Psych Prep U Abuse and Violence

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." 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 violent families, which environment may be the most dangerous place for victims?

Home

Which is a priority nursing intervention when child abuse or neglect is suspected?

Safety The first part of treatment for child abuse or neglect is to ensure the child's safety and well-being.

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." Rape is an underreported crime due to feelings of guilt on the part of the victim. Only approximately 2% of all reported rape cases are false.

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

12-32% Women are 12-32% and men 17% who can expect to be victims of ongoing unwanted pursuit.

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

65% Approximately two-thirds of women are raped by people they know, including spouses, boyfriends, friends, or acquaintances. Among young women, about 50% of rapes are date rapes.

Which are implicated in the majority of elder abuse cases? Select all that apply.

Family member Adults Children Spouses Family members, adults, children, or spouses are implicated in 90% of the cases of elder abuse.

Which would not be considered a risk factor for being a victim of elder abuse?

Older than 65 years Age alone is not a risk factor; the vulnerabilities of being female, cognitively impaired, and financially dependent increase the risks of being abused.

A nurse who provides care in a large, urban emergency department has worked with numerous victims of various forms of abuse as well as those who are abusers. The nurse recognizes that persons who commit abuse are most likely what?

Past victims of abuse themselves While persons who commit abuse are by no means a homogeneous group, they do tend to be victims of abuse themselves. They are not necessarily poor, acutely ill, or older in age.

Which child has the greatest risk for being the target of bullying at school?

the child who wears hearing aids 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.

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." The statement about telling child services that the client is a bad parent reflects coercion and threats. The statement about the abuse never happening reflects power and control through minimizing, denying, and blaming. The statement about whom the client can and cannot see reflects power and control through the use of isolation. The statement about the partner being the master of the castle reflects power and control through the use of privilege.

A nursing student learning about intimate partner violence (IPV) correctly identifies the percentage of deaths attributed to IPV to be what?

70% women and 30% men

Which assessment finding can help the nurse differentiate a child experiencing child neglect rather than child abuse?

A young child is admitted to the hospital with hypothermia because the child is inadequately dressed. Child neglect is the failure to provide for a child's basic physical, medical, or educational needs. Examples of child neglect include withholding adequate clothing. Injuries and sexual touching are examples of child 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 she does not want to be around him and that he has been following her to work and home daily. What should the nurse suspect?

Intimate partner violence 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. Stalking takes place after a victim has ended the relationship with an abuser; however, the abuser makes repeated or persistent attempts to impose unwanted communication or contact on the victim. 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.

Which statement about intimate partner violence (IPV) is accurate?

Knowledge deficits and biases of health care professionals limit its detection. The literature confirms that a significant factor in the underdetection of IPV rests with professional behavior. Health care practitioners often fail to identify and intervene with abused women. The underlying dynamics of poor screening practices are complex and include both biases and knowledge deficits.

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 important outcome of nursing intervention with survivors is appropriate treatment of any disorder resulting from abuse, such as acute stress disorder, posttraumatic stress disorder, anxiety disorders, dissociative identity disorder, major depression, or substance abuse.

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 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.

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 Perpetrators of fatal child abuse are most likely to be caregivers who are young, poorly educated, and living at or below poverty level

Nurses who work with children should be on alert for which physical signs of child abuse?

Unexplained cuts, bruises, burns, and scars

A school health nurse is seeing an 11-year-old child who is refusing to attend school for the past 3 weeks. On assessment, the child describes a recent school experience where the child has been deliberately isolated from social groups. The child tells the nurse this began after an argument with their "best friend". The child is describing:

ostracism. In this case, the child is experiencing ostracism. Ostracism refers to ignoring or excluding a target individual and is a damaging form of bullying. The child's adjustment is clearly being threatened as the child is no longer able to attend school. Terrorism refers to community violence that takes place on a larger scale. Neglect refers to the malicious or ignorant withholding meeting a child's needs for their well-being. This is the abuse of a child by a parent or primary caregiver. Child abuse refers to the various forms of abuse rendered on a child by an adult in the role of caregiver.

