Interpersonal Violence Mastery Assessments

Which statement by the nurse reflects understanding of therapeutic communication with a client experiencing domestic violence?

ANS: "Tell me about your struggles."

The public health nurse is developing a program geared toward primary prevention of domestic violence. Which information would the nurse include in the program for those at high risk?

ANS: Coping skills, Social support, Stress reduction

Which defense mechanism is most often used by individuals who physically abuse others?

ANS: Displacement ******Displacement is a defense mechanism in which one's pent-up feelings toward a threatening person are discharged on those who are less threatening. Repression is the unintentional putting out of the mind unacceptable or troubling thoughts, desires, or experiences. Undoing is making up for an action; abusers may use undoing in the honeymoon cycle of abuse by apologizing or giving gifts to the victim. Sublimation is substituting a constructive act for an unacceptable impulse.

Which would the nurse assess for in pregnant women who present with signs of physical abuse or neglect?

ANS: Human trafficking ****Nurses would assess for human trafficking in women who present with signs of physical abuse or neglect, such as scarring, bruises, burns, bald patches, or tattoos.

Which action must the nurse take first to therapeutically relate to parents who have abused their child?

ANS: Identify personal feelings about child abusers. ****To establish an interpersonal relationship with clients, the nurse must first be aware of personal feelings. This is particularly important when the nurse's personal views are at odds with the clients' behaviors. **developing a trusting relationship with the child , Information about the home environment and assessment of the parents' emotional needs can be obtained after a relationship is established with the parents.

Which rationale describes the reason the nurse would ask a client who has been raped to describe what happened?

ANS: It will let the client put the event in better perspective and help begin the resolution process. ****The rationale for asking the client what happened allows the client to put the event in better perspective to help begin the resolution process.

Which statement most accurately describes women who are involved in a situation of domestic violence?

ANS: Most women try to leave about six times before they are successful.

A mother is worried about the sudden behavioral changes in her child. The child has suddenly developed a fear of certain people and places. The child's school performance is declining rapidly, and the child has developed poor relationships with his or her peers. After assessing the physical findings of the child, the nurse suspects child abuse. Which physical findings would have led the nurse to this suspicion?

ANS: One of the physical findings that may be required to confirm child abuse is the presence of foreign bodies in the rectum, urethra, or vagina.

Which traits would be expected when a client is in the reorganization phase of rape-trauma syndrome?

ANSWERS: -Eating disorders -Fear of being alone or in a crowd *******A client in the reorganization phase of rape-trauma syndrome might develop an eating disorder or express fear of being alone or in a crowd. >Acute period of disorganization, clients may blame themselves for the incident. sometimes flee their job or home or make other radical changes or will have a calm demeanor and seem to act as if nothing happened >Adjustment phase client not able to stop talking about the event.

Which behavior would the nurse identify that a client with histrionic personality disorder is displaying when after being refused a sleeping pill, the client throws a book at the nurse?

ANS: Acting out ****The client is acting out. Acting out is the process of expressing feelings behaviorally.

A woman who is frequently physically abused says, "It's my fault that my husband beats me." Which response would the nurse use?

ANS: "You say that it was your fault—help me understand that." ******Paraphrasing and clarifying are interviewing techniques that promote communication between the nurse and client and help the client hear and explore her words and gain insight into her behavior. >"Why" questions are generally not therapeutic

During a home visit, the nurse discovers that a child in the household who has a disability has been experiencing seizures. The child's parent appears indifferent to the child's physical, emotional, or medical needs and seems to provoke seizure episodes by harsh verbal exchanges with the child. Where would the nurse direct a referral?

ANS: Child Protective Services ******All states have laws about obligatory reporting of child abuse to local authorities. This responsibility is delegated by the state to an appropriate local agency such as Child Protective Services.

A client who has a history of aggressive, violent behavior becomes very angry and starts screaming at the nurse and pounding on the table. Which assessment is the priority?

ANS: Degree of control over the behavior *****Degree of control over the behavior is the most important assessment because it will influence the nurse's intervention. Depending on the extent of the client's control, the nurse may or may not need assistance.

The nurse caring for a pregnant client at 28 weeks' gestation suspects intimate partner violence. Which assessments support this suspicion?

ANSWERS: -The client has injuries to the breasts and abdomen. -The partner answers questions that are asked of the woman. -The client has visited the clinic several times in the past month.