Chapter 12: Abuse and Violence

A mental health nurse presenting an educational program on rape for high school students responds to the statement, "Women cry rape often times just to get even with the guy," by offering which answer?

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

Which assessment question should the nurse ask of a client suspected of being ostracized by a school bully?

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

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

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."

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 been supported by health care professionals and now I want to support other survivors."

A nurse is assessing a survivor of intimate partner violence. During the interview, the nurse determines that the survivor's partner is using power and control over the client through coercion and threats. Which client statement would lead the nurse to suspect this?

"My partner tells me that he or she will tell child services I'm a bad parent."

A nurse is presenting to a church group a program about domestic violence. During the presentation, a member of the audience asks the nurse to explain what "intergenerational transmission of violence" means because the person has seen that phrase used in the media. Which response by the nurse would be most appropriate?

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

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

"You have the right to be safe and respected."

What percentage of women can expect to be a victim of an ongoing unwanted pursuit from stalking?

12-32%

Approximately what percentage of women rape victims are raped by someone they know?

65%

A nurse is working in the emergency department. Which situation would lead the nurse to suspect possible abuse of a client? Select all that apply.

A 3-month-old with a fractured femur A 6-year-old is being seen for the 5th time for a urinary tract infection A baby with contrecoup injuries to the brain

When noted in an assessment of a child, the nurse should suspect child abuse if which common physical findings signaling abuse are present?

Bruises, burns, lacerations, missing teeth, and skeletal injuries

When attempting to preserve evidence from a possible rape with no report of oral sex, the female victim should be instructed that which self-care activities are permitted?

Brushing her teeth

A 27-year-old has been brought to the emergency department by emergency medical services following a violent sexual assault that took place in the parking garage of the client's building. Which task would fall most clearly within the scope of practice of a forensic nurse?

Collecting specimens from the client for use as evidence

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

Cyberstalking

Which is the most commonly identified issue preventing people from leaving an abusive relationship?

Dependency

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

Emotional

The nurse is planning a community education session on elder abuse awareness. Which points should the nurse be sure to include? (Select all that apply.)

It is abuse if your caregiver holds your arm too tight Withholding money for necessities is a form of abuse Not helping you get medical attention you need is a form of abuse It is abuse if you feel forced to have sex

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

Major depression

An 8-month-old infant has been brought to the emergency department unresponsive by the infant's teenage parent and the care team suspects shaken baby syndrome. When providing care for this infant, the nurse should prioritize which assessment?

Neurological assessment

Which statement requires additional education regarding the truth about rape?

Rape is a crime of passion.

A nurse is working on developing a safety plan with a client who is a survivor of violence. Which would the nurse address first?

Recognizing the signs of danger

During an interview, a 6-year-old child tells a nurse that the child is often left alone at home by the child's parents. Which action should the nurse take?

Report the child's information to the child protection agency.

Which type of rapist derives erotic gratification from the victim's suffering?

Sadistic rapist

The nursing student learning about intimate partner violence correctly identifies its prevalence in same-sex couples as what?

Same frequency as in heterosexual couples

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?

Stalking

Which feature would most likely predispose an adult to engage in family violence?

The adult was physically abused as a child

The nurse's suspicion that a child has been sexually abused is supported by what assessment data? Select all that apply.

The anal area is bruised The urinalysis reports a bacterial infection The vulva appears edematous The child reports "itching down there"

The nurse is aware that fewer than half of rapes and sexual assaults are reported. Which are some of the reasons people do not report being sexually assaulted? Select all that apply.

The client is embarrassed of the assault. They have a fear of being blamed for the incident. The perpetrator may use coercion or threats to control the victim.

Which would not increase the likelihood that an older adult will incur physical abuse?

The older adult is independent with activities of daily living.

What are some types of behavior that the nurse would recognize as qualifying as psychological abuse? Select all that apply.

Threatening a victim's dog Criticizing Ridiculing

A nurse is giving a talk about child abuse to a local community group. When discussing risk factors for child abusers, which would the nurse identify as the most likely profile of the perpetrator of fatal child abuse?

Unemployed young woman who dropped out of high school

Which is an inaccurate picture of the cycle of abuse that occurs over time?

Violent episodes are less frequent

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

anger retaliation

A middle-aged client with young children has been the victim of intimate partner violence (IPV). When providing initial care to this family, the nurse should:

carefully assess the children for signs of trauma.

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

neglect

When assessing a 6-year-old child believed to be a victim of emotional abuse, the possibility is supported when the child is ...

observed to be anxious and rejecting adult attention.

A nurse is seeing a 3-year-old child who is brought to a pediatric clinic by the mother with concerns about toilet training. The nurse notes the child has multiple bruises of various ages on the arms, trunk, and legs. The nurse should suspect:

physical abuse.