Mental Health test #3 Chapter 12 Abuse and Violence, Abuse and violence prepU, Ch 12: Prep-U, Chapter 12 Abuse and Violence Questions

Which characteristics are found in violent families? Select all that apply. Adequate support systems Abuse of power and control Alcohol use disorder Social isolation

Correct response: Abuse of power and control Alcohol use disorder Social isolation Explanation: Abuse of power and control, alcohol use disorder, and social isolation are characteristics of violent families, as is an intergenerational transmission process. Adequate support systems are not a characteristic of a violent family.

A young adult client female is assessed after being raped. The client reports being tied up and beaten while the perpetrator forced sexual intercourse. She recalls the perpetrator saying, "I will make you pay." What most accurately describes this category of rapist? power assertive anger retaliation power reassurance anger excitement

Correct response: anger retaliation Explanation: In this case, the most accurate description of this rapist is anger retaliation. In this category, the perpetrator wants to punish the victim and often causes substantial injury. The power assertive rapist desires to dominate and control the victim and may repeat with the same victim. The power reassurance rapist commits rape when the opportunity presents itself, such as when another crime is being committed. An anger excitement rapist acts out fantasies and can be strategic in carrying out the crime, for example, carries a rape kit.

A nurse manager is working with the nursing staff of a busy community-based walk-in clinic that provides care to a large number of survivors of domestic violence. When helping the staff provide care, which information would be most important for the nurse manager to convey to the staff? a. Importance of measuring the clients' progress in small steps b. Expectation that survivors will accept change right away c. Encouragement for staff discussion about specific clients to gain support d. Identification of consequences from changes made by survivors as minimal

a

Which type of child abuse can be most difficult to treat effectively? a. Emotional b. Neglect c. Physical d. Sexual

a

A nurse is gathering information about a health history of a person who has experienced violence. Which are important caring behaviors a nurse should implement during the interview? Select all that apply. a. Establish trustworthiness. b. Maintain a nonjudgmental attitude. c. Ask questions regarding religious background and preference. d. Secure open communication. e. Discuss the nurse's personal feelings on victims of violence.

a b d

The nurse in the emergency room is assessing a client who was brought in by the police for evaluation after receiving a call from a neighbor. The client reports to the nurse that the person who has been cooking and helping around the house has not been home for days. Which type of abuse does the nurse suspect based on the client's statement? physical abandonment emotional neglect

abandonment Although abandonment can cause neglect and lead to physical and emotional abuse, abandonment is the primary type of abuse that this person is experiencing. The older person is calling for help because the caregiver has not been present for days. Neglect is the failure to meet basic needs of shelter and food. Physical abuse is causing injury by hitting, kicking, or pushing. Emotional abuse is injuring the person's self-worth and emotional well-being.

A young adult client female is assessed after being raped. The client reports being tied up and beaten while the perpetrator forced sexual intercourse. She recalls the perpetrator saying, "I will make you pay." What most accurately describes this category of rapist? anger retaliation power assertive anger excitement power reassurance

anger retaliation In this case, the most accurate description of this rapist is anger retaliation. In this category, the perpetrator wants to punish the victim and often causes substantial injury. The power assertive rapist desires to dominate and control the victim and may repeat with the same victim. The power reassurance rapist commits rape when the opportunity presents itself, such as when another crime is being committed. An anger excitement rapist acts out fantasies and can be strategic in carrying out the crime, for example, carries a rape kit.

A client comes to the clinic for a prenatal visit. While the client is in the examining room, her estranged husband appears and insists on seeing the client. The client tells the nurse that they are in the process of getting a divorce and she does not want to be around him. "He's been following me to work and at my home everyday." What should the nurse suspect? a. Intimate partner violence b. Stalking c. Sexual assault d. Neglect

b

A client runs to the urgent care center because the spouse is at home drinking and waving a gun around while yelling at the children. Which action should the nurse take first? b. contact the police c. assess the client for injuries d. call for an ambulance for transport to the hospital e. call a family member to pick up the children

b

A nurse is giving a talk about child abuse to a local community group. When discussing risk factors for child abusers, which would the nurse identify as the most likely profile of the perpetrator of fatal child abuse? a. Middle-aged woman with a college degree b. Unemployed young woman who dropped out of high school c. Middle-aged, wealthy businessman d. Young college graduate who recently gave birth to her first child

b

A nurse is presenting to a church group a program about domestic violence. During the presentation, a member of the audience asks the nurse to explain what "intergenerational transmission of violence" means because the person has seen that phrase used in the media. Which response by the nurse would be most appropriate? a. "People who are violent are that way because of the various neurochemical imbalances in their brains." b. "People who grow up in violent home situations tend to be involved in domestic violence situations as an adult." c. "Recent research has identified a gene that is responsible for transmission of a risk for violent behavior that is passed on from generation to generation." d. "Domestic violence seems to skip every other generation when it is traced in families."

b

A nurse is working on developing a safety plan with a client who is a survivor of violence. Which would the nurse address first? a. Devising an escape route b. Recognizing the signs of danger c. Identifying a safe place to hide d. Identifying a signal to indicate it is safe to leave

b

A young adult client female is assessed after being raped. The client reports being tied up and beaten while the perpetrator forced sexual intercourse. She recalls the perpetrator saying, "I will make you pay." What most accurately describes this category of rapist? a. power assertive b. anger retaliation c. power reassurance d. anger excitement

b

The nurse provides care to individuals who have been sexually assaulted during their childhood. Which characteristic is most commonly noted by the nurse during an assessment of such clients? a. Overly self-confident b. Unusually aggressive c. Overly social d. Too trustful

b

Which assessment finding might indicate elder self-neglect? a. Hesitancy to talk openly with nurse b. Inability to manage personal finances c. Missing valuables that are not misplaced d. Unusual explanations for injuries

b

A nurse is aware of the high incidence of intimate partner violence (IPV) and actively seeks opportunities to screen women for IPV. Which female client represents the best opportunity for assessing for IPV? A client who has brought her young son to the emergency department because he fell at the playground and may have an arm fracture A client who expressed interest in joining a grief support group following the death of her husband A client who is currently exploring long-term care options for her elderly father A client who is in the third trimester of pregnancy and who is having biweekly prenatal appointments at a clinic

A client who is in the third trimester of pregnancy and who is having biweekly prenatal appointments at a clinic Women who are pregnant have frequent contact with the health care system, creating a useful opportunity for IPV screening. None of the other listed situations precludes screening, but none are as ideal as frequent appointments at a consistent setting.

