CH 30 ?'s OB

A client comes to a local community health care facility for a routine check-up. While talking to the nurse, the client happens to mention that every time she has a serious fight with her husband, he forces her to have intercourse with him. The client seems to be very disturbed when revealing this to the nurse. Which is an appropriate response by the nurse? a) "Your husband is just trying to reconcile using intimacy." b) "It's okay in cases of fights where you're really at fault." c) "This behavior is considered sexual abuse." d) "Such behavior is considered normal in a married couple."

"This behavior is considered sexual abuse."

Which of the following statements might empower abuse victims to take action? a. "You deserve better than this." b. "Your children deserve to grow up in a two-parent family." c. "Try to figure out what you do to trigger his abuse and stop it." d. "Give your partner more time to come to his senses about this."

"You deserve better than this."

The nursing student is studying violence and abuse against the older woman. While researching it, she learns that laws require health care professionals to report elder or vulnerable person abuse. How many states currently have these laws? a) 40 b) 52 c) 50 d) 32

50

A client has been seen and treated in the emergency room several times for injuries that are deemed suspicious. The client is reluctant to participate in a screening process. How best can the nurse provide reassurance to this client? A) Being nonjudgmental B) Giving assurances of help C) Establishing a plan to protect the client D) Having the client be honest about the injuries

A) Being nonjudgmental During the screening process the victim is most likely to be uncomfortable and not want to participate. Victims are concerned about being judged by the interviewer, provoking more violence, and being disappointed by the provider's response to the disclosure. The nurse can best help the victim participate in screening by ensuring confidentiality and being nonjudgmental. There is no guarantee the nurse can assure the woman of help. At best, the nurse can provide information of agencies and services. Having the client be honest about the injuries can cause much distress for the client who may feel it will only lead to more injuries after the partner realizes details have been disclosed. Helping the client find community resources to develop a plan of protection is best done with the social worker and community agencies rather than the emergency room nurse. The nurse should make a referral to the social worker to help with this situation.

A nurse is caring for a client who was raped at gunpoint. The client does not want any photos taken of the injuries. The client also does not want the police to be informed about the incident even though state laws require reporting life-threatening injuries. Which intervention should the nurse perform to document and report the findings of the case? A) Use direct quotes and specific language. B) Obtain photos to substantiate the client's case in a court of law. C) Document only descriptions of medical interventions taken. D) Respect the client's opinion and avoid informing the police.

A) Use direct quotes and specific language The nurse should use direct quotes and specific language as much as possible when documenting. The nurse should not obtain photos of the client without informed consent. The nurse should, however, document the refusal of the client to be photographed. Documentation must include details as to the frequency and severity of abuse and the location, extent, and outcome of injuries, not just a description of the interventions taken. The nurse is required by law to inform the police of any injuries that involve knives, firearms, or other deadly weapons or that present life-threatening injuries.

A victim of rape is exhibiting symptoms of posttraumatic stress disorder (PTSD) which the nurse interprets as indicative of intrusion. Which symptoms would the client be exhibiting? Select all that apply. A) nightmares B) recurrent thoughts C) flashbacks D) social withdrawal E) emotional numbing

A) nightmares B) recurrent thoughts C) flashbacks

A nurse is interviewing a rape victim who was assaulted 6 month ago. Which questions should the nurse ask the client to know the extent of physical symptoms of PTSD? Select all that apply. a) "Are you having trouble sleeping?" b) "Do you have heart palpitations or sweating?" c) "Do you ever feel as you are reliving the event?" d) "Do you feel numb emotionally?" e) "Have you felt irritable or experienced outbursts of anger?"

A. "Are you having trouble sleeping?" B. "Do you have heart palpitations or sweating?" C. "Do you ever feel as you are reliving the event?" E. "Have you felt irritable or experienced outbursts of anger?"

