Prep U- Ch. 33-- Violence & Abuse
Approximately what percentage of women rape victims are raped by someone they know? a) 55% b) 65% c) 35% d) 45%
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.
Which medication classification has been used successfully to treat PTSD? a) Anticonvulsants b) Antimanics c) Antidepressants d) Antipsychotics
Antidepressants Explanation: Antidepressants, such as Paxil and Zoloft, have been used to treat PTSD.
A mental health nurse is interviewing a depressed child for suspected abuse. The mother states that the child is having disciplinary problems at school and stutters when approached. From the above behavioral indicators, the nurse would suspect which type of abuse? a) Sexual b) Financial c) Emotional d) Physical
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.
A nurse is caring for a young adult in the mental health clinic. The client tells the nurse that he was physically neglected as a child. The nurse should assess the client for symptoms of which of the following? a) Narcissistic personality disorder b) Major depression c) Panic disorder d) Schizophrenia
Major depression Explanation: An important outcome of nursing intervention with survivors is appropriate treatment of any disorder resulting from abuse, such as acute stress disorder, posttraumatic stress disorder, anxiety disorders, dissociative identity disorder, major depression, or substance abuse.
Which of the following would not be considered a risk factors for being a victim of elder abuse? a) Older than 65 years b) Female c) Impaired cognitive function d) Financial dependency
Older than 65 years Explanation: Age alone is not a risk factor, the vulnerabilities of being female, cognitively impaired, and financially dependent increase the risks of being abused.
A college program aimed at teaching female students about ways to keep themselves safe from attack or rape while walking on campus would be considered which type of prevention? a) Secondary prevention b) Primary prevention c) Tertiary prevention d) Rehabilitative prevention
Primary prevention Explanation: Education aimed at preventing health problems or crises is considered primary prevention.
In a toddler, which injury is most likely the result of child abuse? a) A 1-inch forehead laceration b) A small, isolated bruise on the right lower extremity c) A hematoma on the occipital region of the head d) Several small, circular burns on the child's back
Several small, circular burns on the child's back Explanation: Small circular burns on a child's back are no accident and may be from cigarettes. Toddlers are injury prone because of their developmental stage, and falls are frequent because of their unsteady gait; head injuries are not uncommon. A small area of ecchymosis is not suspicious in this age group.
A parent brings a preschooler to the emergency department for treatment of a dislocated shoulder, which allegedly happened when the child fell down the stairs. Which action should make the nurse suspect that the child was abused? a) The child pulls away from contact with the physician. b) The child does not make eye contact with the nurse. c) The child does not cry when the shoulder is examined. d) The child cries uncontrollably throughout the examination.
The child does not cry when the shoulder is examined. Explanation: A characteristic behavior of abused children is lack of crying when they undergo a painful procedure or are examined by a health care professional. Therefore, the nurse should suspect child abuse. Crying throughout the examination, pulling away from the physician, and not making eye contact with the nurse are normal behaviors for preschoolers.
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? a) A top nursing priority would be to legally remove the son from the home. b) The main focus of the nurse's actions should be on improving the elderly mother's self-esteem. c) Placement for the older adult woman in a nursing home within the community is crucial. d) The nurse must allow the older adult mother to decide whether she wants to leave the situation.
The nurse must allow the older adult mother to decide whether she wants to leave the situation. Explanation: 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.
A nurse who provides care in a large, urban emergency department has worked with numerous victims of various forms of abuse as well as those who are abusers. The nurse recognizes that persons who commit abuse are typically what? a) Of lower socioeconomic class b) Over 50 years of age c) Victims themselves of abuse d) Delusional and/or psychotic
Victims themselves of abuse Explanation: While persons who commit abuse are by no means a homogeneous group, they do tend to be victims of abuse themselves. They are not necessarily poor, acutely ill, or elderly.
Which of the following is an inaccurate picture of the cycle of abuse that occurs over time? a) Severity of the injuries worsen b) Violent episodes are less frequent c) Violent episodes are more frequent d) The period of remorse disappears
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.
Which of the following is an inaccurate picture of the cycle of abuse that occurs over time? a) Violent episodes are more frequent b) Severity of the injuries worsen c) The period of remorse disappears d) Violent episodes are less frequent
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 loss of employment is most likely to trigger abusive behavior toward others by the client who a) Was physically beaten as a child b) Was experiencing financial problems before the loss of employment c) Experiences chronic mild depression d) Is used to being in control
Was physically beaten as a child Explanation: The loss of employment is most likely to trigger abusive behavior toward others by the client who was physically beaten as a child.