A nurse is interviewing a client who is a survivor of abuse. The client is telling the nurse about how the violence occurred. Which statement would the nurse interpret as reflecting phase 3 of the cycle of violence? "He threw me against the wall and started punching my face." "He yells at me for not having dinner waiting for him when he comes home." "He calls me stupid and incompetent, asking himself why he ever married me." "He tells me that he is sorry and that he will never hit me again."

Correct response: "He tells me that he is sorry and that he will never hit me again." Explanation: During phase 3 of the cycle, the perpetrator becomes kind, contrite, and loving, begging for forgiveness and promising never to inflict abuse again. The actual violence occurs in phase 2. Yelling at the client for not having dinner ready and calling her stupid and incompetent reflect phase 1, or tension building.

A nurse is screening a new client for intimate partner violence (IPV). What aspect of this woman's current circumstances is the most significant risk factor? The client's family lives on less than $1,000 per month. The client immigrated less than 5 years ago. The client has four children. The client has no extended family in the area.

Correct response: The client's family lives on less than $1,000 per month. Explanation: Low income is a salient risk factor for IPV. Recent immigration, larger than average numbers of children, and a lack of extended family are not noted as major risk factors.

Which provides the most appropriate example of neglect according to the definition of the term? Disciplining a 6-year-old child for "sassing" by putting tape on the child's mouth. Correcting a child in front of the entire class for copying homework. Criticizing a child frequently for being overweight and restricting the child's diet. Rejecting a 3-year-old who cries and seek affection after falling

Rejecting a 3-year-old who is crying and seeking affection after the child stumbles and falls Neglect is an act of omission that involves a failure by a parent or other adult to meet a dependent's basic needs, such as by providing appropriate emotional care. Rejecting a crying 3-year-old who seeks comfort after falling is an example of neglect. Harsh or humiliating discipline is an act of commission in which the adult actively inflicts physical or psychological harm. Attempting to improve a child's emotional or physical well-being in a misguided and harmful manner does not fit the definition of neglect.

A client comes to the clinic for a prenatal visit. While the client is in the examining room, her estranged husband appears and insists on seeing the client. The client tells the nurse that they are in the process of getting a divorce and she does not want to be around him. "He's been following me to work and at my home everyday." What should the nurse suspect? Intimate partner violence Stalking Sexual assault Neglect

Stalking is a pattern of repeated unwanted contact, attention, and harassment that often increases in frequency (CDC, 2016b). Stalking is a crime of intimidation. Stalkers harass and terrorize their victims through behavior that causes fear or substantial emotional distress. Stalking may include such behaviors as following someone, showing up at the person's home or workplace, vandalizing property, or sending unwanted gifts. Intimate partner violence is the mistreatment or misuse of one person by another in the context of an emotionally intimate relationship. In this case, the relationship is spousal, and 15-25% of pregnant women experience violence during pregnancy. Sexual assault is the act of forcing unwanted sexual activity on a person. In this case, the nurse should first suspect intimate partner violence and can further inquire if unwanted sexual activity is also a feature of the client's situation. Neglect is considered in the context of child abuse.

A client comes to the clinic for an evaluation. The nurse assesses the client and suspects that the client is a victim of abuse. Which finding would support the nurse's suspicion? Select all that apply. The client minimizes the severity of the injuries. The client came to the clinic right after the injuries occurred. The client has a history of frequent visits to the emergency department for injuries. The client is vague about the injuries on the body. The client voices statements about having control over current status.

The client is vague about the injuries on the body. The client minimizes the severity of the injuries. The client has a history of frequent visits to the emergency department for injuries. Findings that would support a suspicion of abuse include vagueness about any injuries and how they occurred, a delay in seeking treatment for the injuries, minimizing or denying about the severity of the injuries, history of frequent visits to the emergency department for injuries, and feelings of a loss of control or powerlessness.

Which statement is true regarding children being raised in a home where they have witnessed intimate partner violence? It has little impact on child functioning. Female children are more likely to experience depression. They are at increased risk for being abused. They have higher rates of schizophrenia.

They are at increased risk for being abused. Children being raised in a home where they have witnessed intimate partner violence demonstrate higher levels of depression and lower levels of self-esteem; these effects are pronounced in boys especially. Children of battered women are at an increased risk for abuse. Exposure to intimate partner violence adversely affects a range of child functioning.

The nurse should consider which as a possible indicator of child neglect? a. Malnourishment unrelated to illness b. Helplessness c. Angry outbursts d. Hesitance to talk openly

a

The psychiatric nurse recognizes that a male rape victim is less likely to report the crime due to which reason? a. The belief that his masculinity will be in question b. The social ramifications of possibly contracting AIDS c. Fear of being accused of engaging in socially inappropriate or illegal activities leading to the rape d. The impact it will have on his family

a

When assessing a 6-year-old child believed to be a victim of emotional abuse, the possibility is supported when the child is ... a. observed to be anxious and rejecting adult attention. b. showing signs of developmental delays. c. attending day care 5 days a week. d. parented by a single parent.

a

Which would not increase the likelihood that an older adult will incur physical abuse? a. The older adult is independent with activities of daily living. b. The older adult has difficulty with mobility and can become confused. c. The older adult lives with a son who receives financial aid. d. An older adult reports frequent multiple bruises that are related to falls.

a

Women in battering relationships often remain in those relationships as a result of faulty or incorrect beliefs. Which belief is valid? a. If she tried to leave, she would be at increased risk for violence. b. If she would do a better job of meeting his needs, the violence would stop. c. No one else would put up with her dependent clinging behavior. d. She often does things that provoke the violent episodes.

a

Which assessment question should the nurse ask of a client suspected of being ostracized by a school bully? "Do you feel like a part of a group in school?" "Do you smoke or use drugs?" "Can you go to the school principal with personal problems?" "Have you talked to your parents about your problems at school?"

Correct response: "Do you feel like a part of a group in school?" Explanation: Ostracism, ignoring and excluding a target individual, has recently emerged as one of the more common and damaging forms of bullying. The victim experiences threats to belonging, self-esteem, meaningful existence, and sense of control. Ostracism may pose an even greater threat to children's adjustment than bullying. Those who bully are more likely to have poor grades and to use alcohol and tobacco. None of the remaining options are directly associated with the issue of ostracizing.