The nurse who works in a woman's health clinic correctly identifies two key objectives for 2020 National Health Goals that addresses violence against women as which of the following? (Check two.) a) reduce the annual rate of rape or attempted rape b) increase the rate of women's depression c) reduce the rate of physical assault by current or former intimate partners d) increase the rate of women's consumed calories

A. reduce the annual rate of rape or attempted rape C. reduce the rate of physical assault by current or former intimate partner

A nurse is caring for a rape victim who was just brought to the local emergency care facility. Which interventions should the nurse perform to minimize risk of pregnancy in this client? a) Wait for first signs of pregnancy before taking action b) Administer prescribed double dose of emergency contraceptive pills c) Apply spermicidal cream or gel near the vaginal area upon arrival d) Administer prescribed regular oral contraceptive pills

Administer prescribed double dose of emergency contraceptive pills

When providing care to a victim of abuse, which of the following would the nurse do? a) Provide an overview of the procedures to be done. b) Make the decisions for the woman. c) Take the lead in providing the interventions quickly. d) Allow the woman to participate in her care.

Allow the woman to participate in her care.

A woman comes to a local community health care facility with her partner. She has a broken arm and bruises on the face that she reports were caused by a fall. The nature of the injuries, however, causes the nurse to be convinced that this is a case of physical abuse. Which intervention should the nurse perform? a) Tell the partner to leave the room immediately b) Ask the partner directly if he was responsible c) Attempt to interview the woman in private d) Question the client about the injury in front of the partner

Attempt to interview the woman in private

Nurses at an urban emergency department seek to develop a plan to help women involved in abusive relationships. Which of the following components is critical to the success of the plan? a) A quality of life assessment tool b) An intimate partner violence (IPV) counselor c) Educational materials d) Avenues for referral

Avenues for referral

A nurse is presenting a discussion on sexual violence at a local community college. When describing the incidence of sexual violence, the nurse would identify that a woman has which chance of experiencing a sexual assault in her lifetime? A) 1 in 3 B) 1 in 5 C) 2 in 15 D) 3 in 20

B) 1 in 5 According to the National Sexual Violence Resource Center (NSVRC), nearly one in five women and one in 9 men in the United States have experienced rape, physical violence, and/or stalking by a partner with IPV-related impact in their lifetimes.

A 74-year-old client presents with depression, insomnia, and atypical chest pain. When asked about thoughts of suicide, the client states "Yes, I do think about ending all this." What will the nurse do next? A) Perform an electrocardiography on the client. B) Ask the client if he or she is being mistreated. C) See how long the client has been depressed. D) Notify the health care provider.

B) Ask the client if he or she is being mistreated. This client is presenting with symptoms of elder mistreatment. The nurse should determine if the client is being mistreated first to know how to properly care for the client. An electrocardiography is not needed as these are symptoms of mistreatment. It is not pertinent to know the history of the client's depression or insomnia. The nurse should know what is going on with the client prior to notifying the health care provider.

A nurse is assessing a rape survivor for posttraumatic stress disorder. The nurse asks the survivor, "Do you feel as though you are reliving the trauma?" The nurse is assessing for which effect of the trauma? A) physical symptoms B) Intrusive thoughts C) avoidance D) hyperarousal

B) Intrusive thoughts The question is used to assess the survivor for intrusive thoughts that reflect the client reexperiencing the trauma. Physical symptoms would be assessed with questions about sleeping, eating, palpitations and other problems. Avoidance would be reflected in questions involving withdrawal socially, avoiding situations that remind the survivor of the rape. Hyperarousal would be noted by irritability and an exaggerated startle response.

The nurse working in the obstetrics clinic has been trained to pick up on warning signs of abuse during pregnancy. These include which of the following?(Select all that apply.) a) more weight gain than recommended b) unrealistic fears c) difficulty with physical exams d) weight fluctuations e) noncompliance with treatment f) poor attendance at prenatal visits

B. unrealistic fears C. difficulty with physical exams D. weight fluctuations E. noncompliance with treatment F. poor attendance at prenatal visits

A nurse is assessing a client for abuse. Which statement by a client would the nurse interpret as suggesting financial abuse? A) "My spouse constantly insults me by calling me names." B) "My spouse grabbed me so hard that it left bruises." C) "My spouse won't let me go out to find a job." D) "My spouse forces me to have sex with other people."

