Psychiatric - Chp 12

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Which of the following are implicated in the majority of elder abuse cases? Select all that apply. a) Adults b) Children c) Spouses d) Family member e) Friends

a) Adults b) Children c) Spouses d) Family member

The nurse is caring for a young adult in the mental health clinic. The client tells the nurse that he was physically neglected as a child. The nurse should assess the client for symptoms of which of the following? a) Major depression b) Narcissistic personality disorder c) Panic disorder d) Schizophrenia

a) Major depression

What percentage of victims of intimate violence report that alcohol was involved in the violent incident? a) Two thirds b) One half c) One quarter d) Seventy-five percent

a) Two thirds

Which type of elder abuse involves harm of self-worth? a) Abandonment b) Neglect c) Emotional d) Physical

c) Emotional

A nursing instructor teaching about sexual assault identifies a need for further instruction when one of the students makes which statement? a) "Sexual assault is the same as rape." b) "Fondling can be a type of sexual assault." c) "Sexual assault occurs about once every 2 minutes in the United States." d) "Sexual assault involves nonconsenting sexual activity."

a) "Sexual assault is the same as rape."

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

a) Destroying another's property c) Insulting e) Humiliating

Which of the following are risk factors for those who are more likely to abuse an older adult? Select all that apply. a) Financial dependence b) Cognitive disability c) History of intergenerational conflict d) Use of drugs e) Lack of social support

a) Financial dependence d) Use of drugs e) Lack of social support

Which of the following nursing interventions would be the most appropriate to prevent a client from becoming violent? a) Helping the client identify and express feelings of anxiety and anger b) Involving the client in a quiet activity to divert attention c) Placing the client in seclusion d) Leaving the client alone until the client can talk about feelings

a) Helping the client identify and express feelings of anxiety and anger

A pregnant woman comes to the clinic for a routine visit. Upon examination the nurse notices bruises on the client's upper arms and neck. The client reports that her husband has been abusive to her. The nurse is concerned because abuse during pregnancy can lead to which of the following? Select all that apply. a) Infections b) Low birth weight c) Hypotension d) Low maternal weight gain e) Anemia f) Miscarriage

a) Infections b) Low birth weight d) Low maternal weight gain e) Anemia f) Miscarriage

A nurse is working with a female client who is anticipating the possibility of leaving an abusive relationship. In helping the client make the decision to leave or to stay in the abusive situation, which of the following would be most important for the nurse to do? a) Inform the client that if she leaves the abusive situation, there is a possibility her partner will attempt to murder her. b) Suggest that the client legally change her name and move out of state so she will be safe from future harm. c) Ensure that the client can effectively describe the behaviors inherent in each phase of the cycle of domestic violence. d) Assist the client in finding a new apartment and a new job so she will be safe after she leaves her current situation.

a) Inform the client that if she leaves the abusive situation, there is a possibility her partner will attempt to murder her.

Which of the following is a possible indicator of neglect? a) Malnourishment not related to a known illness b) Helplessness c) Hesitance to talk openly d) Anger

a) Malnourishment not related to a known illness

Mrs. Jones, 55 years old, is the primary caregiver for her 78-year-old uncle. The uncle's cognition is intact, but he is frail and cannot perform activities of daily living without assistance. Mrs. Jones brings her uncle to the clinic for a routine examination, and the nurse notes that she quickly answers the interview questions for her uncle, stating, "He's OK; everything's fine." When the nurse directs her questions to the client, he looks to his niece before saying, "I'm OK, just old." Findings of the physical examination are unremarkable. Which of the following interventions should the nurse implement? a) Meet with the uncle privately to screen for elder abuse. b) Ask Mrs. Jones if she thinks her uncle is becoming depressed. c) Meet with Mrs. Jones privately to ask if she can manage her role as caregiver. d) Schedule a routine follow-up appointment; there are no signs of elder abuse.

a) Meet with the uncle privately to screen for elder abuse.

A group of nursing students is reviewing information about intimate partner violence (IPV). The group demonstrates understanding of this topic when they identify which of the following? a) Men may not consider behaviors such as slapping or shoving as abuse. b) IPV in same-sex couples occurs less frequently as compared with heterosexual relationships. c) Men are more likely to be seriously injured even though more women are typically victims. d) The reactions to IPV are similar in male and female victims.

a) Men may not consider behaviors such as slapping or shoving as abuse.

