Exam 5 W&C Chapter 33

The nurse is caring for a client suspected of being a victim of human trafficking. Which question, when given priority by the nurse during the admission interview, demonstrates a need for additional training?

"Are you working toward achieving American citizenship?"

The nurse manager is educating staff about the mandate of health care workers to report suspected child abuse (child maltreatment). A staff member asks, "What if you are not certain that it is an abusive situation. What should the nurse do?" The nurse manager is most correct when providing which answer?

"Feel comfortable about reporting your suspicion as the law protects you."

Which statement made by a new nurse demonstrates an understanding of the prevalence of sexual assault and related violence among the population?

"I've come to realize that I need to include questions related to sexual assault and related violence into the assessment of all my clients."

The nurse is teaching a group of nursing students about intimate partner violence. Which statement by the nurse is accurate?

"Power and control are central to the dynamic of intimate partner violence."

The triage nurse receives a phone call from a client stating, "I was just raped and I need help. What should I do?" Which response by the nurse is a priority?

"Tell me if you are in a safe location away from the assailant now."

An 18-month-old is brought to the emergency room by her babysitter. The babysitter states, "She fell from the sofa an hour ago and has not been herself since." Upon questioning, the babysitter appears to be unsure of time and other facts about the incident. Which of the following questions would be most effective in obtaining more information about the child's injuries?1

"Tell me what was happening before she fell."

In most cases of suspected child abuse, for how many hours can the health care facility hold a child to complete an investigation?

72

Physical neglect of children occurs in various ways. In which family below would you suspect neglect?

A father allows his child to stay home from school whenever she chooses.

In which example of a burn would the nurse most likely suspect abuse?

A partial-thickness or second-degree burn on the child's bottom

When beginning care for a victim of rape, the nurse asks the client to "talk about what happened" to her. For which nursing diagnosis is the nurse using this approach?

Anxiety related to recent rape

The school nurse has been told that a 7-year-old child is the subject of bullying. How best does the nurse approach the situation?

Ask the child a general statement such as "How is everything going?"

When initiating care for a client suspected of being a victim of human trafficking, what is the nurse's primary responsibility?

Building trust

A nurse is assessing a child whom the nurse suspects is a victim of physical abuse. Assessment reveals numerous bruises on the thighs and upper back in various stages of healing. The child's caregiver is present in the examination room. Which aspect of care is the priority?

Ensuring child remains safe

The nurse is working with a client who is in a relationship with a man who controls her activities, calls her names, and occasionally hits her. What are the goals in the treatment of this client? Select all that apply.

Maximize the client's safety Empower the client to take control Provide support to the client

A nurse is assigned to care for a child with trauma from abuse who has been admitted through the emergency department to the pediatric unit. What is a priority for the nurse to do when caring for this child?

Observe and document thoroughly and completely.

When caring for a 12-year-old child who has been admitted after being physically abused, which action should be the initial psychosocial intervention to include in the plan of care?

Provide the opportunity to express feelings.

An emergency depatment nurse who suspects child abuse (child maltreatment) should do which of the following?

Report it to the authorities.

During a home visit, a nurse determines that a child is experiencing psychological maltreatment based on which action by the parent?

The child is belittled in front of the nurse and older brother

The nurse is working in a community setting with families whose children have been abused. The nurse notes that fewer of the families come from higher socioeconomic groups than from lower socioeconomic groups. The nurse recognizes that this is most likely because of which of the following?

The higher socioeconomic families have a greater ability to keep the child abuse from being detected.

The nurse is caring for a client believed to be a victim of human trafficking. What action is most important for the nurse to perform?

gain clients trust

The mother of a toddler experiencing stomach pain insists that the child be admitted to find out the cause of the pain. The child has been in the emergency room three other times in the past 6 months for the same complaint. What other information should alert the nurse to investigate the situation further?

The mother is in nursing school.

A nurse is working with a child she suspects may be a victim of maltreatment in her home. Which combination of characteristics related to the parent, the child, and the circumstances would most strongly indicate the risk for maltreatment of this child?

The mother was maltreated as a child; the child was born prematurely; the father recently lost his job.

A nurse is assigned to care for a 7-year-old who has been admitted with infected circular burns to both arms, which resemble cigarette burns. The child states to the nurse, "If I did better in school, this would not happen." What does the nurse understand is most likely the issue with the abusive parents?

The parents have inadequate parenting skills.