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. In cases where children are being physically abused, there is often evidence of old injuries such as scars, untreated fractures, or multiple bruises of various ages. Physical abuse of children often results from severe corporal or unjustifiable punishment for having a toileting accident. Neglect should be suspected if the parent refused to seek medical treatment for the child. Although the nurse should further assess for neglect, in this case the clues for physical abuse are more obvious. Stalking refers to repeated or persistent attempts to impose unwanted communication or contact on another person. This happens between adults. Sexual abuse should be suspected if the child's genitals are assessed and there is a sign of redness, swelling, or other type of injury.

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?" 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.

The nurse can assess potential victims of domestic violence by asking which question?

"Has a past or current partner ever caused you to be afraid?" In posing this question, nurses are sensitive to the client's reluctance to reveal 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?

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

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 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 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." 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 nurse is working with a client who is a survivor of rape. The client asks the nurse, "It's been 6 months since it happened. Why can't I get back into doing the things I did before?" What is the nurse's best response?

"It can take at least a year or more to get back to where you were before." It often takes one or more year for survivors of rape to regain previous levels of functioning. It is important to remind clients that it is possible to return to previous levels of functioning. Clients have many strengths that they don't realize. It is important for the nurse to avoid using the word "victim" and help the client identify as a survivor. The nurse should help the client focus on the present rather than dwell on horrific things from the past.

An emergency department nurse is assessing a client with traumatic injuries. To assess whether or not the client's injuries have resulted from abuse, which question would be most appropriate for the nurse to ask the client?

"It looks like someone has hurt you. Tell me about it." The nurse should say to the client, "It looks like someone has hurt you. Tell me about it." This is an open-ended statement and allows the client to verbalize thoughts and feelings. Asking whether the partner is being mean or asking why the client thinks the spouse has done this beating assumes that the client has been abused. Asking about the person who did this would be ineffective because survivors of violence are unlikely to disclose sensitive information unless they perceive the nurse to be trustworthy and nonjudgmental. Additionally, this question is a closed question that does not allow the client to verbalize her thoughts and feelings openly

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." Violent families create an atmosphere of tension, fear, intimidation, and tremendous confusion about intimate relationships. Children in violent homes often learn violent behavior as an approved and legitimate way to solve problems, especially within intimate relationships. The social learning or intergenerational transmission of violence theory posits that children who witness violence in their homes often perpetuate violent behavior in their own families as adults. Moreover, children who grow up in violent homes learn to accept violence and expect it in their own adult relationships. Neurochemical imbalances, genetics, or skipping generations are unrelated to this theory.

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." When working with someone who is a victim of partner abuse, it is important that the nurse assertively support the client's decision. The affirmation of the client's decision can help to improve the client's self-confidence as she begin the process of leaving her partner. It is important the nurse refrain from recommending couple's counseling, imply doubt about the client's situation, or take charge and do everything for the client.

In which emergency room presentations should the nurse be suspecting abuse? (Select all that apply.)

A 6-year-old is being seen for the 5th time for a urinary tract infection A baby with contrecoup injuries to the brain A 3-month-old with a fractured femur Re-occurring urinary tract infections signal the possibility of sexual abuse of the child. The nurse must assess for further signs of abuse both with parents present and without. A fracture of the femur in a 3-month-old is uncommon given the infant's age and level of development. Contrecoup injuries of the brain in a baby should generate suspicion that the baby has been shaken. A 15-month-old with an allergic reaction to a peanut ingestion and a 3-year-old with a deep finger laceration should not signal abuse to the assessor. The problems are commonly seen in the pediatric emergency room.

Nurses at an urban emergency department seek to develop a plan to help women involved in abusive relationships. Which component is critical to the success of the plan?