Which of the following is not considered a characteristic of violent families? a) Adequate support systems b) Social isolation c) Abuse of power and control d) Alcohol abuse
Which of the following is not considered a characteristic of violent families? a) Adequate support systems b) Social isolation c) Abuse of power and control d) Alcohol abuse
Rape trauma syndrome is a two-phase process that all rape survivors experience. It includes a) a phase of psychosis followed by a phase of recovery. b) exacerbation of symptoms, and a successful recovery phase. c) an acute phase of disorganization and a long-term process of reorganization. d) an acute phase of symptom exaggeration and a short-term phase of reintegration.
an acute phase of disorganization and a long-term process of reorganization. Explanation: The acute phase involves a variety of signs of distress and attempts to cope. Reorganization involves the victim's attempts at regaining normalcy in life.
A 21-year-old woman has just given birth to her first child. Which of the following statements should signal the maternity nurse to the possibility of future abuse? a) "I don't even know where to begin with taking care of the baby." b) "I never really wanted this baby in the first place because the pregnancy was an accident." c) "I'm feeling pretty overwhelmed with everything and I need to get some help ASAP." d) "I don't tend to do very well with no sleep, so I'm pretty worried."
"I never really wanted this baby in the first place because the pregnancy was an accident." Explanation: Indifference or negativity surrounding the birth of a child has been identified as a potential precursor to child abuse. The other statements convey that the client is overwhelmed, which is not an unusual response to the birth of a child.
A 21-year-old woman has just given birth to her first child. Which of the following statements should signal the maternity nurse to the possibility of future abuse? a) "I'm feeling pretty overwhelmed with everything and I need to get some help ASAP." b) "I don't tend to do very well with no sleep, so I'm pretty worried." c) "I never really wanted this baby in the first place because the pregnancy was an accident." d) "I don't even know where to begin with taking care of the baby."
"I never really wanted this baby in the first place because the pregnancy was an accident." Explanation: Indifference or negativity surrounding the birth of a child has been identified as a potential precursor to child abuse. The other statements convey that the client is overwhelmed, which is not an unusual response to the birth of a child.
An emergency department nurse is assessing a female client with traumatic injuries. To assess whether or not the client's injuries have resulted from abuse, which question would be most appropriate for the nurse to ask the client? a) "Can you describe the person who did this to you?" b) "It looks like someone has hurt you. Tell me about it." c) "Why do you think your husband has beaten you?" d) "Is your partner being mean to you?"
"It looks like someone has hurt you. Tell me about it." Explanation: The nurse should say to the client, "It looks like someone has hurt you. Tell me about it." This is an open-ended statement and allows the client to verbalize her thoughts and feelings. Asking whether the partner is being mean or asking why the client thinks the husband has beaten her already assumes that the client has been abused. Asking about the person who did this would be ineffective because survivors of violence are unlikely to disclose sensitive information unless they perceive the nurse to be trustworthy and nonjudgmental. Additionally, this question is a closed question that does not allow the client to verbalize her thoughts and feelings openly.
An emergency department nurse is assessing a female client with traumatic injuries. To assess whether or not the client's injuries have resulted from abuse, which question would be most appropriate for the nurse to ask the client? a) "It looks like someone has hurt you. Tell me about it." b) "Can you describe the person who did this to you?" c) "Why do you think your husband has beaten you?" d) "Is your partner being mean to you?"
"It looks like someone has hurt you. Tell me about it." Explanation: The nurse should say to the client, "It looks like someone has hurt you. Tell me about it." This is an open-ended statement and allows the client to verbalize her thoughts and feelings. Asking whether the partner is being mean or asking why the client thinks the husband has beaten her already assumes that the client has been abused. Asking about the person who did this would be ineffective because survivors of violence are unlikely to disclose sensitive information unless they perceive the nurse to be trustworthy and nonjudgmental. Additionally, this question is a closed question that does not allow the client to verbalize her thoughts and feelings openly.
A nursing instructor teaching about sexual assault identifies a need for further instruction when one of the students makes which statement? a) "Fondling can be a type of sexual assault." b) "Sexual assault is the same as rape." c) "Sexual assault involves nonconsenting sexual activity." d) "Sexual assault occurs about once every 2 minutes in the United States."