C) "My spouse won't let me go out to find a job." Financial abuse would be indicated by the partner preventing one's spouse from going out to find a job. Constant insults and name calling suggest emotional abuse. Grabbing in such a way to leave marks suggests physical abuse. Forcing one's spouse to have sex with other individuals would suggest sexual abuse.

A nurse is assessing a victim of rape. Further assessment reveals that the client received rohypnol. The nurse understands that this drug can lead to memory loss for up to how many hours? A) 2 B) 4 C) 6 D) 8

D) 8 Rohypnol (also known as "roofies," "forget pills," "mind erasers" and the "drop drug") comes in the form of a liquid or pill that quickly dissolves in liquid with no odor, taste, or color. This drug is 10 times as strong as diazepam. The effects can be felt within 30 minutes, and the drug produces memory loss for up to 8 hours.

Which of the following is FALSE regarding emergency contraception (EC)? a) EC will disrupt an established pregnancy if taken within 72 hours. b) EC simply contains the same hormones that are found in birth control pills. c) EC works by preventing fertilization, ovulation, or implantation. d) EC is most effective if it is taken within 12 hours of rape.

EC will disrupt an established pregnancy if taken within 72 hours.

The primary goal of intervention in working with abused women is to: a. Set up an appointment with a mental health counselor for the victim b. Convince them to set up a safety plan to use when they leave c. Help them to develop courage and financial support to leave the abuser d. Empower them and improve their self-esteem to regain control of their lives

Empower them and improve their self-esteem to regain control of their lives

DELETEA nursing student studying sexual violence makes the following statement in class, "A man who has sex with his wife even though she did not want it cannot be charged with sexual abuse." Is this statement true or false? a) False b) True

False

Which of the following are biologic indicators of posttraumatic stress disorder (PTSD)? a) Auditory hallucinations b) A feeling of unreality about oneself c) Memory difficulties d) Flashbacks

Flashbacks

When implementing an intervention for a woman in an abusive situation, what is the primary goal? a) For the woman to be able to stand up to her abuser b) For the woman to be removed from her abusive relationship c) For the woman to regain a sense of control in her life d) For the woman to be able to care for herself

For the woman to regain a sense of control in her life

What is the leading cause of death in pregnant women? a) Amniotic fluid embolism b) Undiagnosed cardiac condition c) Pulmonary embolism d) Intimate partner violence

Intimate partner violence

The nursing instructor is discussing violence and abuse that is seen in women with a student. She realizes that the student needs further instruction when the student states which of the following? a) Nurses will come in contact with violence no matter what health care setting they work. b) Violence against women is on the rise in the United States. c) Nurses will come in contact with sexual abuse no matter what health care setting they work. d) Nurses only come in contact with violence in the ER.

Nurses only come in contact with violence in the ER.

DELETEIn caring for a child who has been admitted after being sexually abused, which of the following interventions would be included in the child's plan of care? a) Encourage frequent family visits b) Weigh on the same scale each day c) Observe for signs of anxiety d) Test the urine for glucose upon admission

Observe for signs of anxiety

A nurse observes telltale signs of injuries from physical abuse on the face and neck of a female client. When questioned, the client tells the nurse that the injuries are the result of a physical attack by her partner and that she has developed palpitations thereafter. Which action should the nurse take to gain the trust of the client and enhance the nurse-client relationship? a) Tell the client to forget about the incident to avoid the trauma b) Inform the client that there is no connection between the violence and palpitations c) Offer referrals so the client can get help that will allow her to heal d) Confirm with the partner whether the client's story is true

Offer referrals so the client can get help that will allow her to heal

A patient who has been seen in the clinic multiple times for counseling recently admitted to being abused by her husband over a period of five years. Today she states, "He has been so sweet to me the last six days that I think this time he has really changed. He even brought me flowers yesterday and said he loves me." How should the nurse respond to this? a) Over a period of time the honeymoon phase ends and abuse becomes accelerated and thus more dangerous. b) That was a very sweet gesture. c) It seems as if he really loves you. d) I certainly would not be sucked into that.