Access to community resources for referral Much of the support and treatment that will be needed for women in abusive relationships is needed in the community. Having access to these resources is the most critical aspect to ensuring effective and sustainable support for women in abusive situations. An IPV counselor in the emergency department will only be available for support when there is an acute situation for which the client has come to hospital. Such a component is effective but not a long-term option to support people in abusive relationships. A quality of life assessment tool is effective for assessment, but this is only the initial part of the plan. Written educational materials are important to enhance knowledge for women in abusive situations; however, community support services are needed to ensure follow through and sustainability.

Which is not considered a characteristic of violent families?

Adequate support systems Having adequate support systems is not a characteristic of a violent family. Abuse of power and control, alcohol abuse, and social isolation are characteristics of violent families.

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 The most common indicators of physical abuse of a child are as follows: (1) bruises involving no breaks in skin integrity, (2) burns, usually due to immersion in hot water, contact with cigarettes, tying with a rope, or the application of a hot iron, (3) lacerations, abrasions, welts, and scars noted on the lips, eyes, face, and external genitalia, (4) missing or loosened teeth, and (5) skeletal injuries such as fractured bones, epiphyseal separation, or stiff, swollen, enlarged joints.

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 To preserve possible evidence, the physical examination should occur before the women has showered, brushed her teeth, douched, changed her clothes, or had anything to drink.If there is no report of oral sex, then rinsing the mouth or drinking fluids can be permitted immediately.

The nurse is legally obligated to report suspected child abuse to local authorities. Which information is essential?

Child's name, location, age, and suspected perpetrator Registered nurses are legally mandated to report child abuse. When reporting, the nurse must provide the child's name, location, age, and the suspected perpetrator. The nurse is not required to prove that abuse has occurred.

When a client reveals to the nurse that he or she was a victim of childhood sexual abuse, the nurse assesses for the presence of what? Select all that apply.

Client has difficulty establishing interpersonal relationships Client has a history of substance abuse Client has difficulty establishing a mutually satisfying sexual relationship Client engages in self-harming behaviors Losing the ability to trust people is a common characteristic of the adult survivor of childhood sexual abuse. Substance abuse is a common characteristic of the adult survivor of childhood sexual abuse. Other characteristics include having difficulty establishing interpersonal relationships and finding mutually satisfying sexual relationships. Also, survivors may engage in self-harm.

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 While a forensic nurse would certainly attempt to reassure a client such as this one, a priority forensic nursing task would be collecting specimens for use as evidence. This would supersede assisting with diagnostics, which falls within the scope of any registered nurse. The police, not a nurse, would be responsible for taking the client's statement.

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

Criticizing Ridiculing Threatening a victim's dog Psychological abuse includes behaviors such as criticizing, insulting, humiliating, or ridiculing someone in private or 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. Asking the client for time alone when frustrated or using assertive language reflect healthy, adaptive communications skills during conflict management. These are not examples of psychological abuse.

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

Dependency 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.

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 A behavioral profile of an emotionally abused child includes stuttering, enuresis, overeating, disciplinary problems, and failure to thrive. The scenario does not refer to physical, financial, or sexual abuse.

A 33-year-old client has been treated for a periorbital hematoma and a broken nose that the client suffered when the client's spouse struck the client. The client does not know where the client currently is, and the client is scheduled for discharge. What action should the care team prioritize in this client's care?

Ensuring that the client goes to a safe place The client's safety supersedes the importance of education and dressing changes, though all of these are appropriate interventions when conducted at the appropriate time.

Nurses working with rape trauma victims need to be aware of their own attitudes about rape and sexual assault. Which rationale best explains why?

Giving back the survivor as much control as possible is important. 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.

Which characteristic would a nurse least likely see in an abused individual?

High self-esteem Abused individuals often demonstrate a pattern of learned helplessness, manifest characteristics of low self-esteem and shame, and often experience feelings of increased dependence, isolation, guilt, and entrapment

Which are forms of psychological abuse? Select all that apply.

Insulting Humiliating Destroying another's property 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 client comes to the mental health clinic and reports feeling depressed for the last 3 months. The client also admits to having thoughts of suicide. When the nurse inquires about the client's relationships, the client tells the nurse that the client's spouse constantly belittles the client, telling the client often that the client is "stupid and fat." Which problem should the nurse assess for further?