"Sexual assault is the same as rape." Explanation: Sexual assault includes any form of non-consenting sexual activity ranging from fondling to penetration. Sexual assault occurs about once every two minutes. Sexual assault is a broader term than rape.
The nurse is talking to a female client who is a survivor of intimate partner violence. The woman relates that her husband has been told that he has the characteristics of an antisocial personality disorder. The woman also informs the nurse that her husband has an extensive criminal record. The nurse interprets this information and suspects that the woman's husband would most likely demonstrate which behavior? a) Intermittent remorse for the violence and abuse that he commits b) Purposefully remaining socially isolated from people other than those in his family c) A risk for aggressive and assaultive violence toward people within and outside of his family d) Symptoms of depression along with harboring feelings of inadequacy
A risk for aggressive and assaultive violence toward people within and outside of his family Explanation: Evidence suggests that when people with borderline personality disorder are distressed, they are predisposed to interpret social situations as threatening and to respond with emotional dysregulation, verbal attacks, and physical violence. People who meet the diagnostic criteria of antisocial personality disorder, have an extensive history of criminal behavior, and who are generally violent are also more likely to be both aggressive and assaultive. These perpetrators have a heightened sensitivity to emotional displays that predispose them to interpret social situations as threatening and to respond with emotional dysregulation, verbal attacks, and physical violence.
Which of the following assessment findings should signal the nurse to the fact that a child may be experiencing child neglect rather than child abuse? a) A girl tells a social worker that she does not like it when her mother's boyfriend touches her "down there." b) A child exhibits multiple scars on his back and buttocks upon examination. c) A young child is admitted to hospital with hypothermia because he is inadequately dressed. d) A boy is brought to a clinic by his father who is nervous and unable to adequately explain how the boy broke his arm.
A young child is admitted to hospital with hypothermia because he is inadequately dressed. Explanation: Child neglect is the failure to provide for a child's basic physical, medical, or educational needs. Examples of child neglect include withholding adequate clothing. Injuries and sexual touching are examples of child abuse.
Which of the following would not be considered a protective factor for children who are abused? a) Secure attachments b) Solid intelligence c) Easy disposition d) Aggressiveness toward potential offenders
Aggressiveness toward potential offenders Explanation: Aggressiveness toward offenders is a direct defense. Protective factors are indirect actions used to minimize the psychic trauma experienced from the abuse.
The nurse can assess potential victims of domestic violence by ... a) "What did you do right before your partner hit you?" b) "Do you need the number of a women's shelter?" c) Asking questions such as "Has a past or current partner ever caused you to be afraid or hurt you?" d) "What is your history of physical injuries?"
Asking questions such as "Has a past or current partner ever caused you to be afraid or hurt you?" Explanation: In posing this question, nurses are sensitive to the client's reluctance to reveal abuse.
The nurse is assessing an elderly female in the emergency department. There are many bruises present on her body in varying stages of healing. After documenting the bruising in the assessment, what should the nurse do next? a) Notify the physician that abuse is suspected b) Follow the facility's policy and procedures for reporting abuse c) Ask the client when and how the bruises occurred d) Call the nursing supervisor immediately
Ask the client when and how the bruises occurred Explanation: The nurse should not assume the bruises were caused by abuse; the client's explanation is an important step in the assessment of potential abuse. A nurse must assess for abuse prior to getting the supervisor and physician involved. Reporting abuse would be initiated after a thorough assessment.
The nurse is assessing an elderly female in the emergency department. There are many bruises present on her body in varying stages of healing. After documenting the bruising in the assessment, what should the nurse do next? a) Notify the physician that abuse is suspected b) Follow the facility's policy and procedures for reporting abuse c) Call the nursing supervisor immediately d) Ask the client when and how the bruises occurred
Ask the client when and how the bruises occurred Explanation: The nurse should not assume the bruises were caused by abuse; the client's explanation is an important step in the assessment of potential abuse. A nurse must assess for abuse prior to getting the supervisor and physician involved. Reporting abuse would be initiated after a thorough assessment.
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? a) Carefully explain that his mother disciplines him because she loves him. b) Give the same reason his sister would give were she asked to explain his injuries. c) Be reluctant to report abuse because of shame or fear of retaliation d) His father is beating him on a regular basis.