Nurses working with rape trauma victims need to be aware of their own attitudes about rape and sexual assault. Which of the following rationales best explains why? a) Nurses need to be emotionally available to their clients. b) Nurses need to be able to sympathize with their clients. c) Nurses can learn from the experiences of clients and thus help prevent becoming victims of assault themselves. d) The attitudes of individual nurses reflect on the overall profession.

a) Nurses need to be emotionally available to their clients.

The psychiatric nurse recognizes that a male rape victim is less likely to report the crime because a) Of the belief that his masculinity will be in question b) He may be accused of engaging in socially inappropriate or illegal activities leading to the rape c) Of the impact it will have on his family d) Of the social ramifications of possibly contracting AIDS

a) Of the belief that his masculinity will be in question

The psychiatric nurse assesses for a child's potential risk factors for sexual abuse when (Select all that apply.) a) Questioning parents and child about school attendance b) Questioning the parents concerning their possible substance abuse c) Determining whether either parent has ever been sexually abused d) Evaluating the child for developmental delays e) Observing for signs of child neglect

a) Questioning parents and child about school attendance b) Questioning the parents concerning their possible substance abuse c) Determining whether either parent has ever been sexually abused d) Evaluating the child for developmental delays

What are some types of behavior that the nurse would recognize as qualifying as psychological abuse? Select all that apply. a) Ridiculing b) Allowing the client's parents to visit often c) Threatening a victim's dog d) Criticism e) Budgeting money to save for the future

a) Ridiculing c) Threatening a victim's dog d) Criticism

Supported by recent research findings, the nurse-manager of a busy community-based walk-in clinic best prepares a new nurse to identify victims of domestic violence by ... a) Scheduling the nurse to attend a seminar that focuses on the management of abused clients b) Assigning the new nurse to shadow an experienced nurse who is caring for a potential abuse victim c) Providing the new nurse with the opportunity and resources to become familiar with effective assessment techniques d) Making experienced nursing staff available to the new nurse to act as a mentor when an assessment of such a client is required

a) Scheduling the nurse to attend a seminar that focuses on the management of abused clients

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) Suicide risk b) Sleep patterns c) Hydration status d) Nutritional status

a) Suicide risk

The nurse uses the following as an example of neglect: a) Telling a 3 year old to stop crying like a baby when he stumbles and falls b) Disciplining a 6-year-old child for "sassing" by putting tape on his mouth c) Correcting a child for copying homework in front of the entire class d) When an adult does not intervene when a 10-year-old child is being bullied by older peers

a) Telling a 3 year old to stop crying like a baby when he stumbles and falls

After a series of admissions to the emergency department over the past several months, an 80-year-old woman's malnutrition, vague history, and pattern of physical injuries lead the nurse to suspect elder abuse. Which of the following aspects of the woman's situation may contribute to elder abuse? Select all that apply. a) The woman's son describes her as "needy, helpless, and pathetic." b) The woman is physically dependent on her son since she lost her mobility. c) The woman and her son are recent immigrants to the United States. d) The woman describes herself and her son as "not well-off, but not terribly poor either." e) The woman has no income or savings of her own.

a) The woman's son describes her as "needy, helpless, and pathetic." b) The woman is physically dependent on her son since she lost her mobility. e) The woman has no income or savings of her own.

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? a) "He acts like he's the master of his castle and I'm his servant." b) "He tells me that he'll tell child services I'm a bad mother." c) "He always tells me that the abuse never happened." d) "He tells me who I can and cannot see."

b) "He tells me that he'll tell child services I'm a bad mother."

The emergency department nurse is assessing a female 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? a) "Why do you think your husband has beaten you?" b) "It looks like someone has hurt you. Tell me about it." c) "Is your partner being mean to you?" d) "Can you describe the person who did this to you?"

b) "It looks like someone has hurt you. Tell me about 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) "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." b) "People who grow up in violent home situations tend to be involved in domestic violence situations as an adult." c) "People who are violent are that way because of the various neurochemical imbalances in their brains." d)"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."

