Abuse Practice Questions
A 5-year-old girl who has been physically abused is having difficulty putting her feelings into words. Which nursing intervention would best enable the child to express her feelings? Engaging in play therapy Giving the child's drawings to the abuser Role playing Reporting the abuse to a prosecutor
Engaging in play therapy The toys and dolls in a play therapy room are useful props to help the child remember situations and reexperience the feelings; acting out the experiences with toys rather than putting them into words is sometimes easier for the child. Role playing for a younger child is difficult, especially without the use of toys or dolls. Giving the drawing to the abuser can put the child in danger. It is the nurse's responsibility to report suspected child abuse to the proper agency, but the reporting does not help the child express her feelings.
The telephone hotline nurse is fielding a complex question about possible intimate partner abuse. From the description that the caller is giving, abuse seems likely. Which is the first priority of the advice nurse? Emphasizing that the caller is not to blame for the abuse Exploring the need for resources Ensuring safety from the partner's abuse Giving information about helpful services
Ensuring safety from the partner's abuse The first priority is ensuring safety from the partner's abuse. The other approaches come next: The lack of blame, the need for resources, and giving information.
The nurse is speaking with a friend who mentions having the problem of being stalked by a previous acquaintance. The nurse should consider this as which type of violence? Cyberbullying Sexual abuse Neglect Intimate partner violence
Intimate partner violence Stalking is a form of intimate partner violence. Stalking is a pattern of repeated, unwanted attention and contact that causes fear or concern for one's own safety or the safety of someone else (e.g., family member or friend). Cyberbullying is pattern of abuse that occurs online and does not include stalking. Stalking is not a form of sexual abuse or neglect.
The nurse suspects that a patient is being abused by a partner, but the patient denies that anything wrong is happening at home. Which is the best action by the nurse? Report the abuse to the authorities. Confront the abuser and explain the dangers of the individual's behavior. Provide a list of referrals in case the patient decides to leave. Notify social services of what is happening.
Provide a list of referrals in case the patient decides to leave. Ultimately, it is up to the patient whether or not to leave the partner. The nurse can provide information about community resources that can help the patient decide whether to leave, but the nurse cannot report the abuse to the authorities or social services (unless children are involved). The nurse should not confront the abuser because of the potential for escalation of the situation.
A young child is brought to the emergency department for evaluation after the parents are arrested for repeated child abuse. Which test should the nurse anticipate the provider to order for assessing old fractures? X-rays DNA swabs Urine samples Focused assessment by sonography in trauma (FAST)
X-rays X-rays can help the provider visualize and locate new and old bone fractures. DNA swabs and urine samples are usually ordered after a sexual assault to help identify the abuser or identify a bladder infection. The FAST test looks for internal bleeding.
The nurse is teaching a group of teachers about signs of sexual abuse to watch for in students. Which sign should the nurse include? Hyperactivity Isolation from peers Stuttering Impulsive behaviors
Isolation from peers Behavioral symptoms of children who have been sexually abused include a lack of peer friendship or isolation from other peers. Impulsivity, hyperactivity, stuttering, and leadership traits are not manifestations of sexual abuse.
The nurse is conducting a lecture about abuse for high school students. Which statement should the nurse include? "Abuse is caused by a need for power and control." "Humiliation and physical injury are unusual components in abusive behaviors." "It is rare for physical abuse to begin as emotional abuse." "Psychologic abuse never occurs with sexual abuse."
"Abuse is caused by a need for power and control." Abuse is often related to control and power, with one individual attempting to control another. Humiliation and physical injuries are quite common characteristics of physical, emotional, and sexual abuse. The different types of abuse often overlap: Both physical and sexual abuse can begin as emotional abuse.
The nurse is speaking with a woman who has a long history of physical abuse by her spouse. The patient does not want to leave her partner at this time, and the nurse initiates teaching of a safety plan. Which patient statement indicates a need for further learning? "I will teach my children how to dial 911." "I should know the easiest escape route from all rooms in my house." "I should keep my wallet and keys hidden so that he can't find them." "I should give my spouse what he wants to diffuse the situation."
"I should keep my wallet and keys hidden so that he can't find them." Part of a safety plan involves keeping the patient's wallet, purse, or keys in an easily accessible place at all times in case of the need to leave quickly and unexpectedly. The woman should teach her children how to dial 911. The patient should also be able to describe the easiest escape route from all rooms in the house. If a situation were to become serious, the woman should be advised to give the spouse what he wants in an attempt to diffuse the situation.
The nurse is caring for a pregnant patient who repeatedly presents to the clinic with multiple bruises. When asked, the patient states that she can deal with what is happening and that her spouse would never hit the baby, even though he didn't want them to have the baby. Which response by the nurse is best? "Most abusers never hit their children or infants." "Infants that are born out of an unwanted pregnancy are at higher risk for abuse or trauma." "Social services can take the baby away after birth if you stay with him." "Men, even abusers, fall in love with and want to protect their babies after they are born."
