Module 14: Abuse, Violence, Trauma, and Stress-Related Disorders

___________________ is repeated and persistent attempts to impose unwanted communication or contact on another person.

Stalking

What of the following are warning signs of relationship violence? Select all that apply. drinks heavily, uses drugs, or tries to get you drunk Guards masculinity by acting tough Talks positively about women in general Gets jealous for appropriate reasons

- Drinks heavily, uses drugs, or tries to get you drunk - Guards masculinity by acting tough ALL: BOX 12.6 Warning Signs of Relationship Violence •Emotionally abuses you (insults, makes belittling comments, or acts sulky or angry when you initiate an idea or activity) •Tells you with whom you may be friends or how you should dress, or tries to control other elements of your life •Talks negatively about women in general •Gets jealous for no reason •Drinks heavily, uses drugs, or tries to get you drunk •Acts in an intimidating way by invading your personal space such as standing too close or touching you when you don't want that •Cannot handle sexual or emotional frustration without becoming angry •Does not view you as an equal: sees self as smarter or socially superior •Guards masculinity by acting tough •Is angry or threatening to the point that you have changed your life or yourself so you won't anger him •Goes through extreme highs and lows: is kind one minute, cruel the next •Berates you for not getting drunk or high, or not wanting to have sex •Is physically aggressive, grabbing and holding you, or pushing and shoving

Which of the following are warning signs of relationship violence? Select all that apply. Goes through extreme highs and lows: is kind one minute, cruel the next. Talks Positively about women in general Gets jealous for no reason Guards masculinity by acting tough Resistant to alcohol and drugs

- Drinks heavily, uses drugs, or tries to get you drunk - Guards masculinity by acting tough - Gets jealous for no reason

Which of the following are important for client and family education? Drink alcohol occasionally Follow a daily routine Join a support group Eat a balanced, healthy diet

- Follow a daily routine - Join a support group - Eat a balanced, healthy diet ALL: CLIENT AND FAMILY EDUCATION •Ask for support from others. •Avoid social isolation. •Join a support group. •Share emotions and experiences with others. •Follow a daily routine. •Set small, specific, achievable goals. •Accept feelings as they occur. •Get adequate sleep. •Eat a balanced, healthy diet. •Avoid alcohol and other drugs. •Practice stress reduction techniques.

Bullying, ignoring and excluding a target individual, has recently emerged as one of the more common and damaging forms of bullying. True False

False Ostracism, ignoring and excluding a target individual, has recently emerged as one of the more common and damaging forms of bullying.

Pregnant women experience a decrease in violence during pregnancy. False True

False Pregnant women experience an increase in violence during pregnancy. Battering during pregnancy leads to adverse outcomes, such as miscarriage and stillbirth, as well as further physical and psychological problems for the woman. The increase in violence often results from the partner's jealousy, possessiveness, insecurity, and lessened physical and emotional availability of the pregnant woman.

The first part of treatment for child abuse or neglect is to ensure family therapy is being done. True False

False The first part of treatment for child abuse or neglect is to ensure the child's safety and well-being. This may involve removing the child from the home, which also can be traumatic.

What are appropriate nursing interventions for a patient with a diagnosis of Posttrauma Syndrome? Select all that apply. High self-esteem Increased concentration Flashbacks Depression

Flashbacks or reexperiencing the traumatic event(s), Depression, Decreased concentration, Low self-esteem *this is WRONG but is entered as such

_____________ techniques remind the client that he or she is in the present, is an adult, and is safe.

Grounding

_____________ or initiation rites, is prevalent in both high school and college. Victims may be subjected to humiliating activities, or even illegal activities.

Hazing

Which of the following are characteristics of violent families? Select all that apply. Intergenerational transmission process Active family Social isolation Alcohol abuse

Intergenerational transmission process Social isolation Alcohol abuse ALL: BOX 12.1 Characteristics of Violent Families •Social isolation •Abuse of power and control •Alcohol and other drug abuse •Intergenerational transmission process

Although domestic violence affects all types of families, a specific population is particularly at risk: immigrant women. True False

True

As many as 50% of female victims do not acknowledge a sexual assault, minimizing it as a misunderstanding or a lesser event True False

True

Prevalence rates of PTSD and depression remain elevated 15 years later. True False

True

Some mental health professionals believe there is danger of inducing false memories of childhood sexual abuse through imagination in psychotherapy. True False

True Some mental health professionals believe there is danger of inducing false memories of childhood sexual abuse through imagination in psychotherapy. This so-called false memory syndrome has created problems in families when clients made groundless accusations of abuse.

The intergenerational transmission process shows that patterns of violence are perpetuated from one generation to the next through role modeling and social learning. False True

True The intergenerational transmission process shows that patterns of violence are perpetuated from one generation to the next through role modeling and social learning.

The nurse is likely to find these clients have low self-esteem. True False

True The nurse is likely to find these clients have low self-esteem. They may believe they are bad people who somehow deserve or provoke the abuse.