Which statement made by a client raises the greatest concern that the client may be experiencing relationship violence? "He was so much nicer when we started dating." "His father physically abused his mother for years." "He doesn't like it when I go out with my girlfriends." "I don't know what else I can do to keep him from getting angry at me."

Correct response: "I don't know what else I can do to keep him from getting angry at me." Explanation: A warning sign of relationship violence is feeling that you must change your life or yourself so you won't anger him or her. The remaining statements, while troublesome, are not as clearly associated with behaviors of violence.

A nurse is assessing a client in a community clinic who reports feeling anxious lately because she is considering leaving her marriage. The client describes a long history of partner abuse associated with this relationship. How should the nurse respond to this client? "You have the right to be safe and respected." "Relationship counseling can be very helpful." "I wonder if your perceptions of the relationship are accurate." "I am here to help you through every step of this process."

Correct response: "You have the right to be safe and respected." Explanation: When working with someone who is a victim of partner abuse, it is important that the nurse assertively support the client's decision. The affirmation of the client's decision can help to improve the client's self-confidence as she begin the process of leaving her partner. It is important the nurse refrain from recommending couple's counseling, imply doubt about the client's situation, or take charge and do everything for the client.

A nurse is working in the emergency department. Which situation would lead the nurse to suspect possible abuse of a client? Select all that apply. A 6-year-old is being seen for the 5th time for a urinary tract infection A baby with contrecoup injuries to the brain A 3-month-old with a fractured femur A 15-month-old with shortness of breath after peanut ingestion A 3-year-old with a deep finger laceration

Correct response: A 6-year-old is being seen for the 5th time for a urinary tract infection A baby with contrecoup injuries to the brain A 3-month-old with a fractured femur Explanation: Re-occurring urinary tract infections signal the possibility of sexual abuse of the child. The nurse must assess for further signs of abuse both with parents present and without. A fracture of the femur in a 3-month-old is uncommon given the infant's age and level of development. Contrecoup injuries of the brain in a baby should generate suspicion that the baby has been shaken. A 15-month-old with an allergic reaction to a peanut ingestion and a 3-year-old with a deep finger laceration should not signal abuse to the assessor. The problems are commonly seen in the pediatric emergency room.

Which type of elder abuse involves leaving an older adult and no longer providing care for the individual? Abandonment Emotional Physical Neglect

Correct response: Abandonment Explanation: The six types of elder abuse are physical (injury by hitting, kicking, pushing, slapping, burning, and so on); sexual (unconsented sexual act); emotional (harm of self-worth or emotional well-being); neglect (failure to meet the older adult's basic needs of shelter, food, and so on); abandonment (leaving an older adult alone and no longer providing care); and financial (illegally misusing money, property, or assets).

A client is brought to the Emergency Department by a family member that reports being sexually assaulted while leaving work. What action by the nurse would best promote placing control back to the client? Inform the client that charges will have to be pressed against the perpetrator Allow the client to make decisions regarding care whenever possible Educate the client about attending a support group as soon as possible Inform the client that the assessment must be completed as soon as possible

Correct response: Allow the client to make decisions regarding care whenever possible Explanation: The nurse can best offer support by allowing decisions to be made about care, who to call, and allow the care to be delivered at a pace that is comfortable for the client. It is the clients decision about whether or not to file charges and testify against the perpetrator. Educating the client about attending a support group may be done after the assessment and would be important but does not directly offer the support that is needed at this time. The assessment can be very traumatic for the client and should not be hurried or rushed through.

A nurse is caring for a child who had experienced sexual abuse. Which are expected behaviors of a child who has experienced sexual abuse? Select all that apply. Avoidance of sexually related content Secretiveness of behaviors Open and honest discussion about history High self-esteem Distorted view of sex

Correct response: Avoidance of sexually related content Secretiveness of behaviors Distorted view of sex Explanation: A victim of prolonged sexual abuse will develop low self-esteem, a feeling of worthlessness, and a distorted view of sex. The child may become withdrawn, distrustful, or suicidal. Other characteristics of children who have been sexually abused include an unusual interest or avoidance of sexually related content, seductiveness, refusal to go to school, delinquency, secretiveness, and unusual aggressiveness.

A school nurse is aware that a student has requested aspirin three times during the past week because his "back hurts." The nurse has noticed that he often wears long-sleeved sweaters and sweatshirts even in warm weather. The nurse suspects that the student may be the victim of physical abuse. The nurse is preparing to ask the child about his ongoing backache. Which of the following would the nurse anticipate being reported by the child if he was being abused? His father is beating him on a regular basis. Be reluctant to report abuse because of shame or fear of retaliation Give the same reason his sister would give were she asked to explain his injuries. Carefully explain that his mother disciplines him because she loves him.

Correct response: Be reluctant to report abuse because of shame or fear of retaliation Explanation: Most survivors do not report violence to health care providers without specifically being asked about it. Survivors may be reluctant to report abuse because of shame and fear of retaliation, especially if the victim depends on the abuser as a caregiver. In addition, children may fear they will not be believed.

A 27-year-old has been brought to the emergency department by emergency medical services following a violent sexual assault that took place in the parking garage of the client's building. Which task would fall most clearly within the scope of practice of a forensic nurse? Providing reassurance to the client that the care team and the police will prioritize the client's care Collecting specimens from the client for use as evidence Assisting with diagnostic tests to determine the extent of the client's injuries Asking the client to describe the perpetrator in detail and documenting the client's statement

Correct response: Collecting specimens from the client for use as evidence Explanation: While a forensic nurse would certainly attempt to reassure a client such as this one, a priority forensic nursing task would be collecting specimens for use as evidence. This would supersede assisting with diagnostics, which falls within the scope of any registered nurse. The police, not a nurse, would be responsible for taking the client's statement.

What are some types of behavior that the nurse would recognize as qualifying as psychological abuse? Select all that apply. Criticizing Ridiculing Threatening a victim's dog Asking for time alone when frustrated Using assertive language

Correct response: Criticizing Ridiculing Threatening a victim's dog Explanation: Psychological abuse includes behaviors such as criticizing, insulting, humiliating, or ridiculing someone in private or public. It can also involve actions such as destroying another's property, threatening or harming pets, controlling or monitoring spending and activities, or isolating a person from family and friends. Asking the client for time alone when frustrated or using assertive language reflect healthy, adaptive communications skills during conflict management. These are not examples of psychological abuse.

