ch 12 NCLEX questions
What percentage of women can expect to be a victim of an ongoing unwanted pursuit from stalking? 5-10% 50-60% 12-32% 40-48%
12-32% Rationale: Women are 12-32% and men 17% who can expect to be victims of ongoing unwanted pursuit.
The nurse should consider which as a possible indicator of child neglect? Helplessness Hesitance to talk openly Malnourishment unrelated to illness Angry outbursts
Malnourishment unrelated to illness Rationale: Malnourishment is a possible indicator of neglect. Helplessness, hesitance to talk openly, and anger could be psychological or emotional indicators of abuse.
Which type of abuse includes name calling and belittling? Sexual abuse Psychological abuse Physical abuse Sodomy
Psychological abuse Rationale: 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? No person deserves to be raped. Rape can occur between married individuals. Rape is a crime of passion. No person wants to be raped.
Rape is a crime of passion. Rationale: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.
Which is a priority nursing intervention when child abuse or neglect is suspected? Physiologic needs Social support Safety Psychological needs
Safety Rationale: The first part of treatment for child abuse or neglect is to ensure the child's safety and well-being.
The majority of perpetrators of elder abuse include which population? Spouses Siblings Adult children Grandchildren
Spouses Rationale: Most cases of elder abuse occur when one older spouse is taking care of another.
After a series of admissions to the emergency department over the past several months, an 80-year-old client's malnutrition, vague history, and pattern of physical injuries lead the nurse to suspect elder abuse. Which aspect of the client's situation may contribute to elder abuse? Select all that apply. The client and client's child are recent immigrants to the United States. The client is physically dependent on the client's son since losing mobility. The client's son describes the client as "needy, helpless, and pathetic." The client self-describes and describes the client's child as "not well-off, but not terribly poor either." The client has no income or savings of the client's own.
The client is physically dependent on the client's son since losing mobility. The client's son describes the client as "needy, helpless, and pathetic." The client has no income or savings of the client's own. Rationale: 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.
Which is an inaccurate picture of the cycle of abuse that occurs over time? The period of remorse disappears Violent episodes are more frequent Violent episodes are less frequent Severity of the injuries worsen
Violent episodes are less frequent Rationale: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 child has the greatest risk for being the target of bullying at school? ii the child who wears hearing aids the child who just transferred to the school the child who recently immigrated to America the child who is short for his or her age
the child who wears hearing aids Rationale: Children with special physical health-care needs are bullied more often, and children with a chronic emotional, behavioral, or developmental problem are more likely to be a victim of bullying. While any child may be a target for bullying, none on the other children have the obvious risk factor that a special needs child brings about.
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?" "Can you go to the school principal with personal problems?" "Do you smoke or use drugs?" "Have you talked to your parents about your problems at school?"
"Do you feel like a part of a group in school?" Rationale: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? "I don't know what else I can do to keep him from getting angry at me." "He doesn't like it when I go out with my girlfriends." "His father physically abused his mother for years." "He was so much nicer when we started dating."
"I don't know what else I can do to keep him from getting angry at me." Rationale: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.
In a toddler, which injury is most likely the result of child abuse? A small, isolated bruise on the right lower extremity A 1-inch forehead laceration Several small, circular burns on the child's back A hematoma on the occipital region of the head
Several small, circular burns on the child's back Rationale: 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 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 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." "He yells at me for not having dinner waiting for him when he comes home."
"He tells me that he is sorry and that he will never hit me again." Rationale: 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.
Which statement, made by a nurse who experienced sexual abuse as as a child, demonstrates being best prepared to work with sexual abuse and trauma survivors? "I've put the incident behind me and seldom think of it." "Survivors of sexual assault deserve the best care I can give them." "I've been supported by health care professionals and now I want to support other survivors." "Working with survivors of sexual trauma is very fulfilling work."
"I've been supported by health care professionals and now I want to support other survivors." Rationale: Nurses with a personal history of abuse or trauma must seek professional assistance to deal with these issues before working with survivors of trauma or abuse. Such nurses can be very effective and supportive of other survivors but only after engaging in therapeutic work and accepting and understanding their own trauma. The nurse should not repress the memories of the trauma but rather engage in the work needed to accept the incident. The other options present true statements but none are associated with being prepared to provide the necessary care.
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? Emotional abuse Neglect Physical abuse Sexual abuse
Emotional abuse Rationale: 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.
Which characteristics are found in violent families? Select all that apply. Abuse of power and control Social isolation Adequate support systems Alcohol use disorder
Abuse of power and control Social isolation Alcohol use disorder Rationale: 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.
Which is the most commonly identified issue preventing people from leaving an abusive relationship? Possessiveness Jealousy Emotional immaturity Dependency
Dependency Rationale:Dependency is the most common trait seen in abused wives who stay with their husbands. Women often cite personal and financial dependency as reasons why they find leaving an abusive relationship extremely difficult.
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 need to be able to sympathize with their clients. Nurses can learn from the experiences of clients and thus help prevent becoming victims of assault themselves. The attitudes of individual nurses reflect on the overall profession. Giving back the survivor as much control as possible is important.
Giving back the survivor as much control as possible is important. Rationale: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.
In violent families, which environment may be the most dangerous place for victims? Work Home Church School
Home Rationale: In violent families, the home, which is normally a safe haven of love and protection, may be the most dangerous place for victims.
Which are forms of psychological abuse? Select all that apply. Incest isolating a person from family Insulting Humiliating Rape
Isolating a person from family Insulting Humiliating Rationale: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.
A nurse is working on developing a safety plan with a client who is a survivor of violence. Which would the nurse address first? Identifying a signal to indicate it is safe to leave Devising an escape route Identifying a safe place to hide Recognizing the signs of danger
Recognizing the signs of danger Rationale: 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.
Which provides the most acceptable 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 for copying homework in front of the entire class Rejecting a 3-year-old who is crying and seeking affection after the child stumbles and falls When an adult does not intervene when a 10-year-old child is being bullied by older peers
Rejecting a 3-year-old who is crying and seeking affection after the child stumbles and falls Rationale: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 the child stumbles and falls is an example of neglect.
During the nurse's assessment of a new client on a medical unit, the client confides in the nurse that the client's spouse often "slaps me around" after the client has been drinking. What action should the nurse take in response to this statement? Report the client's statement promptly to the appropriate authorities. Elicit further detail from the client to determine the validity of the accusation. Discuss with the client the possible triggers that set off the spouse's behavior. Ask the client to write down descriptions of these instances and make these documents part of the client's medical record.
Report the client's statement promptly to the appropriate authorities. Rationale: The nurse's responsibility in cases of suspected abuse is to report the allegations. It is not the nurse's responsibility to determine validity, encourage a written statement, or counsel the client on the dynamics of the abuse.
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? Neglect Intimate partner violence Stalking Sexual assault
Stalking Rationale: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.