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 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? a) Carefully explain that his mother disciplines him because she loves him. b) Give the same reason his sister would give were she asked to explain his injuries. c) His father is beating him on a regular basis. d) Be reluctant to report abuse because of shame or fear of retaliation
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.
Which of the following is a warning indicator from a caregiver that may indicate elder abuse? a) Inability to manage finances b) Blaming the elder for his or her illness or limitations c) Lack of toilet facilities d) Failure to keep medical appointments
Blaming the elder for his or her illness or limitations Explanation: Blaming the elder for his or her illness or limitations is a warning indicator from a caregiver that may indicate elder abuse. Indicators of self-neglect are inability to manage finances, failure to keep medical appointments, and lack of toilet facilities.
Five common physical findings that indicate that a child has been abused are what? a) Missing teeth, scars on genitalia, loose bones, broken legs, and burn marks b) Broken bones and finger joints, bruises, scars, and eye injuries c) Bruises, burns, lacerations, missing teeth, and skeletal injuries d) Eye, head, and skeletal injuries; swollen glands; and breaks in skin
Bruises, burns, lacerations, missing teeth, and skeletal injuries Explanation: The most common indicators of physical abuse of a child are as follows: (1) bruises involving no breaks in skin integrity, (2) burns, usually due to immersion in hot water, contact with cigarettes, tying with a rope, or the application of a hot iron, (3) lacerations, abrasions, welts, and scars noted on the lips, eyes, face, and external genitalia, (4) missing or loosened teeth, and (5) skeletal injuries such as fractured bones, epiphyseal separation, or stiff, swollen, enlarged joints.
The nurse is caring for a 16-year-old boy with a history of being sexually abused. The nurse might expect this adolescent to ... a) Experience nightmares and flashbacks b) Have no ill effects due to his age c) Reject his mother for not protecting him d) Want to confront the perpetrator
Experience nightmares and flashbacks Explanation: Nightmares and flashbacks are common in people who were abused as children regardless of their current age. Answer B, C, and D are inappropriate responses.
The following are frequently experienced during the first phase of rape trauma syndrome: a) Fear, depression, anxiety, anger, and withdrawal. b) Depression, anxiety, resolution, and mental comfort. c) Fear, anxiety, disbelief, anger, and shock. d) Resolving feelings, seeking support, crying, and difficulty sleeping.
Fear, anxiety, disbelief, anger, and shock. Explanation: Depression and some form of resolution usually appear later in the reorganization phase. The first phase is characterized by more intense affective responses.
Which of the following characteristics would a nurse least likely see in an abused individual? a) Guilt b) High self-esteem c) Isolation d) Entrapment
High self-esteem Explanation: Abused individuals often demonstrate a pattern of learned helplessness, manifest characteristics of low self-esteem and shame, and often experience feelings of increased dependence, isolation, guilt, and entrapment.
Which of the following characteristics would a nurse least likely see in an abused individual? a) High self-esteem b) Entrapment c) Guilt d) Isolation
High self-esteem Explanation: Abused individuals often demonstrate a pattern of learned helplessness, manifest characteristics of low self-esteem and shame, and often experience feelings of increased dependence, isolation, guilt, and entrapment.
In many cases, family members tolerate abusive and violent behavior from relatives that they would never accept from strangers. In violent families, which normal safe haven may be the most dangerous place for victims? a) Work b) Church c) School d) Home
Home Explanation: In violent families, the home, which is normally a safe haven of love and protection, may be the most dangerous place for victims
Which of the following would not be an indicator of physical abuse of an elder? a) Bruises b) Frequent ER visits with unexplained trauma c) Intimidation of the elderly person d) Dislocations or sprains
Intimidation of the elderly person Explanation: Intimidation constitutes psychological abuse, not physical abuse. Bruises, frequent ER visits with unexplained trauma, and dislocations or sprains could be indicative of elder abuse.
A nurse is caring for a young adult in the mental health clinic. The client tells the nurse that he was physically neglected as a child. The nurse should assess the client for symptoms of which of the following? a) Major depression b) Schizophrenia c) Narcissistic personality disorder d) Panic disorder
Major depression Explanation: An important outcome of nursing intervention with survivors is appropriate treatment of any disorder resulting from abuse, such as acute stress disorder, posttraumatic stress disorder, anxiety disorders, dissociative identity disorder, major depression, or substance abuse.
