Mental health 2

When interviewing the parents of an injured child, which of the following is the strongest indicator that child abuse may be a problem? A The injury isn't consistent with the history or the child's age. B The mother and father tell different stories regarding what happened. C The family is poor. D The parents are argumentative and demanding with emergency department personnel.

A Option A: When the child's injuries are inconsistent with the history given or impossible because of the child's age and developmental stage, the emergency department nurse should be suspicious that child abuse is occurring. Option B: The parents may tell different stories because their perception may be different regarding what happened. If they change their story when different healthcare workers ask the same question, this is a clue that child abuse may be a problem. Option C: Child abuse occurs in all socioeconomic groups. Option D: Parents may argue and be demanding because of the stress of having an injured child.

Which nursing action is best when trying to diffuse a client's impending violent behavior? A Helping the client identify and express feelings of anxiety and anger B Involving the client in a quiet activity to divert attention C Leaving the client alone until the client can talk about feelings D Placing the client in seclusion

Option A: In many instances, the nurse can diffuse impending violence by helping the client identify and express feelings of anger and anxiety. Such statements as "What happened to get you this angry?" may help the client verbalize feelings rather than act on them. Option B: Close interaction with the client in a quiet activity may place the nurse at risk for injury should the client suddenly become violent. Option C: An agitated and potentially violent client shouldn't be left alone or unsupervised because the danger of the client acting out is too great. Option D: The client should be placed in seclusion only if other interventions fail or the client requests this. Unlocked seclusion can be helpful for some clients because it reduces environmental stimulation and provides a feeling of security.

A 16-year-old boy is admitted to the facility after acting out his aggressions inappropriately at school. Predisposing factors to the expression of aggression include: A violence on television. B passive parents. C an internal locus of control. D a single-parent family

Option A: Violence on television has been correlated with an increase in aggressive behavior. Option B: Passive parents contribute to acting-out behaviors but not specifically to violence. Option C: An internal locus of control leads to a positive sense of self-esteem and isn't related to violence or aggression. Option D: There is no direct correlation between single-parent families and violence.

Before helping a male client who has been sexually assaulted, nurse Maureen should recognize that the rapist is motivated by feelings of: A Hostility B Inadequacy C Incompetence D Passion.

Option A: Rapists are believed to harbor and act out hostile feelings toward all women through the act of rape.

A client is brought to the emergency department after being beaten by her husband, a prominent attorney. The nurse caring for this client understands that: A open boundaries are common in violent families. B violence usually results from a power struggle. C domestic violence and abuse span all socioeconomic classes. D violent behavior is a genetic trait passed from one generation to the next.

Option C: Domestic violence and abuse affect all socioeconomic classes. Options A and B: Closed boundaries and an imbalance of power, with one member having control over the others, are common in violent families. Option D: Although violent behavior may be passed from one generation to the next, it's a learned behavior, not a genetic trait.

Which of the following is important when restraining a violent client? A Have three staff members present, one for each side of the body and one for the head. B Always tie restraints to side rails. C Have an organized, efficient team approach after the decision is made to restrain the client. D Secure restraints to the gurney with knots to prevent escape.

Option C: Emergency department personnel should use an organized, team approach when restraining violent clients so that no one is injured in the process. Option A: The leader, located at the client's head, should take charge; four staff members are required to hold and restrain the limbs. Option B: For safety reasons, restraints should be fastened to the bed frame instead of the side rails. Option D: For quick release, loops should be used instead of knots

A husband and wife seek emergency crisis intervention because he slapped her repeatedly the night before. The husband indicates that his childhood was marred by an abusive relationship with his father. When intervening with this couple, the nurse knows they are at risk for repeated violence because the husband: A has only moderate impulse control. B denies feelings of jealousy or possessiveness. has learned violence as an acceptable behavior. D feels secure in his relationship with his wife.

Option C: Family violence usually is a learned behavior, and violence typically leads to further violence, putting this couple at risk. Option A: Repeated slapping may indicate poor, not moderate, impulse control. Options B and D: Violent people commonly are jealous and possessive and feel insecure in their relationships.

In a toddler, which of the following injuries is most likely the result of child abuse? A A hematoma on the occipital region of the head B A 1-inch forehead laceration C Several small, dime-sized circular burns on the child's back D A small isolated bruise on the right lower extremity

Option C: Small circular burns on a child's back are no accident and may be from cigarettes. Options A and B: Toddlers are injury prone because of their developmental stage, and falls are frequent because of their unsteady gait; head injuries aren't uncommon. Option D: A small area of ecchymosis isn't suspicious in this age-group.

When working with children who have been sexually abused by a family member it is important for the nurse to understand that these victims usually are overwhelmed with feelings of: A Humiliation B Confusion C Self blame D Hatred

Option C: These children often have nonsexual needs met by individual and are powerless to refuse.Ambivalence results in self-blame and also guilt.

Victims of domestic violence should be assessed for what important information? A Reasons they stay in the abusive relationship (for example, lack of financial autonomy and isolation) B Readiness to leave the perpetrator and knowledge of resources C Use of drugs or alcohol D History of previous victimization

B Option B: Victims of domestic violence must be assessed for their readiness to leave the perpetrator and their knowledge of the resources available to them. Nurses can then provide the victims with information and options to enable them to leave when they are ready. Option A: The reasons they stay in the relationship are complex and can be explored at a later time. Option C: The use of drugs or alcohol is irrelevant. Option D: There is no evidence to suggest that previous victimization results in a person's seeking or causing abusive relationships.

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 cries uncontrollably throughout the examination. B The child pulls away from contact with the physician. C The child doesn't cry when the shoulder is examined. D The child doesn't make eye contact with the nurse

C Option C: A characteristic behavior of abused children is lack of crying when they undergo a painful procedure or are examined by a healthcare professional. Therefore, the nurse should suspect child abuse. Options A, B, and D: Crying throughout the examination, pulling away from the physician, and not making eye contact with the nurse are normal behaviors for preschoolers.