Intimate partner violence Intimate partner violence is a significant public health problem. It involves psychological, physical, or sexual harm perpetrated by a current spouse or partner. The client's partner's comments reflect psychological abuse.

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 While there may be musculoskeletal damage as a result of shaken baby syndrome, the most serious damage is neurological.

In clients who do not completely recover from being victimized by rape, which mental illness is most likely to develop?

Post-traumatic distress syndrome Post-traumatic distress syndrome can result at least 1 month after an identifiable traumatic event. Symptoms include generalized anxiety, intrusive thoughts or images of the trauma, flashbacks, nightmares, and other sleep disturbances.

Which type of abuse includes name calling and belittling?

Psychological abuse 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 provides the most acceptable example of neglect according to the definition of the term?

Rejecting a 3-year-old who is crying and seeking affection after the child stumbles and fall 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.

When health care professionals detect signs of elder abuse in clients, the law requires them to take which action?

Report the abuse to the state authorities. Once nurses have detected elder abuse, they are responsible for reporting the mistreatment. Each state has its own guidelines to follow. Usually, after nurses have reported the abuse, a state protective services worker meets with the victim.

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

Sadistic rapist Sadistic rapists derive erotic gratification from the victim's suffering. Power rapists often attack people their own age and use intimidation and minimal physical force to control their victims. Their assaults are premeditated. Anger rapists use extreme force and restraint that results in physical injury to the victim. There is not a type of rapist called premeditated.

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

Same frequency as in heterosexual couples Intimate partner violence in same-sex couples occurs with at least the same frequency as in heterosexual relationships, but people with same-sex partners may not be afforded the same support

In a toddler, which injury is most likely the result of child abuse?

Several small, circular burns on the child's back 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.

An older adult client has been attending a local day program for the elderly. The nurse who facilitates the program notices the client has multiple bruises on the arms, has scrapes to the hands and face, and is socially withdrawn. A referral to the client's family physician confirms the client has genital herpes. Which type of elder abuse should the nurse suspect?

Sexual abuse The physical bruising and presence of genital herpes indicate abuse that is sexual in nature. Older adults are increasingly the victims of abuse (e.g., physical, sexual, psychological, or neglect).

A 3-year-old who has been seen in the emergency department for various fall-related injuries is being treated for apparent blindness in the left eye as a result of retinal hemorrhage. The nurse should suspect that which form of child abuse is part of the cause of the child's condition?

Shaken baby syndrome Despite its name, shaken baby syndrome has been documented in children up to 5 years of age. The physical findings usually include bruising from being grabbed firmly along with major head injury, such as subdural hematoma or cerebral edema. Nonfatal consequences include blindness due to retinal hemorrhage.

The majority of perpetrators of elder abuse include which population?

Spouse in the caregiver role Most cases of elder abuse occur when one older spouse is taking care of another.

Which is a pattern of repeated unwanted contact, attention, and harassment that often increases in frequency?

Stalking Stalking is a pattern of repeated unwanted contact, attention, and harassment that often increases in frequency. Stalking is a crime of intimidation. Rape is the penetration of any bodily orifice by the penis, fingers, or an object. Incest involves sexual contact between family members. Physical abuse involves bodily harm

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 child reports "itching down there" The vulva appears edematous The urinalysis reports a bacterial infection The nurse's suspicion that a child has been sexually abused is supported when the assessment data includes a bruised anal area, itching reported by the child, an edematous vulva, and a urinary infection. Ear infections are common among children.

The psychiatric nurse recognizes that a male rape victim is less likely to report the crime due to which reason?

The belief that his masculinity will be in question It is a common misconception that males cannot be sexually abused, that only "sissies and weaklings allow abuse," leading to the possibility that his masculinity is at stake if he is identified as a victim.

Which is not a risk factor for child sexual abuse?