A nurse is caring for a young adult in the mental health clinic. The client tells the nurse that he was physically neglected as a child. The nurse should assess the client for symptoms of which of the following? a) Schizophrenia b) Panic disorder c) Major depression d) Narcissistic personality disorder
Major depression Explanation: An important outcome of nursing intervention with survivors is appropriate treatment of any disorder resulting from abuse, such as acute stress disorder, posttraumatic stress disorder, anxiety disorders, dissociative identity disorder, major depression, or substance abuse.
Which of the following is a possible indicator of neglect? a) Helplessness b) Malnourishment not related to a known illness c) Hesitance to talk openly d) Anger
Malnourishment not related to a known illness Explanation: Malnourishment is a possible indicator of neglect. Helplessness, hesitance to talk openly, and anger are psychological or emotional indicators of abuse.
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? a) IPV in same-sex couples occurs less frequently than in heterosexual relationships. b) Men are more likely to be seriously injured even though more women are typically victims. c) The reactions to IPV are similar in male and female victims. d) Men may not consider behaviors such as slapping or shoving as abuse.
Men may not consider behaviors such as slapping or shoving as abuse. Explanation: 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 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? a) Men are more likely to be seriously injured even though more women are typically victims. b) The reactions to IPV are similar in male and female victims. c) Men may not consider behaviors such as slapping or shoving as abuse. d) IPV in same-sex couples occurs less frequently than in heterosexual relationships.
Men may not consider behaviors such as slapping or shoving as abuse. Explanation: 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.
When assessing a 6-year-old child believed to be a victim of emotional abuse, the possibility is supported when the child is a) Attending day care 5 days a week b) Parented by a single parent c) Observed stuttering during the interview d) Showing signs of developmental delays
Observed stuttering during the interview Explanation: While stuttering may not be related to emotional abuse, it is a characteristic viewed as being a possible red flag. 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.
Which of the following is a priority intervention in the treatment of the client diagnosed with PTSD? a) Promoting the client's self-esteem b) Establishing social support c) Promoting the client's safety d) Assisting the client to cope with stress and emotions
Promoting the client's safety Explanation: Promoting the client's safety is the priority intervention for the client diagnosed with PTSD. The nurse continually must assess the client's potential for self-harm or suicide and take action immediately.
Intimate partner violence is the mistreatment or misuse of one person by another in the context of an emotionally intimate relationship. Which type of abuse includes name calling and belittling? a) Physical abuse b) Psychological abuse c) Sexual abuse d) Sodomy
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 antidepressant has been the most helpful to victims of rape in managing symptoms through recovery? a) Olanzapine b) MAOIs c) TCAs d) SSRIs
SSRIs Explanation: Biochemical treatment with antidepressants (especially selective serotonin reuptake inhibitors) and antianxiety medications helps reduce symptoms of PTSD, depression, and anxiety.
Which of the following is a priority intervention when dealing with child abuse or neglect? a) Physiologic needs b) Psychological needs c) Social support d) Safety
Safety Explanation: The first part of treatment for child abuse or neglect is to ensure the child's safety and well-
Supported by recent research findings, the nurse-manager of a busy community-based walk-in clinic best prepares a new nurse to identify victims of domestic violence by ... a) Providing the new nurse with the opportunity and resources to become familiar with effective assessment techniques b) Making experienced nursing staff available to the new nurse to act as a mentor when an assessment of such a client is required c) Assigning the new nurse to shadow an experienced nurse who is caring for a potential abuse victim d) Scheduling the nurse to attend a seminar that focuses on the management of abused clients
Scheduling the nurse to attend a seminar that focuses on the management of abused clients Explanation: Research has shown that educational programs are necessary to help nurses feel better equipped to identify potential victims and be more comfortable in asking about domestic violence. The other provided options are not necessarily inappropriate but none represents the best option for this scenario.
Exploitation of children is considered which type of abuse? a) Neglect b) Emotional abuse c) Sexual abuse d) Physical abuse
Sexual abuse Explanation: Sexual abuse can involve exploitation, such as making, promoting, or selling pornography involving minors and coercion of minors to participate in obscene acts. Physical abuse includes burning, biting, or cutting a child. Neglect is malicious or ignorant withholding of physical, emotional, or educational necessities for the child's well-being. Emotional abuse includes verbal assaults, such as blaming, name-calling, and using sarcasm.