Dissociative disorders, relatively rare in the general population, are much more prevalent among those with histories of childhood physical and sexual abuse. True False

True. Dissociative disorders, relatively rare in the general population, are much more prevalent among those with histories of childhood physical and sexual abuse.

Group the following. Physical abuse indicators Marital abuse indicators Psychosocial abuse indicators

Physical Abuse Indicators • Frequent, unexplained injuries accompanied by a habit of seeking medical assistance from various locations • Reluctance to seek medical treatment for injuries or denial of their existence • Disorientation or grogginess indicating misuse of medications • Fear or edginess in the presence of family member or caregiver Material Abuse Indicators • Unpaid bills • Standard of living below the elder's means • Sudden sale or disposal of the elder's property/possessions • Unusual or inappropriate activity in bank accounts • Signatures on checks that differ from the elder's • Recent changes in will or power of attorney when the elder is not capable of making those decisions • Missing valuable belongings that are not just misplaced • Lack of television, clothes, or personal items that are easily affordable • Unusual concern by the caregiver over the expense of the elder's treatment when it is not the caregiver's money being spent Psychosocial Abuse Indicators • Change in elder's general mood or usual behavior • Isolated from previous friends or family • Sudden lack of contact from other people outside the elder's home • Helplessness • Hesitance to talk openly • Anger or agitation • Withdrawal or depression

Which of the following are false regarding rape? Select all that apply. Rape is exciting for some women. Rape is a crime of passion. Rape is not about having sex. Walking alone at night is an invitation for rape.

Rape is exciting for some women. Rape is a crime of passion. Walking alone at night is an invitation for rape. ALL: BOX 12.5 Common Myths about Rape •Rape is about having sex. •When a woman submits to rape, she really wants it to happen. •Women who dress provocatively are asking for rape. •Some women like rough sex but later call it rape. •Once a man is aroused by a woman, he cannot stop his actions. •Walking alone at night is an invitation for rape. •Rape cannot happen between persons who are married. •Rape is exciting for some women. •Rape occurs only between heterosexual couples. •If a woman has an orgasm, it can't be rape. •Rape usually happens between strangers. •Rape is a crime of passion. •Rape happens spontaneously.

Posttraumatic _______ disorder is a disturbing pattern of behavior demonstrated by someone who has experienced, witnessed, or been confronted with a traumatic event such as a natural disaster, combat, or an assault.

stress

Which of the following are warning signs for abused or neglected children? Select all that apply. Inconsistencies or changes in the child's history during the evaluation by either the child or the adult High incidence of urinary tract infections; bruised, red, or swollen genitalia; tears or bruising of rectum or vagina Children meeting developmental milestones on time with no delays Serious injuries such as fractures, burns, or lacerations with no reported history of trauma

- Inconsistencies or changes in the child's history during the evaluation by either the child or the adult - High incidence of urinary tract infections; bruised, red, or swollen genitalia; tears or bruising of rectum or vagina - Serious injuries such as fractures, burns, or lacerations with no reported history of trauma ALL: BOX 12.3 Warning Signs of Abused/Neglected Children • Serious injuries such as fractures, burns, or lacerations with no reported history of trauma • Delay in seeking treatment for a significant injury • Child or parent giving a history inconsistent with severity of injury, such as a baby with contrecoup injuries to the brain (shaken baby syndrome) that the parents claim happened when the infant rolled off the sofa • Inconsistencies or changes in the child's history during the evaluation by either the child or the adult • Unusual injuries for the child's age and level of development, such as a fractured femur in a 2-month-old or a dislocated shoulder in a 2-year-old • High incidence of urinary tract infections; bruised, red, or swollen genitalia; tears or bruising of rectum or vagina • Evidence of old injuries not reported, such as scars, fractures not treated, and multiple bruises that parent/caregiver cannot explain adequately

Which of the following are true regarding general appearance and motor behavior for clients with PTSD? Select all that apply. Will be sitting still Reacts to small environmental noises with a startle response Appears uncomfortable Anxious

- Reacts to small environmental noises with a startle response - Appears uncomfortable - Anxious ALL: appears hyperalert and reacts to even small environmental noises with a startle response uncomfortable if the nurse is too close physically and may require greater distance or personal space than most people appear anxious or agitated difficulty sitting still sit very still, seeming to curl up with arms around knees.

Match the following: Physical abuse Emotional abuse Honeymoon period Intimate partner violence

A typical pattern exists; usually, the initial episode of battering or violence is followed by a period of the abuser expressing regret, apologizing, and promising it will never happen again. He professes his love for his wife and may even engage in romantic behavior (e.g., buying gifts and flowers). This period of contrition or remorse is sometimes called the honeymoon period. The woman naturally wants to believe her husband and hopes the violence was an isolated incident. After this honeymoon period, the tension-building phase begins; there may be arguments, stony silence, or complaints from the husband. The tension ends in another violent episode after which the abuser once again feels regret and remorse and promises to change. This cycle continually repeats itself.

______________ is the wrongful use and maltreatment of another person.

Abuse