The public health nurse is providing immunizations to a family that includes three children. Which requires investigation for possible child neglect?

Two have an ear infection (in one of which the eardrum is ruptured) and one has scabies.

The nurse is instructing first-time parents on newborn care. Which instruction is most important to promote newborn safety?

View a video on abusive head trauma (shaken baby syndrome) and answer questions.

In which areas would bruising on a young toddler alert the nurse to a potential abuse situation? Select all that apply.

abdomen thighs mouth

The elementary school nurse is caring for four clients with physical injuries. Which child would require follow-up?

an 8-year-old with bruising noted on the inner aspect of the arms

A mother brings her 4-year-old to the emergency department. She says that her child has frequent vomiting and diarrhea. When the nurse obtains previous medical history from the computer, it shows that this family has had 12 visits in the last 2 months for the same problems with no substantiated symptoms observed by the staff. The child is smiling and interactive with no signs of dehydration. What does the nurse suspect may be occurring?

caregiver fabricated illness

A family nurse practitioner is speaking to a community group about family abuse and informs the group that such abuse can take various forms, including which of the following? Select all that apply.

child abuse (child maltreatment) spouse abuse other family member abuse substance abuse

A nurse is working with a child who has been psychologically neglected by the parents. The nurse would anticipate which complication for this child?

developmental delay and mental health issues

A nurse is assigned to care for a hospitalized 14-year-old with gastroenteritis. The teen tells the nurse that a brother ran away about 2 months ago and hasn't been heard from since, a sister has a substance abuse problem, and both parents are fighting. What type of situation is this family displaying?

dysfunctional dynamics

A child with acute bronchitis has just been hospitalized. The nurse overhears the child's mother say to the child that if he is not good, she will leave and not come back until he is ready to return home. What should the nurse suspect in this situation?

emotional abuse

A pregnant client with multiple bruises in various stages of healing comes to the clinic for treatment. She appears withdrawn and quiet when the nurse approaches her. Her partner accompanies her to the exam room and begins to answer for the client. There is minimal eye contact from the client to the nurse. Which action will the nurse complete next?

have the partner leave the room

Which client's physical assessment finding of a school-age child should the nurse question as a potential indication of child abuse (child maltreatment)?

linear abrasions on his ankles and wrists

A nurse is caring for a baby admitted to the hospital with suspected abusive head trauma (shaken baby syndrome). Which assessment finding would confirm this suspicion?

retinal hemorrhages

A 10-year-old accompanies a parent to the emergency department. The child reports that the parent has taken pills and "a lot" of alcohol. The child assists the parent onto a stretcher. The parent states, "I wouldn't be drinking if it wasn't for you!" In what type of situation are the parent and child existing?

role reversal

Which type of fracture is most indicative of child abuse (child maltreatment)?

spiral fracture

The responsibility of the nurse caring for a victim of child abuse (child maltreatment) in the emergency room would include which of the following?

suggesting to the attending physician that the child be admitted for observation

Which adolescent behavior is most common if the parents have substance use problems?

taking on adult responsibilities

The elementary school teacher invites the nurse into the classroom to observe a pupil's interaction when completing an assignment. Which characteristic alerts the school nurse that the child may be the victim of emotional abuse?

The child is fretful and worried about the project.

The nurse is caring for a child who has unusual bruises and marks that do not match the child's developmental age. When completing an admission assessment, which other information does the nurse identify as a potential factor in child abuse?

long-term unemployment without supplemental income

Which elements are included in child abuse (child maltreatment )? Select the best answer.

psychological, physical, and sexual maltreatment and neglect

Which action is most helpful in encouraging the expression of feelings in a pediatric client who is abused?

using play to reduce stress

A 5-year-old child has frequent visits to the school nurse's office. Which assessment data should alert the nurse that this child may be a victim of physical neglect?

malnourished with frequent absences from school

A mother brings her 10-year-old daughter in and tells the nurse that she believes the child has a brain tumor and quickly runs through a list of some classic symptoms associated with brain cancer. On examination and after performing routine blood work, however, the nurse finds nothing wrong with the child. The child says that she feels fine. When the nurse reviews the client's chart, she finds that this is the sixth time the mother has brought the girl in for various serious conditions in the past 6 months. Which of the following situations does the nurse suspect?

medical child abuse

The nurse is caring for a pediatric client with the injury pictured. When asking the caregivers about the way in which the client received these injuries, which communication manner is essential?

nonjudgmental manner