Over a period of time the honeymoon phase ends and abuse becomes accelerated and thus more dangerous.

Women recovering from abusive relationships need to learn ways to improve their: a. Educational level by getting a college degree b. Earning power so they can move to a better neighborhood c. Self-esteem and communication skills to increase assertiveness d. Relationship skills so they will be better prepared to deal with their partners

Self-esteem and communication skills to increase assertiveness

A female client has been admitted to the 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) Suicide risk c) Sleep patterns d) Nutritional status

Suicide risk

The first phase of the abuse cycle is characterized by: a. The woman provoking the abuser to bring about battering b. Tension building and verbal or minor battery c. A honeymoon period that lulls the victim into forgetting d. An acute episode of physical battering

Tension building and verbal or minor battery

Question: Place the three phases of intimate partner violence in the order in which they occur. 1. Acute violence phase 2.Tension-building phase 3.Honeymoon phase

Tension-building phase, Acute violence phase, Honeymoon phase

Nurses sometimes have difficulty assessing women for violence. Which of the following refers to the screen protocol to use to be the most thorough? a) The RACE model b) The FACE model c) The SBAR model d) The SAVE model

The SAVE model

A nurse is conducting an awareness session on sexual abuse, and she is explaining the psychological profile of an average abuser. Which trait is often displayed by abusers? a) They belong to the low-income group. b) They are usually physically imposing. c) They have parents who are divorced. d) They exhibit antisocial behaviors.

They exhibit antisocial behaviors.

A 16-year-old girl is seen in an emergency room following a rape. The management of a rape victim should be directed primarily toward a) teaching the child how to prevent further attacks. b) decreasing guilt and increasing self-esteem. c) assessing for sources of infection resulting from the rape. d) relieving physical discomfort and pain.

decreasing guilt and increasing self-esteem.

The nurse has learned that the number one factor that will motivate a woman to escape an abusive relationship is which of the following? a) fear of harm to herself b) fear of death c) fear of harm to other family members d) fear of harm to her unborn child

fear of harm to her unborn child

The nurse who counsels women who suffer from abuse understands that abuse can come in different forms that include which of the following? (Check all that apply.) a) sexual abuse b) spiritual abuse c) physical abuse d) financial abuse e) emotional abuse

sexual abuse physical abuse financial abuse emotional abuse

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? a) "He calls me stupid and incompetent, asking himself why he ever married me." b) "He threw me against the wall and started punching my face." c) "He tells me that he is sorry and that he will never hit me again." d) "He yells at me for not having dinner waiting for him when he came home."

"He tells me that he is sorry and that he will never hit me again."

Which of the following is TRUE regarding intimate partner violence? a) Even though women seldom blame themselves for the abuse, they often cannot leave the relationship. b) One in four women will be a victim of violence. c) Abusers often have outward signs that they are abusers or have a mental illness. d) Women who are in an abusive relationship experience less abuse while they are pregnant.

One in four women will be a victim of violence.

A patient who is abused fails to report the abuse MAINLY because of which of the following reasons? a) She feels lucky to be alive. b) She feels responsible for causing the incident. c) She does not want anyone to know. d) She thinks it will not happen again.

She feels responsible for causing the incident.

DELETEWalter is an 11-year-old boy who was raised in a home where his father beat his mother on a regular basis. Which of the following statements is true regarding children being raised in a home where they have witnessed intimate partner violence? a) They have higher rates of schizophrenia b) They are at increase risk for being abused c) It has little impact on child functioning d) Female children are more likely to experience depression

They are at increase risk for being abused

DELETEA nurse is caring for a client who was raped at gunpoint. The client does not want any photos taken of her injuries. The client also does not want the police to be informed about the incident even though state laws require reporting life-threatening injuries. Which intervention should the nurse perform to document and report the findings of the case? a) Document only descriptions of medical interventions taken b) Use direct quotes and specific language c) Respect the client's opinion and avoid informing the police d) Obtain photos to substantiate the client's case in a court of law

Use direct quotes and specific language

Which of the following is FALSE regarding screening for intimate partner violence in women? a) Screening should be routinely done at every visit. b) Although women who are abused may exhibit certain behavior patterns, all women should be screened for intimate partner violence. c) Women tend to fit a profile of abuse, and victims tend to share similar physical characteristics. d) An elderly female may be a victim of intimate partner violence.