The child is aged 10 years or younger. Children at high risk for sexual abuse include those who • Are aged 3 years or younger • Suffer from a developmental delay • Live in a home where substance abuse occurs • Have adolescent parents or a single parent • Are in foster care • Have primary caretakers who were sexually abused themselves • Have primary caretakers who are mentally ill or have a developmental delay

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 is physically dependent on the client's son since losing mobility. The client has no income or savings of the client's own. The client's son describes the client as "needy, helpless, and pathetic." 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 would not increase the likelihood that an older adult will incur physical abuse?

The older adult is independent with activities of daily living. The correct option indicates that the older adult enjoys independence, an attribute that is not commonly seen in those older adults who experience physical abuse. Common factors that predispose older adult clients to physical abuse include having chronic medical or mental health conditions, living with a familial caregiver who is a male and has financial problems, and the reluctance to report abuse despite the presence of signs such as multiple bruises.

Which statement is true regarding children being raised in a home where they have witnessed intimate partner violence?

They are at increased risk for being abused. Children being raised in a home where they have witnessed intimate partner violence demonstrate higher levels of depression and lower levels of self-esteem; these effects are pronounced in boys especially. Children of battered women are at an increased risk for abuse. Exposure to intimate partner violence adversely affects a range of child functioning.

Which three elements are necessary to legally define rape of a male, female, or mixed gendered person?

Use of force; vaginal, oral, or anal penetration; nonconsent of victim Three essential elements are necessary to legally define rape of a man or woman: • Use of force, threat, intimidation, or duress • Vaginal, oral, or anal penetration • Nonconsent by the victim

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

Violent episodes are less frequent Over time, the violent episodes are more frequent, the period of remorse disappears altogether, and the level of violence and severity of injuries worsen.

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 In this case, the most accurate description of this rapist is anger retaliation. In this category, the perpetrator wants to punish the victim and often causes substantial injury. The power assertive rapist desires to dominate and control the victim and may repeat with the same victim. The power reassurance rapist commits rape when the opportunity presents itself, such as when another crime is being committed. An anger excitement rapist acts out fantasies and can be strategic in carrying out the crime, for example, carries a rape kit.

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. Children are inevitable victims in an IPV situation and must be assessed and cared for accordingly. The nurse must avoid false reassurance. It is unnecessary, and often impossible, to identify specific causes for IPV. Relationship skills can be addressed in follow-up care.

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 Neglect, in this case, is the malicious withholding of a physical necessity for this child's well-being. For this child, the neglect is intended to be punitive for bed wetting. The nurse would need to investigate further and take the necessary action in reporting this as abuse. Sexual abuse refers to sexual acts performed by an adult on a child under the age of 18. In this case, the evidence does not support that the child is being sexually abused. Physical abuse refers to a deliberate physical assault by an adult on the child such as burning, biting, poking, or twisting a limb. Psychological abuse refers to verbal assaults such as blaming, screaming, name-calling, and using sarcasm. The child has not reported that this is occurring, therefore, this is most likely a situation in which the form of abuse is 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 While anxiety can be a sign of many different problems, an anxious child who rejects the attention of an adult may raise a red flag encouraging the nurse to assess further and possibly making a report. Developmental delays are not necessarily an indicator of emotional abuse, nor is attending day care on a regular basis. Being raised by a single parent is also not necessarily an indicator of emotional abuse.

When the school nurse is assessing an adolescent who reports troubling sleeping, which characteristics of the client indicate there may be violence in the home? (Select all that apply.)

the client's father monitors contact with friends has a family history of alcohol abuse must go straight home after school each day Having contact with friends monitored by the father indicates there is an abuse of power and control in the home. Having to go straight home after school indicates the client is being forced into social isolation. In addition, there is a family history of alcohol abuse. These are all characteristics of violent families. Adolescents commonly report feelings of being left out and experiencing social pressures to experiment with drugs and alcohol. These are not characteristics of violent families.

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.)

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 it is abuse if your caregiver holds your arm too tight