Mrs. Jacobs has been attending a local day program. Her counselor there notices that she has been coming in with bruises and scrapes and is increasingly depressed. On physical examination, Mrs. Jacobs is diagnosed with genital herpes. Which type of elder abuse do you suspect? a) Sexual abuse b) Physical neglect c) Psychological abuse d) Financial abuse
Sexual abuse Explanation: The physical bruising and presence of genital herpes indicate abuse that is sexual in nature. Older adults are increasingly the victims of abuse (e.g., physical, sexual, psychological, or neglect).
A female client has been admitted to an inpatient psychiatric facility with a diagnosis of posttraumatic stress disorder after a history of violence by her boyfriend. During the initial assessment interview, which assessment would be the priority? a) Hydration status b) Sleep patterns c) Suicide risk d) Nutritional status
Suicide risk Explanation: The first, and most important, assessment conducted is a lethality assessment that determines whether the survivor's life is in danger, either from homicide or suicide, and, if children are in the home, whether they are in danger. Then the physiologic areas such as nutrition, hydration, and sleep can be assessed.
The nurse uses the following as an example of neglect: a) When an adult does not intervene when a 10-year-old child is being bullied by older peers b) Telling a 3 year old to stop crying like a baby when he stumbles and falls c) Correcting a child for copying homework in front of the entire class d) Disciplining a 6-year-old child for "sassing" by putting tape on his mouth
Telling a 3 year old to stop crying like a baby when he stumbles and falls Explanation: Neglect is an act of omission and refers to a parent's or other person's failure to meet a dependent's basic needs, such as providing appropriate emotional care. Telling a 3 year old to stop crying like a baby when he stumbles and falls is an example of neglect.
Which of the following behaviors would first alert the school nurse or teacher to suspect sexual abuse in a 7-year-old child? a) Telling sexually explicit stories to peers b) Withdrawn behavior and enuresis c) Extreme friendliness to peers d) Learning problems and shyness
Telling sexually explicit stories to peers Explanation: Children who have sexual knowledge not expected at their age have often been sexually abused.
To preserve evidence from a possible rape with no report of oral sex, the female victim should avoid all of the following except ... a) Brushing her teeth b) The victim should avoid all of these activities prior to physical examination c) Shower d) Douching
The victim should avoid all of these activities prior to physical examination Explanation: To preserve possible evidence, the physical examination should occur before the women has showered, brushed her teeth, douched, changed her clothes, or had anything to drink.
To preserve evidence from a possible rape with no report of oral sex, the female victim should avoid all of the following except ... a) The victim should avoid all of these activities prior to physical examination b) Douching c) Shower d) Brushing her teeth
The victim should avoid all of these activities prior to physical examination Explanation: To preserve possible evidence, the physical examination should occur before the women has showered, brushed her teeth, douched, changed her clothes, or had anything to drink.
The nurse is working in the emergency department with a woman who was raped 1 hour ago. In planning care, it is important for the nurse to remember which of the following? a) The woman may feel threatened by some of the procedures. b) Evidence collection according to procedures is the priority. c) The nurse will need to make decisions for this client. d) Angry feelings need to be set aside until physical care is completed.
The woman may feel threatened by some of the procedures. Explanation: Many of the examination procedures, such as a pelvic exam, may cause the woman to feel violated again.
Nurses who work with children should be alert for which of the following physical signs of child abuse? a) Stomach aches, skin rashes, and obesity b) Unexplained cuts, bruises, burns, and scars c) Poor appetite, hypoactivity, and listlessness d) Excessive crying, temper tantrums, and talkativeness
Unexplained cuts, bruises, burns, and scars Explanation: Cuts, bruises, burns, and scars are common indicators of physical abuse in children. The other choices include symptoms that are common in children (crying, temper tantrums, poor appetite) and may occur with specific physical illnesses (e.g., stomach aches, skin rashes) but are not necessarily indicators that abuse has occurred.
Three elements that are necessary to legally define rape of a male or female are ... a) Use of force, consent of victim, oral penetration b) Use of gun or weapon, nonconsent of victim, victim unaware of assault c) Use of force; vaginal, oral, or anal penetration; nonconsent of victim d) Nonconsent of victim, bruising or swelling of perineum, lack of duress
Use of force; vaginal, oral, or anal penetration; nonconsent of victim Explanation: Three essential elements are necessary to legally define rape of a man or woman: • Use of force, threat, intimidation, or duress • Vaginal, oral, or anal penetration • Nonconsent by the victim
Rape trauma syndrome is a two-phase process that all rape survivors experience. It includes a) an acute phase of symptom exaggeration and a short-term phase of reintegration. b) an acute phase of disorganization and a long-term process of reorganization. c) a phase of psychosis followed by a phase of recovery. d) exacerbation of symptoms, and a successful recovery phase.
an acute phase of disorganization and a long-term process of reorganization. Explanation: The acute phase involves a variety of signs of distress and attempts to cope. Reorganization involves the victim's attempts at regaining normalcy in life.