Women tend to fit a profile of abuse, and victims tend to share similar physical characteristics.

Which of the following are forms of emotional abuse? Select all that apply. a) Humiliating b) Incest c) Destroying another's property d) Insulting e) Rape

• Insulting • Humiliating • Destroying another's property

A woman is being cared for in the emergency department following a sexual assault. In addition to the physical exam and collection of the rape kit, what sexually transmitted infection (STI) testing should the nurse prepare to collect during the initial examination visit? A) Chlamydia, trichomoniasis, gonorrhea and hepatitis B B) HIV, hepatitis B, chlamydia, and human papillomavirus C) HIV, hepatitis C, hepatitis A, and gonorrhea D) Syphilis, HIV, chlamydia, and herpes simplex

A) Chlamydia, trichomoniasis, gonorrhea and hepatitis B When testing for STIs following a sexual assault the following tests should be done: chlamydia, gonorrhea, trichomoniasis, syphilis, HIV and hepatitis B. These should also be rechecked 1 to 2 weeks after the assault. HIV testing includes three different test times after the assault. Checking for human papillomavirus should be done as a visual examination for warts 1 to 2 months after a sexual assault. Hepatitis C testing is not done routinely after a sexual assault, nor is testing for the herpes simplex virus.

A nurse is working in a local community health care facility where she frequently encounters victims of abuse. For which signs should the nurse assess to find out if a client is a victim of abuse? Select all that apply. a) Reported history of the injury is inconsistent with the presenting problem b) Injuries on the face, head, and neck c) Partner of the suspected victim seems relaxed and not overly worried d) Affected by STIs frequently e) Mental health problems such as depression, anxiety, or substance abuse

A. Reported history of the injury is inconsistent with the presenting problem B. Injuries on the face, head, and neck E. Mental health problems such as depression, anxiety, or substance abuse

A pregnant client and her husband are at their first prenatal visit. While performing the admission history, the nurse notes several new and old bruises on the woman's neck and body. She is silent and withdrawn. The husband answers all the questions. Based on these observations, the nurse suspects intimate partner violence. Which of the following is the most appropriate nursing intervention at this time? a) Ask the woman if she would like her husband to wait outside in the lobby. b) Ask the husband to wait in the lobby while the client is being examined. c) Ask the couple if they would like to see a social worker. d) Ask the husband if he feels the client has been depressed throughout the pregnancy.

Ask the husband to wait in the lobby while the client is being examined.

Homicide from intimate partner violence is the number-one cause of death in pregnant women. a) False b) True

True

Which statement made by a new nurse demonstrates an understanding of the prevalence of sexual assault and related violence among the population? A) "The vast majority of victims of sexual assault and related violence are seen in the emergency room when they seek treatment." B) "I've come to realize that I need to include questions related to sexual assault and related violence into the assessment of all my clients." C) "It seems obvious that the greatest number of clients experiencing sexual abuse and related violence are the young and middle-aged adults." D) "The greatest need for thorough assessment regarding sexual assault and related violence is among those who are dependent and rely on the care of others."

B) "I've come to realize that I need to include questions related to sexual assault and related violence into the assessment of all my clients."

A woman has just confided in the nurse that her partner slapped and kicked her that morning. What is the best response by the nurse? a) "Oh my goodness, I cannot believe that happened to you. You poor thing, I feel terrible for you." b) "It's very brave of you to tell me all this. Help is available if you choose it." c) "Maybe he didn't mean to do it. Have you talked with him about it?" d) "Is this the first and only time he has done anything?"

"It's very brave of you to tell me all this. Help is available if you choose it."