A nurse manager is working with the nursing staff of a busy community-based walk-in clinic that provides care to a large number of survivors of domestic violence. When helping the staff provide care, which information would be most important for the nurse manager to convey to the staff? Importance of measuring the clients' progress in small steps Expectation that survivors will accept change right away Encouragement for staff discussion about specific clients to gain support Identification of consequences from changes made by survivors as minimal

Correct response: Importance of measuring the clients' progress in small steps Explanation: Nurses must become accustomed to measuring gains in small steps when working with survivors. Making any changes in significant relationships has serious consequences and can be done only when the adult survivor is ready. It is easy to become angry or discouraged with survivors, so it is important not to communicate such feelings. Discussing such feelings with other staff provides a way of dealing with them appropriately. In such discussions with supervisors or other staff, it is a must to protect the patient's confidentiality by discussing feelings around issues, not particular patients.

Which type of abuse includes name calling and belittling? Psychological abuse Physical abuse Sexual abuse Sodomy

Correct response: Psychological abuse Explanation: Name calling and belittling are examples of psychological abuse. Physical abuse ranges from shoving and pushing to severe battering and choking. Sexual abuse includes assaults during sexual relations such as pulling hair, slapping, hitting, and rape. Sodomy is anal intercourse.

Which statement requires additional education regarding the truth about rape? Rape is a crime of passion. No person wants to be raped. No person deserves to be raped. Rape can occur between married individuals.

Correct response: Rape is a crime of passion. Explanation: Rape is a crime of violence and humiliation of the victim expressed through sexual means. The remaining options present accurate information about the act of rape so no further education or correction is needed.

A nurse is working on developing a safety plan with a client who is a survivor of violence. Which would the nurse address first? Devising an escape route Recognizing the signs of danger Identifying a safe place to hide Identifying a signal to indicate it is safe to leave

Correct response: Recognizing the signs of danger Explanation: One of the most important teaching goals is to help survivors develop a safety plan. The first step in developing such a plan is helping the survivor recognize the signs of danger. Changes in tone of voice, use of alcohol and other drugs, and increased criticism may indicate that the perpetrator is losing control. Detecting early warning signs helps survivors to escape before battering begins. The next step is to devise an escape route. This involves mapping the house and identifying where the battering usually occurs and what exits are available. The survivor needs to have a bag packed and hidden, but readily accessible, containing what is needed to get away. If children are involved, the adult survivor should make arrangements to get them out safely. That might include arranging a signal to indicate when it is safe for them to leave the house and to meet at a prearranged place. A safety plan for a child or dependent older adult might include safe places to hide and important telephone numbers, including 911, police and fire departments, and other family members and friends.

During an interview, a 6-year-old child tells a nurse that the child is often left alone at home by the child's parents. Which action should the nurse take? Continue with the interview and ignore the accusations. Report the child's information to the child protection agency. Tell the parents about the accusations. Do nothing—the nurse should not get involved in any possible criminal investigation.

Correct response: Report the child's information to the child protection agency. Explanation: If a child reports family violence, in this case, by neglect, the nurse has a legal responsibility to report the abuse to child protection agencies.

Which type of rapist derives erotic gratification from the victim's suffering? Sadistic rapist Power rapist Anger rapist Premeditated rapist

Correct response: Sadistic rapist Explanation: Sadistic rapists derive erotic gratification from the victim's suffering. Power rapists often attack people their own age and use intimidation and minimal physical force to control their victims. Their assaults are premeditated. Anger rapists use extreme force and restraint that results in physical injury to the victim. There is not a type of rapist called premeditated.

The nurse provides care to individuals who have been sexually assaulted during their childhood. Which characteristic is most commonly noted by the nurse during an assessment of such clients? Overly self-confident Unusually aggressive Overly social Too trustful

Correct response: Unusually aggressive Explanation: A child who is a survivor of prolonged sexual abuse will develop low self-esteem, as well as developing feelings of worthlessness, and become socially withdrawn, distrustful, or suicidal. Other characteristics of children who have been sexually abused include becoming unusually aggressive.

Which is an inaccurate picture of the cycle of abuse that occurs over time? Violent episodes are less frequent Violent episodes are more frequent The period of remorse disappears Severity of the injuries worsen

Correct response: Violent episodes are less frequent Explanation: Over time, the violent episodes are more frequent, the period of remorse disappears altogether, and the level of violence and severity of injuries worsen.

The nurse in the emergency room is assessing a client who was brought in by the police for evaluation after receiving a call from a neighbor. The client reports to the nurse that the person who has been cooking and helping around the house has not been home for days. Which type of abuse does the nurse suspect based on the client's statement? neglect physical emotional abandonment

Correct response: abandonment Explanation: Although abandonment can cause neglect and lead to physical and emotional abuse, abandonment is the primary type of abuse that this person is experiencing. The older person is calling for help because the caregiver has not been present for days. Neglect is the failure to meet basic needs of shelter and food. Physical abuse is causing injury by hitting, kicking, or pushing. Emotional abuse is injuring the person's self-worth and emotional well-being.

A middle-aged client with young children has been the victim of intimate partner violence (IPV). When providing initial care to this family, the nurse should: carefully assess the children for signs of trauma. determine what initially caused the violence to begin. teach the client life skills for moving on from the relationship. reassure the client that this will never happen again.

Correct response: carefully assess the children for signs of trauma. Explanation: Children are inevitable victims in an IPV situation and must be assessed and cared for accordingly. The nurse must avoid false reassurance. It is unnecessary, and often impossible, to identify specific causes for IPV. Relationship skills can be addressed in follow-up care.

The nurse is approached by a teacher who suspects a student is being neglected after observing changes in the student's behavior. The teacher asks the nurse what other behaviors to watch for. Which symptoms of neglect should the nurse include in the discussion ? Select all that apply. fighting with other students deteriorating grades in school smoking a cigarette after school saving lunch items to take home for later refusing to answer when called on in class

Correct response: fighting with other students deteriorating grades in school smoking a cigarette after school refusing to answer when called on in class Explanation: Children who are abused or neglected are at risk for physical, emotional, and behavioral problems. They may have problems getting along with others leading to fights. Cognitive development may be impaired causing academic difficulties. They are at risk for substance abuse such as cigarettes. They may have low self-esteem and not want to participate in class. Saving food for later could indicate food insecurity which not identified as a problem associated with abuse or neglect.