"Infants that are born out of an unwanted pregnancy are at higher risk for abuse or trauma." Infants are especially prone to neglect or abuse, especially if the pregnancy wasn't wanted. It is not likely that social services will immediately remove the baby from the house at birth unless there is reason to believe that the baby is in immediate danger. It is incorrect that infants are likely to be protected by the abusive parent after birth.
The nurse is talking with a patient who just had a beautiful potted flower delivered. Suddenly, the patient starts to cry and stares out the window. The patient has a prior history of abuse by an ex-spouse. Which intervention should the nurse include in the plan of care for this patient? Give the patient some time and return later. Tell the patient to enjoy the flowers and that the patient will feel better in a little while. Assess if the patient is having a flashback of previous abuse. Tell the patient that the abuse was in the past.
Assess if the patient is having a flashback of previous abuse. Patients who have experienced trauma such as interpersonal or intimate partner violence may experience flashbacks. The flowers may trigger flashbacks for this patient. The nurse needs to assess if the patient is having a flashback and stay with the patient to help the patient cope during the flashback. Leaving the patient alone while having a flashback of previous events is not therapeutic because the patient may be experiencing a feeling of being in danger. Telling the patient that the abuse was in the past does not acknowledge the patient's past experience with abuse. It also does not allow the patient to express feelings about the past events that have occurred.
A middle-aged woman who has been physically and financially abused by her son tells the nurse, "I am not pressing charges against my son because I am afraid that he will put me out on the street, and I will have no place to go." Which should be the priority nursing intervention for this patient? Assess the patient's safety and help her develop a safety plan. Support the patient's wishes to not press charges due to fear. Encourage the patient to move out of her son's home to avoid future encounters with him. Instruct the patient not to worry about her son because she is in the hospital, so her son will not do it again.
Assess the patient's safety and help her develop a safety plan. The patient may be at risk for future attacks because she is being abused by someone with whom she lives. The nurse needs to make a thorough assessment of the patient's safety and assist the patient in developing a safety plan in the event the son abuses the patient again. Having the patient move out may not be an option because the patient may have nowhere else to live. Even though the patient is in the hospital, the patient is still in danger. Supporting the patient's wishes to not press charges due to fear is not a therapeutic intervention.
The nurse is counseling a man who confesses to pushing his wife when he gets really mad. The patient asks the nurse what he can do to help control his temper. Which is the best advice by the nurse? Avoid using drugs or alcohol. Switch to a low-carbohydrate diet. Begin an intense weight-training regimen. Reconnect with his estranged father, who was also abusive.
Avoid using drugs or alcohol. Although alcohol and drug use don't cause violent behavior, their use can increase the risk of it occurring. It can also contribute to aggressive behavior, which can lead to abuse. A low-carbohydrate diet is not associated with decreased aggression. Intense exercise can increase testosterone levels, which can increase aggression. Reconnecting with an estranged abusive parent is not likely to reduce anger or aggression.
The nurse is assessing a pediatric patient in the clinic during a well-child visit. Which manifestation should prompt the nurse to ensure the child's safety at home? Bruises in different stages of healing Cupping Coining A soft-spoken and shy demeanor
Bruises in different stages of healing The first priority for a nurse dealing with a child victim of violence is to ensure the safety of the child. The nurse should follow institution policy about reporting suspected abuse. Cupping is the act of placing a glass cup on the skin and then using heat to create suction; often this is performed to promote blood flow and overall healing. Coin rubbing is used to treat a multitude of ailments, from headaches and fevers to minor illnesses, but it also leaves marks on the skin. Neither of these treatments is abusive in nature; they are considered a form of healing. Being soft-spoken and shy alone does not indicate abuse because this may be the child's natural personality. The accompanying image shows bruises in multiple stages of healing, a finding that prompts the nurse to ensure the child's safety at home.
A young woman presents to the emergency department and informs the nurse of being raped by her date this evening. Which test should the nurse anticipate the healthcare provider to order? Computerized tomography (CT) scan DNA swabs Pregnancy test Chest x-ray
DNA swabs DNA swabs are essential whenever someone is sexually assaulted because they can help to identify the attacker. It is too early to take a pregnancy test; a woman will not test positive if she conceived as a result of this rape. A CT scan or chest x-ray is not relevant after a sexual assault unless there are internal injuries resulting from the attack.