A nurse is presenting a program to a church group about domestic violence. During the presentation, a member of the audience asks the nurse to explain what "intergenerational transmission of violence" means because he has seen that phrase used in the media. Which of the following responses by the nurse would be most appropriate? a) "Domestic violence seems to skip every other generation when it is traced in families." 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) "People who are violent are that way because of the various neurochemical imbalances in their brains."

"People who grow up in violent home situations tend to be involved in domestic violence situations as an adult."

The nursing instructor overhears students discussing their recent lecture topic of abuse and realizes that they need clarification when she hears a student say which of the following? a) Violence against lesbian relationships may go unreported for fear of harassment. b) Abuse occurs only in heterosexual relationships. c) Violence against gay relationships may go unreported for fear of harassment. d) Abuse occurs in both heterosexual and homosexual relationships.

Abuse occurs only in heterosexual relationships.

The generation-to-generation continuum of violence refers to the fact that a) Children who grow up in abusive homes almost always become abusers themselves unless they have professional intervention b) Children who grow up in an abusive home are less likely to be abusers themselves because they see first hand the devastation that violence can cause c) Violence is an innate behavior, and children become abusers because of external factors in their environment more often than in their family d) Violence is a learned behavior, and children who witness abuse are more likely to become abusers themselves

Violence is a learned behavior, and children who witness abuse are more likely to become abusers themselves

DELETEWhich of the following is TRUE regarding intimate partner violence? A) Abusers often have outward signs that they are abusers or have a mental illness. B) Even though women seldom blame themselves for the abuse, they often cannot leave the relationship. C) One in four women will be a victim of violence. D) Women who are in an abusive relationship experience less abuse while they are pregnant.

C) One in four women will be a victim of violence. Approximately 20% to 30% of women will be a victim of violence. Women experience an increase in violence during pregnancy. Abusers often have no outward signs that they are abusers or have a mental illness. Women usually blame themselves and feel they cannot leave the relationship.

A 13-year-old immigrant from Asia is admitted to the health care facility with vaginal bleeding. A genital examination reveals unhealed circumcision wounds. The client can understand limited English but cannot speak the language fluently. The service of an interpreter is employed. What are the points the nurse should keep in mind when interacting with this client? a) Allow the interpreter to question the client directly to assist with data gathering b) Use pictures and diagrams to supplement the questions and answers of the client's understanding c) Condemn the cultural practice and explain why it is wrong to the client d) She is still a child so convey important information in precise medical terms to ease understanding

Use pictures and diagrams to supplement the questions and answers of the client's understanding

When teaching a group of students about the cycle of violence, which behavior would the nurse describe as eventually disappearing as the violence becomes accelerated over time? a) Denial of the seriousness of the injuries b) Apologies for the pain and abuse c) Loss of control d) Excessive hostility and friction

Apologies for the pain and abuse

Which statement made by a male client who has a history of perpetrating intimate partner violence reflects a known factor that is characteristic of this behavior? A) "My classmates always called me a bully." B) "Sports like football and soccer are my life." C) "My mother was the disciplinarian in our family." D) "It was just mom and me after dad died."

A) "My classmates always called me a bully." Risk factors for intimate partner violence in men include taking aggression out on others while growing up as demonstrated by bullying. A male-dominated family life is considered a relationship factor that may trigger such violence. A preference for sports, such as football and soccer, are not considered risk factors for intimate partner violence.

A nurse is conducting an in-service program for a group of clinic nurses about screening for intimate partner violence. One of the participants asks the nurse, "I find it difficult to ask the woman questions about this. What's the best kind of question?" Which response by the nurse would be most appropriate? A) "There is no one best type of question. Use the type that makes you most comfortable." B) "Direct questions are often best since there is no room for interpretation." C) "Indirect questions work well but may take you longer to get the answer." D) "Remember that your question is reflecting your judgment about the situation."

A) "There is no one best type of question. Use the type that makes you most comfortable." To screen for intimate partner violence, nurses need to ask difficult questions in an empathetic and nonthreatening manner and remain nonjudgmental in all responses and interactions. The best question is the type of question that makes the nurse feel most comfortable. Direct and indirect questions produce the same results.