A nursing student learning about intimate partner violence (IPV) correctly identifies the percentage of deaths attributed to IPV to be which of the following? a) 90% women and 10% men b) 70% men and 30% women c) 50% women and 50% men d) 70% women and 30% men

b) 70% men and 30% women

What does rape trauma syndrome refer to? a) An abnormally severe psychological response to a sexual assault b) A process that includes an acute disorganization phase and a long-term reorganization phase c) Physical injuries incurred during the assault d) Irritability and difficulty concentrating for extended periods after the attack

b) A process that includes an acute disorganization phase and a long-term reorganization phase

Which of the following is not considered a characteristic of violent families? a) Abuse of power and control b) Adequate support systems c) Alcohol abuse d) Social isolation

b) Adequate support systems

Five common physical findings that indicate that a child has been abused are what? a) Broken bones and finger joints, bruises, scars, and eye injuries b) Bruises, burns, lacerations, missing teeth, and skeletal injuries c) Eye, head, and skeletal injuries; swollen glands; and breaks in skin d) Missing teeth, scars on genitalia, loose bones, broken legs, and burn marks

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

Which of the following is the most common trait found in abused wives who stay with their husbands? a) Jealousy b) Dependency c) Possessiveness d) Emotional immaturity

b) Dependency

In violent families, which normal safe haven may be the most dangerous place for victims? a) Church b) Home c) School d) Work

b) Home

A public health nurse is asked to develop secondary rape prevention strategies for the inner-city business community. Which of the following actions is consistent with this directive? a) Choose a specific hospital to which rape victims will be taken for assessment. b) Identify situations that place the individual at risk. c) Create a press release that gives community members a toll-free number to call for information about sexual assault. d) Design an education program that explores male/female relationships.

b) Identify situations that place the individual at risk.

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? a) Neglect b) Intimate partner violence c) Stalking d) Sexual assault

b) Intimate partner violence

A client comes to the mental health clinic and reports feeling depressed for the last 3 months. She also admits to having thoughts of suicide. When the nurse asks her how her home life is, the client says that her husband constantly belittles her and tells her that she is stupid and fat. What problem should the nurse suspect? a) Bipolar disorder b) Intimate partner violence (IPV) c) Normal marital challenges d) Sexual abuse

b) Intimate partner violence (IPV)

Which of the following would not be considered a risk factors for being a victim of elder abuse? a) Impaired cognitive function b) Older than 65 years c) Female d) Financial dependency

b) Older than 65 years

Which of the following is a priority intervention when dealing with child abuse or neglect? a) Social support b) Safety c) Psychological needs d) Physiologic needs

b) Safety

A 3-year-old who has been seen in the ED for various fall-related injuries is being treated for apparent blindness in the left eye as a result of retinal hemorrhage. The nurse expresses a concern related to possible a) Child neglect b) Shaken baby syndrome c) Munchausen's syndrome by proxy d) Ineffective supervision

b) Shaken baby syndrome

All except which of the following are risk factors for child sexual abuse? a) The child has primary caretaker who is mentally ill. b) The child is aged 10 years or younger. c) The child suffers from developmental delays. d) The child lives in a home where substance abuse occurs.

b) The child is aged 10 years or younger.

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 typically what? a) Delusional and/or psychotic b) Victims themselves of abuse c) Over 50 years of age d) Of lower socioeconomic class

b) Victims themselves of abuse

The loss of employment is most likely to trigger abusive behavior toward others by the client who a) Is used to being in control b) Was physically beaten as a child c) Was experiencing financial problems before the loss of employment d) Experiences chronic mild depression

b) Was physically beaten as a child

Which type of male rapist impulsively uses his victims as objects for gratification? a) Inadequate men b) Exploitive predators c) Sexual sadists d) Men for whom anger is displaced

b) exploitive predators

The nursing student learning about child abuse correctly identifies which of the following individuals to be at the highest risk for abuse? a) 16-year-old girl b) 12-year-old boy c) 5-year-old girl d) 18-year-old boy

c) 5-year-old girl

The nurse can assess potential victims of domestic violence by ... a) "What is your history of physical injuries?" b) "Do you need the number of a women's shelter?" c) Asking questions such as "Has a past or current partner ever caused you to be afraid or hurt you?" d) "What did you do right before your partner hit you?"

c) Asking questions such as "Has a past or current partner ever caused you to be afraid or hurt you?"