The school health nurse is asked to see a child who has been coming to school with no lunch for the past week. The child tells the nurse, "I don't get a lunch this week, I have been wetting the bed." The nurse identifies that this child is experiencing which type of abuse? physical sexual neglect psychological

Correct response: neglect Explanation: Neglect, in this case, is the malicious withholding of a physical necessity for this child's well-being. For this child, the neglect is intended to be punitive for bed wetting. The nurse would need to investigate further and take the necessary action in reporting this as abuse. Sexual abuse refers to sexual acts performed by an adult on a child under the age of 18. In this case, the evidence does not support that the child is being sexually abused. Physical abuse refers to a deliberate physical assault by an adult on the child such as burning, biting, poking, or twisting a limb. Psychological abuse refers to verbal assaults such as blaming, screaming, name-calling, and using sarcasm. The child has not reported that this is occurring, therefore, this is most likely a situation in which the form of abuse is neglect.

When assessing a 6-year-old child believed to be a victim of emotional abuse, the possibility is supported when the child is ... observed to be anxious and rejecting adult attention. showing signs of developmental delays. attending day care 5 days a week. parented by a single parent.

Correct response: observed to be anxious and rejecting adult attention. Explanation: While anxiety can be a sign of many different problems, an anxious child who rejects the attention of an adult may raise a red flag encouraging the nurse to assess further and possibly making a report. Developmental delays are not necessarily an indicator of emotional abuse, nor is attending day care on a regular basis. Being raised by a single parent is also not necessarily an indicator of emotional abuse.

When the school nurse is assessing an adolescent who reports trouble sleeping, which characteristics of the client indicate there may be violence in the home? (Select all that apply.) the client's father monitors contact with friends feeling social pressure to use alcohol feeling left out of peer group has a family history of alcohol abuse must go straight home after school each day

Correct response: the client's father monitors contact with friends has a family history of alcohol abuse must go straight home after school each day Explanation: Having contact with friends monitored by the father indicates there is an abuse of power and control in the home. Having to go straight home after school indicates the client is being forced into social isolation. In addition, there is a family history of alcohol abuse. These are all characteristics of violent families. Adolescents commonly report feelings of being left out and experiencing social pressures to experiment with drugs and alcohol. These are not characteristics of violent families.

A psychiatric-mental health nurse is conducting a program for a women's group. When describing psychological abuse, which information would the nurse address? Select all that apply. Criticism Isolating a person from family Uncontrollable spending Insults Public ridicule

Criticism Insults Public ridicule Isolating a person from family Psychological abuse includes behaviors such as criticizing, insulting, humiliating, or ridiculing someone in private or in public. It can also involve actions such as destroying another's property, threatening or harming pets, controlling or monitoring spending and activities, or isolating a person from family and friends.

A nurse is caring for a family in which the elderly mother has been a victim of abuse and neglect by her son 48 years of age. Which of the following would be most important for the nurse to keep in mind before interviewing the family? The main focus of the nurse's actions should be on improving the elderly mother's self-esteem. The nurse must allow the older adult mother to decide whether she wants to leave the situation. A top nursing priority would be to legally remove the son from the home. Placement for the older adult woman in a nursing home within the community is crucial.

The nurse must allow the older adult mother to decide whether she wants to leave the situation. Removing children and older adults from their families or caregivers often is necessary to ensure immediate safety. If the home of an abused or neglected child or older adult cannot be made safe, the nurse must facilitate the involvement of other professionals in placing the child or older adult in a foster home or nursing home. Still, intervening in cases of elder abuse is not a clear-cut issue. When an older adult's decision making is not impaired (competence is the legal term), he or she must be allowed an appropriate degree of autonomy in deciding how to manage the problem, even if the choice is to remain in the abusive situation. Forcing someone to do something against his or her wishes is in itself a form of victimization and denies autonomous decision making.

Which would not increase the likelihood that an older adult will incur physical abuse? The older adult lives with a son who receives financial aid. An older adult reports frequent multiple bruises that are related to falls. The older adult is independent with activities of daily living. The older adult has difficulty with mobility and can become confused.

The older adult is independent with activities of daily living. The correct option indicates that the older adult enjoys independence, an attribute that is not commonly seen in those older adults who experience physical abuse. Common factors that predispose older adult clients to physical abuse include having chronic medical or mental health conditions, living with a familial caregiver who is a male and has financial problems, and the reluctance to report abuse despite the presence of signs such as multiple bruises.

A nurse is aware of the high incidence of intimate partner violence (IPV) and actively seeks opportunities to screen women for IPV. Which female client represents the best opportunity for assessing for IPV? a. A client who is in the third trimester of pregnancy and who is having biweekly prenatal appointments at a clinic b. A client who has brought her young son to the emergency department because he fell at the playground and may have an arm fracture c. A client who is currently exploring long-term care options for her elderly father d. A client who expressed interest in joining a grief support group following the death of her husband

a - rates of partner violence increase during pregnancy

A nurse is working in the emergency department. Which situation would lead the nurse to suspect possible abuse of a client? Select all that apply. a. A 6-year-old is being seen for the 5th time for a urinary tract infection b. A baby with contrecoup injuries to the brain c. A 3-month-old with a fractured femur d. A 15-month-old with shortness of breath after peanut ingestion e. A 3-year-old with a deep finger laceration

a b c

What are some types of behavior that the nurse would recognize as qualifying as psychological abuse? Select all that apply. a. Criticizing b. Ridiculing c. Threatening a victim's dog d. Asking for time alone when frustrated e. Using assertive language

a b c

The nurse is planning care for a client who is a victim of violence. Which of the following should the nurse identify as goals for this client's plan of care? Select all that apply. a. ensure safety b. prevent injury c. restore health d. prevent disease e. stop the violence

a b c e

nurse is caring for a child who had experienced sexual abuse. Which are expected behaviors of a child who has experienced sexual abuse? Select all that apply. a. Avoidance of sexually related content b. Secretiveness of behaviors c. Open and honest discussion about history d. High self-esteem e. Distorted view of sex

a b e

A mental health nurse presenting an educational program on rape for high school students responds to the statement, "Women cry rape often times just to get even with the guy," by offering which answer? "If a man is falsely accused, the woman is prosecuted by the law." "Actually, fewer than 2% of all reported rapes are found to be false." "I'm not sure where you heard that but statistically it isn't true." "I don't believe that's true but even if it were it doesn't excuse the real rapes that occur."