To properly assist a victim of intimate partner violence, which action would be most appropriate for the nurse to do? A) Document the details. B) Summarize the details of the incident. C) Discuss the details with the victim. D) Confront the abuser about the details.

A) Document the details. Accurate documentation is critical because this evidence may support the client's case in court. Documentation must include details about the frequency and severity of violence; location, extent, and outcome of injuries; and any treatments or interventions. Documentation should always use direct quotes, and be very specific.

A nurse is caring for a pregnant woman who has multiple bruises in varying stages across her body. Which is the priority nursing action? A) Report this as intimate partner violence. B) Ask if anyone at home has hit or hurt her. C) Tell her about resources for abuse victims. D) Refer her to counseling with her partner.

B) Ask if anyone at home has hit or hurt her. In the case of suspected intimate partner violence, it is best for the nurse to ask direct questions. Asking all women at physical examinations to account for any bruise they have helps detect physical maltreatment. Intimate partner violence is not typically reported by the nurse, but by the adult client. Once the nurse believes abuse is occurring, it is important to give her resources for abuse victims. Referring to counseling may be an option, but it is best to verify first.

A client is receiving treatment for injuries sustained during a fight with her partner. The nurse observes that the partner visits her daily in the hospital and appears very solicitous and contrite. When questioned, the client tries to convince the nurse that her partner always apologizes and brings gifts after a fight. Which information should the nurse provide this client? a) "Your partner seems to be genuinely contrite." b) "Although your partner seems sorry, often they will repeat this behavior in the future." c) "Sometimes people do things that cause them to be a victim of physical abuse." d) "You should try not to upset your partner in the future."

b) "Although your partner seems sorry, often they will repeat this behavior in the future."

A nurse is performing a physical examination of a pregnant woman. During examination, the nurse notices a bruise on the client's abdomen. Which action should the nurse take? A) Ask the client to account for the bruise. B) Assume that the bruise is from an accident and not worry about it. C) Make a note in the client's chart regarding the finding, and plan to observe for other signs of intimate partner violence in the future. D) Assume that the bruise is from intimate partner violence, and call the police while the client is still in the room.

A) Ask the client to account for the bruise. Many women seen in emergency departments are there because they have been maltreated by their intimate partner. Common injuries suffered include burns, lacerations, bruises, and head injuries. Asking all women at physical examinations to account for any bruise they have helps detect physical maltreatment. The nurse should not assume that the bruise is just the result of an accident or that it is the result of intimate partner violence; she should question the client to learn more. Depending on how the client responds, it may be appropriate to make a note in the client's chart or to take some other action to help protect the client.

A group of nursing students is preparing a talk on violence against women and how to prevent it. They want to list characteristics of intimate partner violence and should include which of the following? (Check all that apply.) a) use and abuse of substances such as alcohol b) history of childhood abuse c) history of antisocial behavior d) negative affect (hostility and depression) e) current unemployment f) easy-going personality

A. use and abuse of substances such as alcohol B. history of childhood abuse C. history of antisocial behavior D. negative affect (hostility and depression) E. current unemployment

A new nurse in the emergency department is caring for a pregnant woman who was beaten by her partner. Which statement by the new nurse would require intervention from the supervising nurse? A) "I don't understand why abused women don't leave their partners." B) "That woman must be doing something to get beaten like that." C) "I will give her information about women's shelters in our area." D) "She needs an emergency plan in case she ever decides to leave.

B) "That woman must be doing something to get beaten like that." It is important not to blame abuse victims for the violence they receive. Therefore, the supervising nurse would need to intervene and clarify for the new nurse not to make comments that place blame on the victim. The other statements are fine; many nurses do not understand why abused women do not leave their partners. It is helpful to give information about women's shelters and provide input on an emergency plan in case the woman wants to leave and maintain safety.

