Over- or under-reacts to the injury.
• B. Reports the injury as accidental.
• C. Shows no fear or concern about the injury.
• D. Has no accompanying medical records.

Answer: (D)

The main idea is that gaps in evidence can signal potential violence. When a patient presents injuries but there are no accompanying medical records to document those injuries or the care they received, it raises a concern that the injury may be hidden or not openly treated. Survivors of abuse often face barriers to seeking care, fear of retaliation, or controlling partners who discourage or restrict medical visits, leading to injuries that aren’t consistently documented. That lack of medical documentation makes it harder to verify the timing, mechanism, and severity of the injury, so clinicians should approach with heightened caution, conduct a trauma-informed assessment, ensure the patient’s safety, and document thoroughly while offering supportive resources. Other scenarios—such as reacting oddly to the injury, describing it as accidental, or showing unusual fear or concern—can occur for various reasons, but they don’t carry the same level of diagnostic concern as the absence of medical records.