"Actually, fewer than 2% of all reported rapes are found to be false."

Which assessment question should the nurse ask of a client suspected of being ostracized by a school bully? "Do you feel like a part of a group in school?" "Do you smoke or use drugs?" "Can you go to the school principal with personal problems?" "Have you talked to your parents about your problems at school?"

"Do you feel like a part of a group in school?"

Which statement made by a client raises the greatest concern that the client may be experiencing relationship violence? "He was so much nicer when we started dating." "He doesn't like it when I go out with my girlfriends." "I don't know what else I can do to keep him from getting angry at me." "His father physically abused his mother for years."

"I don't know what else I can do to keep him from getting angry at me." A warning sign of relationship violence is feeling that you must change your life or yourself so you won't anger him or her. The remaining statements, while troublesome, are not as clearly associated with behaviors of violence.

Question 10 of 10 The nurse is providing care to client who is currently in a sexually abusive relationship. To best manage the development of additional comorbid disorders, what question(s) should the nurse ask this client? Select all that apply. "Do you have a safety and escape plan in place?" "What community resources related to HIV and pregnancy are you aware of?" "What are the early symptoms of posttraumatic stress disorder (PTSD)?" "What do you do to avoid angering your abuser?" "Are you aware of self-defense strategies to physically protect oneself?"

"What community resources related to HIV and pregnancy are you aware of?" "What are the early symptoms of posttraumatic stress disorder (PTSD)?" "Are you aware of self-defense strategies to physically protect oneself?" "Do you have a safety and escape plan in place?" Information should focus on effective safety and health promotion interventions including relevant health screenings, early symptom identification, and safety plans. Physical self-defense strategies may be acquired but they are an established method of assuring safety in abusive situations. The anger is unpredictable, unavoidable, and outside the control of the abused.

A nurse is assessing a client in a community clinic who reports feeling anxious lately because she is considering leaving her marriage. The client describes a long history of partner abuse associated with this relationship. How should the nurse respond to this client?

"You have the right to be safe and respected." When working with someone who is a victim of partner abuse, it is important that the nurse assertively support the client's decision. The affirmation of the client's decision can help to improve the client's self-confidence as she begin the process of leaving her partner. It is important the nurse refrain from recommending couple's counseling or imply doubt about the client's situation. The nurse will likely not be involved in every step of the client's process of leaving the relationship, as the client will use a variety of resources outside the nurse-client relationship, nor should the nurse take charge and do everything for the client or imply that this will happen.

A client discloses to a nurse therapist that the client has been verbally abusive to the client's 6-year-old child and belittles the child routinely. Which form of abuse best describes the client's treatment of the child? Neglect Emotional abuse Physical abuse Sexual abuse

Emotional abuse Emotional abuse includes acts such as name-calling, belittling, screaming, yelling, destroying property, making threats, refusing to speak to the child, or ignoring the child.

The nurse is aware that fewer than half of rapes and sexual assaults are reported. Which are some of the reasons people do not report being sexually assaulted? Select all that apply. The person is concerned about the financial issues associated with the hospitalization. The client is embarrassed of the assault. The perpetrator may use coercion or threats to control the victim. They have a fear of being blamed for the incident. The victim is responsible for the attack.

1. The client is embarrassed of the assault. 2. They have a fear of being blamed for the incident. 3. The perpetrator may use coercion or threats to control the victim. Fewer than half of rapes and sexual assaults are reported, generally because of shame, embarrassment, concern about not being believed or fear of being blamed for the assault. Knowing the attacker may also be a factor that inhibits reporting. The majority of sexual violence is perpetrated by intimate partner or acquaintances and does not involve weapons or severe physical violence. The perpetrator may use coercion, threats, or substances to control the victim. The nurse needs to understand these reasons to develop a therapeutic relationship to assist in the care of the client victim.

What percentage of women can expect to be a victim of an ongoing unwanted pursuit from stalking? 40-48% 50-60% 12-32% 5-10%

12-32% Women are 12-32% and men 17% who can expect to be victims of ongoing unwanted pursuit.

What assessment data, related to a 77 year old client, would be considered the highest risk for possible elder abuse? Lives with adult daughter Diagnosed with mild dementia Requires assistance with food preparation Widowed, female

Correct response: Diagnosed with mild dementia Explanation: While the risk of elder abuse exists in all the options provided, such abuse is more likely when the elder client has chronic mental and/or physical health problems that limit there ability to express their concerns and/or describe their current living conditions.

A mental health nurse is interviewing a child for suspected abuse. The parent states that the child is having disciplinary problems at school and stutters when approached. From the listed behavioral indicators, the nurse would suspect which type of abuse? Physical Financial Emotional Sexual

Correct response: Emotional Explanation: A behavioral profile of an emotionally abused child includes stuttering, enuresis, overeating, disciplinary problems, and failure to thrive. The scenario does not refer to physical, financial, or sexual abuse.

Which is the best action for the nurse to take when assessing a child who might be abused? a. Confront the parents with the facts, and ask them what happened. b. Consult with a professional member of the health team about making a report. c. Ask the child which parent caused this injury. d. Say or do nothing; the nurse has only suspicions, not evidence.

b

Which assessment finding can help the nurse differentiate a child experiencing child neglect rather than child abuse?

A young child is admitted to the hospital with hypothermia because the child is inadequately dressed.

What percentage of women can expect to be a victim of an ongoing unwanted pursuit from stalking? 5-10% 12-32% 40-48% 50-60%

Correct response: 12-32% Explanation: Women are 12-32% and men 17% who can expect to be victims of ongoing unwanted pursuit.