When a pregnant patient is abused during her pregnancy what complication is likely to occur after delivery due to the abuse? a) post-partum depression b) schizophrenia c) low birth weight d) edema

post-partum depression

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) A risk for moderate to severe violence with people both within and outside his family b) Symptoms of depression along with harboring feelings of inadequacy c) Purposefully remain socially isolated from people other than those in his family d) Intermittent remorse for the violence and abuse that he commits

A risk for moderate to severe violence with people both within and outside his family

Which of the following would the nurse identify as indicating emotional abuse? Select all that apply. a) Calling the victim names b) Throwing things at a victim c) Not allowing the victim to seek care for an injury d) Threatening to hit the victim e) Controlling how the family's money is spent f) Forcing the victim to perform a degrading act

A. Calling the victim names D. Threatening to hit the victim F. Forcing the victim to perform a degrading act

When caring for an abused woman, the nurse uses the ABCDES framework to provide interventions. Which of the following are components of this framework? Select all that apply. a) Plan of action and resources for safety for when the woman decides to leave b) Clear documentation of the nurse's perception of the abuse c) Expression of the belief that there may be a reason for the violence d) Education about the cycle of violence and its escalation e) Maintenance of confidentiality of the information reported f) Reassurance that the woman is not alone in this situation

A. Plan of action and resources for safety for when the woman decides to leave D. Education about the cycle of violence and its escalation E. Maintenance of confidentiality of the information reported F. Reassurance that the woman is not alone in this situation

A nurse is a guest speaker for a local college campus group discussing violence and rape. After discussing rape with the group, the nurse determines that additional discussion is needed when the group states which information? A) "It may take victims several years to recover from the rape." B) "Most rape victims tell someone about the rape." C) "A rape victim often feels vulnerable and betrayed afterwards." D) "Rape is not an act of impulsive, uncontrolled passion."

B) "Most rape victims tell someone about the rape." In reality, the most victims never tell anyone about being raped and almost two-thirds of victims never report the rape to the police. It can take several years to recover from rape, and the rape victim often feels vulnerable, betrayed, and insecure afterward. Rape is a premeditated act of violence, it is not an act of impulsive, uncontrolled passion.

A nurse is caring for a pregnant client and discovers signs of bruises near her neck. On questioning, the nurse learns that the bruises were caused by her husband. The client tells the nurse that her husband had stopped abusing her some time ago, but this was the first time during the pregnancy that she was assaulted. She blames herself because she admits to not paying enough attention to her husband. Which facts about abuse during pregnancy should the nurse tell the client to convince her that the abuse was not her fault? Select all that apply. a) Most men exhibit violent reactions during pregnancy as a way of coping with the stress. b) Abuse is a result of insecurity and jealousy of the pregnancy and the responsibilities it brings. c) Abuse is a result of the perception of the partner that the baby will be a competitor after he or she is born. d) Abuse is a result of concern for the unborn child when the mother doesn't fulfill her responsibilities toward the newborn. e) Abuse is a result of resentment toward the interference of the growing fetus and change in the woman's shape.

B. Abuse is a result of insecurity and jealousy of the pregnancy and the responsibilities it brings C. Abuse is a result of the perception of the partner that the baby will be a competitor after he or she is born. E. Abuse is a result of resentment toward the interference of the growing fetus and change in the woman's shape.

An obese client admits to regularly binging on large amounts of food. The client expresses feelings of guilt and shame but is unable to stop this behavior. What does the nurse recognize is the major treatment goal for this client? A) Eliminate purging episodes B) Normalize potassium levels C) Determine mental health needs D) Reduce number of binge episodes E) Increase daily physical activity level

D) Reduce number of binge episodes Binge eating disorder is frequent binging—or bouts of overeating—without inappropriate compensatory behaviors, such as purging or excessive exercise. Binging is generally considered to be consuming the equivalent of two or more meals or 2,000 calories or more within a given period of time (such as 2 hours). People with binge eating disorder have a higher BMI on average than the general population and are more likely to be obese. The goal of treatment is to reduce the number of binge episodes and decrease weight as needed. Purging is not part of this disorder, so eliminating purging is not an appropriate goal. Potassium levels are a problem for bulimics due to purging. It is not a problem for binge eaters. Although this client may have a mental health disorder, it is not the primary diagnosis. Increasing physical activity levels does not prevent binge eating, although it may help with weight loss.