Chapter 30: Vulnerable Population

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? 1 Use direct quotes and specific language. 2 Obtain photos to substantiate the client's case in a court of law. 3 Document only descriptions of medical interventions taken. 4 Respect the client's opinion and avoid informing the police.

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The nurse is caring for a client who is seeking care after being raped. What is the primary reason the nurse does not leave the client alone during the emergency room stay? 1 Promotes the client's sense of safety 2 Provides the opportunity for the client to validate feelings 3 Assures the nurse will be available to meet the client's needs 4 Helps guarantee proper attention to the preservation of evidence

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A 10 weeks' gestation client states "My partner used to hit me before the pregnancy, but promised to stop now that I'm pregnant. My partner loves our baby." How will the nurse respond? 1 "I am glad your partner is going to stop. Hitting you could harm your baby." 2 "You are at a higher risk for violence since you are pregnant." 3 "If your partner hits you, the baby will be protected by the amniotic fluid." 4 "You need to move into a shelter during your pregnancy."

2

A client at 36 weeks' gestation presents in the emergency department with a broken arm. The client states, "I fell while cooking dinner." During the assessment, the nurse notes no prenatal care for this pregnancy, as well as bruises in multiple stages of healing on the client's abdomen, arms, and chest. What action will the nurse perform next? 1 Notify the health care provider of the findings 2 Ask the client how she acquired the bruises 3 Document the findings in the client's chart 4 Provide brochures on shelters for female victims of intimate partner violence

2

A nurse is preparing a teaching plan for victims who are recovering from intimate partner violence. The nurse would focus the teaching on ways to: 1 enhance their personal appearance and hairstyle. 2 develop their creativity and work ethic. 3 improve their communication skills and assertiveness. 4 plan more nutritious meals to improve their own health.

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A nurse is screening a client for intimate partner violence using indirect questions. Which question would the nurse most likely ask? 1 "I know it can be difficult to talk about, but does your partner hit you?" 2 "Have you ever been abused?" 3 "Clients with your injuries are often abused. Is anything like this happening now?" 4 "It's okay to talk about this subject. Are you in an abusive relationship?"

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A nurse is working with a group of clients who are victims of intimate partner violence. The nurse focuses interventions on which area as the primary goal? 1 convincing them to leave the abuser soon 2 helping them cope with their life as it is 3 empowering them to regain control of their life 4 arresting the abuser so he or she cannot abuse again

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An adolescent who is 8 weeks' pregnant is at her first perinatal visit. During the health history interview, the nurse asks the client, "Are you afraid of anyone?" What is the nurse assessing with this question? 1 mood 2 mental status 3 intimate partner violence 4 social history

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While interviewing a client, the client tells the nurse, "Our budget is tight. My spouse controls how all the money is spent. And I am not allowed to get a job either." The nurse suspects that the client may be experiencing which type of abuse? 1 physical 2 emotional 3 financial 4 sexual

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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? 1 Chlamydia, trichomoniasis, gonorrhea and hepatitis B 2 HIV, hepatitis B, chlamydia, and human papillomavirus 3 HIV, hepatitis C, hepatitis A, and gonorrhea 4 Syphilis, HIV, chlamydia, and herpes simplex

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The nurse is caring for a client who is a victim of sexual violence. How can the nurse best support the necessary grieving process? 1 Actively listening to the client as he or she talks about the experience 2 Reinforcing the fact that violence is never deserved 3 Educating the client about the symptoms of post traumatic stress disorder 4 Teaching the client stress management strategies

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When beginning care for a victim of rape, the nurse asks the patient to "talk about what happened" to her. For which nursing diagnosis is the nurse using this approach? 1 Anxiety related to recent rape 2 Fear related to repeated episodes of maltreatment 3 Disabled family coping related to recent rape of family member 4 Risk for other-directed violence related to admitted poor self-control

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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? 1 physical symptoms 2 intrusive thoughts 3 avoidance 4 hyperarousal

2

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? 1 Ask the client to account for the bruise. 2 Assume that the bruise is from an accident and not worry about it. 3 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. 4 Assume that the bruise is from intimate partner violence, and call the police while the client is still in the room.

1

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? 1 1 in 3 2 1 in 5 3 2 in 15 4 3 in 20

2

The nurse decides to spend extra time with a pregnant patient in the prenatal clinic in efforts to determine if the patient is a victim of intimate partner violence. What caused the nurse to make this plan prior to assessing the patient? 1 Patient chatting with another patient in the waiting room 2 Patient wearing a long sleeved jacket on a hot summer day 3 Patient periodically looking at a wrist watch to check the time 4 Patient unconsciously rubbing the abdomen while reading a magazine

2

Which of the following scenarios should the nurse follow up on as a potential indication of intimate partner violence? 1-The partner of a pregnant woman attends each of her appointments. The partner is friendly and outgoing. Each time the nurse asks the client a question, the partner answers. While the partner speaks, the client looks at her lap. 2- The partner of a pregnant woman attends each of her appointments. The partner is friendly and outgoing. Each time the nurse asks the client a question the partner tries to answer. When the partner speaks, the client interrupts and answers the question herself. The partner listens to the answer. 3- The partner of a pregnant woman attends an ultrasound appointment. The partner is friendly and outgoing. When the technician reveals the client's belly to apply the electrodes, the partner comments that the client is really fat. The client pulls at the partner's shirt and says the partner is fat too. They both laugh. 4- The partner of a pregnant woman attends an ultrasound appointment. The partner is friendly and outgoing. The nurse notices bruises on the client's upper arms and says they look sore. The client says she's getting so big she keeps bumping into things. She maintains good eye contact with the nurse as she explains.

1

When a pregnant client is victim of intimate partner violence during pregnancy, what complication is likely to occur after birth due to the abuse? 1 edema 2 postpartum depression 3 low birth weight 4 schizophrenia

2

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? 1 "My partner always tells me that the abuse never happened." 2 "My partner tells me who I can and cannot see." 3 "My partner tells me that I will be turned into child services for being a bad mother." 4 "My partner acts like the master of the castle and I'm the servant."

3

A nurse is conducting a discussion group at a local women's health center about violence and women. The nurse would include that women are at a higher risk for violence at which time? 1 during pregnancy 2 during winter 3 on paydays 4 if they leave the abuser

4

After teaching a class at a local college campus on date rape, the nurse determines that the teaching was successful when the class identifies which substance as the most common date rape drug? 1 gamma hydroxybutyrate 2 liquid ecstasy 3 ketamine 4 rohypnol

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