A nurse is working in the emergency department. Which situation would lead the nurse to suspect possible abuse of a client? Select all that apply. A 3-month-old with a fractured femur A 6-year-old is being seen for the 5th time for a urinary tract infection A 15-month-old with shortness of breath after peanut ingestion A baby with contrecoup injuries to the brain A 3-year-old with a deep finger laceration

A 6-year-old is being seen for the 5th time for a urinary tract infection A baby with contrecoup injuries to the brain A 3-month-old with a fractured femur Re-occurring urinary tract infections signal the possibility of sexual abuse of the child. The nurse must assess for further signs of abuse both with parents present and without. A fracture of the femur in a 3-month-old is uncommon given the infant's age and level of development. Contrecoup injuries of the brain in a baby should generate suspicion that the baby has been shaken. A 15-month-old with an allergic reaction to a peanut ingestion and a 3-year-old with a deep finger laceration should not signal abuse to the assessor. The problems are commonly seen in the pediatric emergency room.

Which type of elder abuse involves leaving an older adult and no longer providing care for the individual? Neglect Abandonment Physical Emotional

Abandonment The six types of elder abuse are physical (injury by hitting, kicking, pushing, slapping, burning, and so on); sexual (unconsented sexual act); emotional (harm of self-worth or emotional well-being); neglect (failure to meet the older adult's basic needs of shelter, food, and so on); abandonment (leaving an older adult alone and no longer providing care); and financial (illegally misusing money, property, or assets).

Nurses at an urban emergency department seek to develop a plan to help women involved in abusive relationships. Which component is critical to the success of the plan? Access to community resources for referral Written educational materials An intimate partner violence (IPV) counselor A quality of life assessment tool

Access to community resources for referral Much of the support and treatment that will be needed for women in abusive relationships is needed in the community. Having access to these resources is the most critical aspect to ensuring effective and sustainable support for women in abusive situations. An IPV counselor in the emergency department will only be available for support when there is an acute situation for which the client has come to hospital. Such a component is effective but not a long-term option to support people in abusive relationships. A quality of life assessment tool is effective for assessment, but this is only the initial part of the plan. Written educational materials are important to enhance knowledge for women in abusive situations; however, community support services are needed to ensure follow through and sustainability.

Approximately what percentage of women rape victims are raped by someone they know? 65% 35% 45% 55%

Correct response: 65% Explanation: Approximately two-thirds of women are raped by people they know, including spouses, boyfriends, friends, or acquaintances. Among young women, about 50% of rapes are date rapes.

A nursing student learning about intimate partner violence (IPV) correctly identifies the percentage of deaths attributed to IPV to be what? 70% women and 30% men 70% men and 30% women 50% women and 50% men 90% women and 10% men

Correct response: 70% women and 30% men Explanation: Approximately 70% of victims killed by IPV are women and 30% are men.

Which is true about domestic violence between same-sex partners? a. Such violence is less common than that between heterosexual partners. b. The frequency and intensity of violence are greater than between heterosexual partners. c. Rates of violence are about the same as between heterosexual partners. d. None of the above.

b

A 27-year-old has been brought to the emergency department by emergency medical services following a violent sexual assault that took place in the parking garage of the client's building. Which task would fall most clearly within the scope of practice of a forensic nurse? Providing reassurance to the client that the care team and the police will prioritize the client's care Collecting specimens from the client for use as evidence Asking the client to describe the perpetrator in detail and documenting the client's statement Assisting with diagnostic tests to determine the extent of the client's injuries

Collecting specimens from the client for use as evidence While a forensic nurse would certainly attempt to reassure a client such as this one, a priority forensic nursing task would be collecting specimens for use as evidence. This would supersede assisting with diagnostics, which falls within the scope of any registered nurse. The police, not a nurse, would be responsible for taking the client's statement.

A female client states that she has been receiving numerous text and phone messages from a co-worker. Which type of harassment should be documented in the nurse's notes? Harassment Cyberstalking Isolation Jealousy

Cyberstalking Stalking is a pattern of repeated unwanted contact, attention, and harassment that often increases in frequency. Cyberstalking is the use of the Internet, e-mail, or other telecommunications technology to harass or stalk another person. The nurse should document the conversation in the nurse's notes.

ignoring and excluding a target individual, has recently emerged as one of the more common and damaging forms of bullying is called what? a. neglect b. ostracism c. physical abuse d. psychological abuse (emotional abuse) e. rape

b

Nurses working with rape trauma victims need to be aware of their own attitudes about rape and sexual assault. Which rationale best explains why? Nurses can learn from the experiences of clients and thus help prevent becoming victims of assault themselves. Giving back the survivor as much control as possible is important. Nurses need to be able to sympathize with their clients. The attitudes of individual nurses reflect on the overall profession.

Giving back the survivor as much control as possible is important. Knowing how to recognize when personal feelings are likely to interfere with optimal care is part of the nurse's professional responsibility. Giving back the survivor as much control possible is important by allowing the client to make decisions about who to call, what to do next, and what the client would like done in relation to the crime. The nurse's role in helping the survivor regain control is an essential part of recovery.

A group of nursing students is reviewing information about intimate partner violence (IPV). The group demonstrates understanding of this topic when they identify which of the following? Men are more likely to be seriously injured even though more women are typically victims. The reactions to IPV are similar in male and female victims. IPV in same-sex couples occurs less frequently than in heterosexual relationships. Men may not consider behaviors such as slapping or shoving as abuse.

Men may not consider behaviors such as slapping or shoving as abuse. Men are sometimes hesitant to report victimization or may not consider behaviors such as shoving or slapping "abuse." Nearly one in four women and one in nine men are victims of IPV at some point in their lives. Women are much more likely than men to be seriously injured as a result of IPV and to require medical treatment. IPV in same-sex couples occurs with at least the same frequency as in heterosexual relationships, but individuals with same-sex partners may not be afforded the same support. The reaction to IPV may differ by gender.

A nurse is caring for a young adult in the mental health clinic. The client tells the nurse that the client was physically neglected as a child. The nurse should assess the client for symptoms of what? Major depression Panic disorder Schizophrenia Narcissistic personality disorder

Major depression

A nurse is working with a child whose parents have subjected him to neglect and emotional maltreatment, which primarily took the form of unavailability and general disinterest in his welfare. The nurse should expect that a child subjected to this type of maltreatment would experience problems in which of the following? Multiple intellectual, physical, behavioral, and emotional arenas Emotional and intellectual functioning Behavioral and emotional functioning Behavioral and physical functioning

Multiple intellectual, physical, behavioral, and emotional arenas Maltreated children tend to have difficulties in social, behavioral, emotional, and intellectual functioning, as well as physical growth and development.