If recovery from the rape does not occur, the victim may develop ... a) borderline personality disorder b) delirium. c) post-traumatic distress syndrome. d) anxiety disorders.
post-traumatic distress syndrome. Explanation: PTSD can result at least 1 month after an identifiable traumatic event. Symptoms include generalized anxiety, intrusive thoughts or images of the trauma, flashbacks, nightmares, and other sleep disturbances.
Which of the following are implicated in the majority of elder abuse cases? Select all that apply. a) Adults b) Children c) Family member d) Friends e) Spouses
• Children • Spouses • Adults • Family member Explanation: Family members, adults, children, or spouses are implicated in 90% of the cases of elder abuse.
When a client reveals to the nurse that he or she was a victim of childhood sexual abuse, the nurse assesses for indications of which of the following? Select all that apply. a) Client exhibits antisocial tendencies b) Client has difficulty establishing a mutually satisfying sexual relationship c) Client has a history of substance abuse d) Client engages in self-harming behaviors e) Client has difficulty establishing interpersonal relationships
• Client has difficulty establishing interpersonal relationships • Client has a history of substance abuse • Client has difficulty establishing a mutually satisfying sexual relationship • Client engages in self-harming behaviors Explanation: Losing the ability to trust people is a common characteristic of the adult survivor of childhood sexual abuse. Substance abuse is a common characteristic of the adult survivor of childhood sexual abuse. Other characteristics include having difficulty establishing interpersonal relationships and finding mutually satisfying sexual relationships. Also, survivors may engage in self-harm.
Which of the following are forms of psychological abuse? Select all that apply. a) Incest b) Rape c) Insulting d) Humiliating e) Destroying another's property
• Insulting • Humiliating • Destroying another's property Explanation: 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. Rape and incest are forms of sexual assault.
The psychiatric nurse assesses for a child's potential risk factors for sexual abuse when (Select all that apply.) a) Questioning the parents concerning their possible substance abuse b) Observing for signs of child neglect c) Questioning parents and child about school attendance d) Evaluating the child for developmental delays e) Determining whether either parent has ever been sexually abused
• Questioning the parents concerning their possible substance abuse • Evaluating the child for developmental delays • Determining whether either parent has ever been sexually abused • Questioning parents and child about school attendance Explanation: The psychiatric nurse assesses for a child's potential risk factors for sexual abuse when questioning the parents concerning their possible substance abuse, evaluating the child for developmental delays, determining whether either parent has ever been sexually abused, and questioning parents and child about school attendance.
After a series of admissions to the emergency department over the past several months, an 80-year-old woman's malnutrition, vague history, and pattern of physical injuries lead the nurse to suspect elder abuse. Which of the following aspects of the woman's situation may contribute to elder abuse? Select all that apply. a) The woman's son describes her as "needy, helpless, and pathetic." b) The woman describes herself and her son as "not well-off, but not terribly poor either." c) The woman is physically dependent on her son since she lost her mobility. d) The woman has no income or savings of her own. e) The woman and her son are recent immigrants to the United States.
• The woman is physically dependent on her son since she lost her mobility. • The woman has no income or savings of her own. • The woman's son describes her as "needy, helpless, and pathetic." Explanation: Physical and financial dependence and personality conflicts with caregivers and children are known to contribute to elder abuse. Low socioeconomic status and recent immigration are not identified as causative factors.
The nurse's suspicion that a child has been sexually abused is supported when the assessment data includes (Select all that apply.) a) The vulva appears edematous b) The child attends day care 3 days a week c) The child reports "itching down there" d) Urinalysis reports a bacterial infection e) The anal area is bruised
• Urinalysis reports a bacterial infection • The anal area is bruised • The child reports "itching down there" • The vulva appears edematous Explanation: The nurse's suspicion that a child has been sexually abused is supported when the assessment data includes a bruised anal area, itching reported by the child, an edematous vulva, and a urinary infection.