Four causative factors related to domestic violence are what? a) Low educational level, physical illness, high social support, and learned behaviors b) Learned behaviors, physical illness, low social support, and higher education c) Drug or alcohol abuse, lack of nurturing, poor socioeconomic status, and poor communication skills d) Lack of money, lack of time, higher education, and low self-esteem

c) Drug or alcohol abuse, lack of nurturing, poor socioeconomic status, and poor communication skills

Deborah has been verbally abusive to her 6-year-old daughter and belittles her routinely. What type of maltreatment is Deborah engaging in? a) Sexual abuse b) Physical abuse c) Emotional abuse d) Neglect

c) Emotional abuse

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

c) Flashbacks

Which of the following characteristics would a nurse least likely see in an abused individual? a) Guilt b) Isolation c) High self-esteem d) Entrapment

c) High self-esteem

The nurse is counseling a trauma victim. In the second stage of trauma treatment, the nurse will plan to encourage the client to do which of the following? a) Focus on issues of identity and intimacy. b) Start antidepressant medication. c) Learn ways to feel safe again. d) Develop a support system.

c) Learn ways to feel safe again.

When health care professionals detect signs of elder abuse in clients, the law requires them to do what? a) Find temporary housing for the client. b) Educate the client and family about elder abuse. c) Report the abuse to the state authorities. d) Set up family counseling sessions.

c) Report the abuse to the state authorities.

Which type of rapist derives erotic gratification from the victim's suffering? a) Power rapist b) Premeditated rapist c) Sadistic rapist d) Anger rapist

c) Sadistic rapist

Mrs. Jacobs has been attending a local day program. Her counselor there notices that she has been coming in with bruises and scrapes and is increasingly depressed. On physical examination, Mrs. Jacobs is diagnosed with genital herpes. Which type of elder abuse do you suspect? a) Physical neglect b) Psychological abuse c) Sexual abuse d) Financial abuse

c) Sexual abuse

A nurse is caring for a 6-month-old baby in the pediatric unit. The baby has just returned from CT. The findings of the CT scan show a subdural hematoma. The baby also has bruising on the arms and legs. The nurse may conclude that this baby is suffering from what type of physical abuse? a) Sexual abuse b) Munchausen's syndrome by proxy c) Shaken baby syndrome d) Neglect

c) Shaken baby syndrome

The nurse is caring for a family in which the elderly mother has been a victim of abuse and neglect by her son age 48 years. Which of the following would be most important for the nurse to keep in mind before interviewing the family? a) Placement for the older adult woman in a nursing home within the community is crucial. b) A top nursing priority would be to legally remove the son from the home. c) The nurse must allow the older adult mother to decide if she wants to leave the situation or not. d) The main focus of the nurse's actions should be on improving the elderly mother's self-esteem.

c) The nurse must allow the older adult mother to decide if she wants to leave the situation or not.

A nurse is giving a talk about child abuse to a local community group. When discussing risk factors for child abusers, which of the following would the nurse identify as the most likely profile of the perpetrator of fatal child abuse? a) Middle-aged, wealthy businessman b) Young college graduate who recently gave birth to her first child c) Unemployed young woman who dropped out of high school d) Middle-aged woman with a college degree

c) Unemployed young woman who dropped out of high school

Three elements that are necessary to legally define rape of a male or female are ... a) Use of gun or weapon, nonconsent of victim, victim unaware of assault b) Nonconsent of victim, bruising or swelling of perineum, lack of duress c) Use of force; vaginal, oral, or anal penetration; nonconsent of victim d) Use of force, consent of victim, oral penetration

c) Use of force; vaginal, oral, or anal penetration; nonconsent of victim

What percentage of women can expect to be a victim of an ongoing unwanted pursuit from stalking? a) 50% b) 10% c) 40% d) 25%

d) 25%

Which of the following assessment findings should signal the nurse to the fact that a child may be experiencing child neglect rather than child abuse? a) A boy is brought to a clinic by his father who is nervous and unable to adequately explain how the boy broke his arm. b) A child exhibits multiple scars on his back and buttocks upon examination. c) A girl tells a social worker that she does not like it when her mother's boyfriend touches her "down there." d) A young child is admitted to hospital with hypothermia because he is inadequately dressed.

d) A young child is admitted to hospital with hypothermia because he is inadequately dressed.