The nursing student learning about intimate partner violence correctly identifies its prevalence in same-sex couples as what? Twice as often as in heterosexual couples Same frequency as in heterosexual couples Three times more frequent as in heterosexual couples Half as frequent as in heterosexual couples

Same frequency as in heterosexual couples Intimate partner violence in same-sex couples occurs with at least the same frequency as in heterosexual relationships, but people with same-sex partners may not be afforded the same support.

A nurse is working on developing a safety plan with a client who is a survivor of violence. Which would the nurse address first? Devising an escape route Recognizing the signs of danger Identifying a safe place to hide Identifying a signal to indicate it is safe to leave

Recognizing the signs of danger One of the most important teaching goals is to help survivors develop a safety plan. The first step in developing such a plan is helping the survivor recognize the signs of danger. Changes in tone of voice, use of alcohol and other drugs, and increased criticism may indicate that the perpetrator is losing control. Detecting early warning signs helps survivors to escape before battering begins. The next step is to devise an escape route. This involves mapping the house and identifying where the battering usually occurs and what exits are available. The survivor needs to have a bag packed and hidden, but readily accessible, containing what is needed to get away. If children are involved, the adult survivor should make arrangements to get them out safely. That might include arranging a signal to indicate when it is safe for them to leave the house and to meet at a prearranged place. A safety plan for a child or dependent older adult might include safe places to hide and important telephone numbers, including 911, police and fire departments, and other family members and friends.

The nurse can assess potential victims of domestic violence by asking which question? a. "Has a past or current partner ever caused you to be afraid?" b. "What did you do right before your partner hit you?" c. "What is your history of physical injuries?" d. "Do you need the number of a shelter?"

a

A female client comes to an urgent care clinic and says, "I've just been raped." What should the nurse do? a. Allow the client to express whatever she wants. b. Ask the client if staff can call a friend or family member for her. c. Offer the client coffee, tea, or whatever she likes to drink. d. Get the examination completed quickly to decrease trauma to the client. e. Provide the client privacy; let her go to a room to make phone calls. f. Stay with the client until someone else arrives to be with her.

a b f

A client comes to the clinic for an evaluation. The nurse assesses the client and suspects that the client is a victim of abuse. Which finding would support the nurse's suspicion? Select all that apply. a. The client is vague about the injuries on the body. b. The client came to the clinic right after the injuries occurred. c. The client minimizes the severity of the injuries. d. The client has a history of frequent visits to the emergency department for injuries. e. The client voices statements about having control over current status.

a c d

Examples of child maltreatment include a. calling the child stupid for climbing on a fence and getting injured. b. giving the child a time-out for misbehaving by hitting a sibling. c. failing to buy a desired toy for Christmas. d. spanking an infant who won't stop crying. e. watching pornographic movies in a child's presence. f. withholding meals as punishment for disobedience.

a d e f

A 27-year-old has been brought to the emergency department by emergency medical services following a violent sexual assault that took place in the parking garage of the client's building. Which task would fall most clearly within the scope of practice of a forensic nurse? a. Providing reassurance to the client that the care team and the police will prioritize the client's care b. Collecting specimens from the client for use as evidence c. Assisting with diagnostic tests to determine the extent of the client's injuries d. Asking the client to describe the perpetrator in detail and documenting the client's statement

b

the school health nurse is asked to see a child who has been coming to school with no lunch for the past week. The child tells the nurse, "I don't get a lunch this week, I have been wetting the bed." The nurse identifies that this child is experiencing which type of abuse? a. physical b. sexual c. neglect d. psychological

c

A nurse is preparing a presentation for an adolescent and young adult community group about stalking. Which group would the nurse identify as having the highest risk of being stalked? a. Boys and young men, ages 12 to 21 years b. Men, ages 24 to 28 years c. Girls and young women, ages 10 to 18 years d. Women, ages 18 to 24 years

d

The nurse assesses a client who comes to the emergency room for vaginal bleeding and swelling. The client reports she had sexual intercourse with her boyfriend the previous night and states, "It was consensual, but sometimes he is rough." The client begins to cry and looks away. What should the nurse suspect? sodomy neglect intimate partner violence family violence

intimate partner violence The client is experiencing sexual abuse in the context of a relationship with an intimate partner, also known as intimate partner violence. The physical injuries sustained as a result of sexual intercourse should generate suspicion that the client may have been raped by her boyfriend and further assessment for abuse is warranted. Sodomy is defined as anal intercourse. The client presents to the emergency room with vaginal bleeding and swelling indicating vaginal intercourse took place, not anal. Family violence takes place in the traditional family context and is directed at a spouse and/or the children who reside in the family unit. Neglect refers to the malicious or ignorant withholding of physical, emotional, or educational necessities for a child's well-being.

When assessing a 6-year-old child believed to be a victim of emotional abuse, the possibility is supported when the child is ... showing signs of developmental delays. observed to be anxious and rejecting adult attention. attending day care 5 days a week. parented by a single parent.

observed to be anxious and rejecting adult attention. While anxiety can be a sign of many different problems, an anxious child who rejects the attention of an adult may raise a red flag encouraging the nurse to assess further and possibly making a report. Developmental delays are not necessarily an indicator of emotional abuse, nor is attending day care on a regular basis. Being raised by a single parent is also not necessarily an indicator of emotional abuse.

A 3-year-old who has been seen in the emergency department for various fall-related injuries is being treated for apparent blindness in the left eye as a result of retinal hemorrhage. The nurse should suspect that which form of child abuse is part of the cause of the child's condition? Child neglect Shaken baby syndrome Munchausen's syndrome by proxy Ineffective supervision

shaken baby syndrome Despite its name, shaken baby syndrome has been documented in children up to 5 years of age. The physical findings usually include bruising from being grabbed firmly along with major head injury, such as subdural hematoma or cerebral edema. Nonfatal consequences include blindness due to retinal hemorrhage.

True or False? - rape is not sexual crime, rather a exertion of power, control, infliction of pain or punishment.

true

A client who has been victimized repeatedly by a spouse is angry and verbally lashing out on the nurse. Based on the client's behavior, which technique would the nurse use with this client? provide stories about survivors of abuse suggest reenacting the abuse instruct in relaxation techniques use "I feel" statements

use "I feel" statements

Intimate partner violence can occur in what three phases of a cycle?

violent episode honeymoon episode tension building