Which type of elder abuse involves leaving an older adult and no longer providing care for the individual? a) Neglect b) Physical c) Emotional d) Abandonment

d) Abandonment

The school nurse is aware that a student has requested aspirin three times during the past week because his "back hurts." The nurse has noticed that he often wears long-sleeved sweaters and sweatshirts even in warm weather. The nurse suspects that the student may be the victim of physical abuse. The nurse is preparing to ask the child about his ongoing backache. Which of the following would the nurse anticipate being reported by the child if he was being abused? a) Child would give the same reason his sister would give were she asked to explain his injuries. b) Child would carefully explain that his mother disciplines him because she loves him. c) Child would explain that his father is beating him on a regular basis. d) Child would give a far-fetched explanation not logically connected to his injuries.

d) Child would give a far-fetched explanation not logically connected to his injuries.

A mental health nurse is interviewing a depressed child for suspected abuse. The mother states that the child is having disciplinary problems at school and stutters when approached. From the above behavioral indicators, the nurse would suspect which type of abuse? a) Physical b) Financial c) Sexual d) Emotional

d) Emotional

A 33-year-old woman has been treated for a periorbital hematoma and a broken nose that she suffered when her husband struck her. She does not know where he currently is, and she is scheduled for discharge. What action should the care team prioritize in this client's care? a) Educating the woman about the dynamics of domestic violence b) Ensuring that the woman knows how to change her nasal dressings c) Teaching the woman improved coping and conflict-resolution skills d) Ensuring that the woman goes to a safe place

d) Ensuring that the woman goes to a safe place

A group of nursing students is reviewing information about the types of abuse. The students demonstrate understanding of the information when they identify stalking as a crime of which of the following? a) Violence b) Jealousy c) Fear d) Intimidation

d) Intimidation

Which type of abuse includes name calling and belittling? a) Physical abuse b) Sodomy c) Sexual abuse d) Psychological abuse

d) Psychological abuse

A nurse is working on developing a safety plan with a client who is a survivor of violence. Which of the following would the nurse address first? a) Identifying a safe place to hide b) Identifying a signal to indicate it is safe to leave c) Devising an escape route d) Recognizing the signs of danger

d) Recognizing the signs of danger

The nursing student learning about intimate partner violence (IPV) correctly identifies its prevalence in same-sex couples as which of the following? a) Three times more frequent as in heterosexual couples b) Half as frequent as in heterosexual couples c) Twice as often as in heterosexual couples d) Same frequency as in heterosexual couples

d) Same frequency as in heterosexual couples

In a toddler, which injury is most likely the result of child abuse? a) A hematoma on the occipital region of the head b) A small, isolated bruise on the right lower extremity c) A 1-inch forehead laceration d) Several small, circular burns on the child's back

d) Several small, circular burns on the child's back

Which of the following is a pattern of repeated unwanted contact, attention, and harassment that often increases in frequency? a) Rape b) Incest c) Physical abuse d) Stalking

d) Stalking

A client who has experienced intimate partner violence (IPV) for many years has just been diagnosed with post-traumatic stress disorder (PTSD). The nurse realizes that this will increase the client's risk for which of the following? a) Schizophrenia b) Paraphilias c) Bipolar disorder d) Suicide

d) Suicide

Nurses who work with children should be alert for which of the following physical signs of child abuse? a) Poor appetite, hypoactivity, and listlessness b) Excessive crying, temper tantrums, and talkativeness c) Stomach aches, skin rashes, and obesity d) Unexplained cuts, bruises, burns, and scars

d) Unexplained cuts, bruises, burns, and scars

Which of the following is an inaccurate picture of the cycle of abuse that occurs over time? a) Severity of the injuries worsen b) The period of remorse disappears c) Violent episodes are more frequent d) Violent episodes are less frequent

d) Violent episodes are less frequent

If recovery from the rape does not occur, the victim may develop ... a) delirium. b) borderline personality disorder c) anxiety disorders. d) post-traumatic distress syndrome.

d) post-traumatic distress syndrome.


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