The nurse is caring for the parents of a young child who was beaten up at school by another student. The healthcare provider orders the focused assessment by sonography in trauma (FAST) test. Which purpose should the nurse expect this test to fulfill? Assessing level of consciousness Measuring response to pain Finding blood in body cavities Screening for antibodies
Finding blood in body cavities The purpose of a FAST test is to find blood in body cavities. It is not concerned with level of consciousness, pain, or antibodies.
The nurse is caring for a patient who experienced a deep laceration to the arm as the result of an assault. The patient is resting comfortably and is denying any pain but will need sutures to close the wound. Which pharmacologic therapy should the nurse anticipate for this patient prior to suturing? Opioid Nonsteroidal anti-inflammatory drug (NSAID) Antibiotic Local anesthetic
Local anesthetic The nurse would anticipate that the patient would require a local anesthetic, such as lidocaine, prior to the suturing that will be required to close the wound. The patient is not complaining of intense pain; therefore, an opioid would not be anticipated. The patient may be sent home with prescriptions for ibuprofen for pain and/or an antibiotic to prevent infection, but these medications are not required prior to suturing.
The nurse orienting to the emergency department is caring for a patient who presents with a right clavicular fracture. Which nursing intervention by the orienting nurse requires immediate correction from the preceptor? Offering resources and assistance Documenting the description and location of any injuries Initiating a thorough physical and emotional assessment Mediating a discussion between the victim and the abuser
Mediating a discussion between the victim and the abuser Nursing interventions for intimate partner violence include initiating a thorough physical and emotional assessment; offering resources and assistance; and documenting the description and location of any bruising, burns, scars, and other physical injuries or abnormalities. Nursing interventions for intimate partner violence do not include mediating a discussion between the victim and the abuser
The nurse is planning to initiate a new type of support group for young children who have been the victims of abuse and neglect. Which type of activity should the nurse plan? Cognitive therapy Playground time Self-defense training Play therapy
Play therapy Play therapy is most appropriate for young children who are recovering from a trauma like abuse. It can also help them process what happened to them. Cognitive therapy and self-defense training aren't age-appropriate, and playground time, although fun, does not help a child to process trauma.
A woman wishes to take the children and leave her abusive husband. The patient has no family nearby and asks the nurse for help in finding somewhere to go. Which is the best referral by the nurse? Referral to a nearby motel Referral to a domestic violence shelter that cares for women and children Referral to the police to have the husband removed from the house Referral to the local community center
Referral to a domestic violence shelter that cares for women and children Domestic violence shelters offer a range of services, not just a safe place to sleep. Many offer referrals to attorneys and education and training services. A nearby motel can be expensive and is likely not sustainable long-term, making it not the best option. The police may not be able to remove the spouse from the home without a court order or as a long-term solution, so this is not the best option for the patient. A local community center does not provide housing options.
An alert and oriented older adult patient is receiving home care services following a cerebrovascular accident that has left the patient with right-sided hemiparesis. The patient lives with a family member. The nurse suspects that the patient is being neglected after observing that the patient's hair and clothes are dirty and that the patient smells of urine. Which intervention would be a priority for this patient? Report the neglect to the appropriate agency. Wait until enough trust has been developed to enable the patient to approach the nurse first. Confront the family member with the suspicions. Interview the family member to gain the family member's perspective on the situation.
Report the neglect to the appropriate agency. Reporting the abuse to the appropriate agency, according to the requirements of state law, is a nonpharmacologic treatment of older adult abuse and takes priority in this case. Developing trust is also important, but it does not take priority in this case. The nurse should not confront the family member but should report the suspected neglect to the proper authorities and allow them to investigate the situation. The nurse caring for a patient who is a victim of abuse needs to focus on interventions that include establishing a therapeutic relationship, encouraging and facilitating communication, and promoting empowerment.
The nurse is giving a presentation to middle school children about cyberbullying and the potential dangers associated with online abuse. Which manifestation should the nurse include as a potential complication? Sexual assault Suicide Financial loss Bullying of younger siblings
Suicide Cyberbullying has been known to cause anxiety, depression, and even suicide. It is not, however, associated with sexual assault, financial loss, or victims bullying their younger siblings.
The nurse is assessing a 9-year-old child whose teacher suspects that the child is a victim of abuse. The physical assessment reveals no unexplained or untreated injuries, and the child does not appear to be malnourished or dehydrated. Which clinical manifestation should indicate to the nurse that this child might be a victim of abuse? The child reports disliking doctor visits. The child still wets the bed on some nights. The child has a bandage over a scrape on the left knee. The child has multiple cavities that have been filled.
The child still wets the bed on some nights. Bedwetting in a 9-year-old is not a normal behavior and can indicate that abuse is present in the home. An aversion to going to the doctor would not be considered an indication of abuse. Young children fall and injure themselves frequently, so the bandage over a scrape on the child's knee is a normal finding and indicates the child is being cared for. Dental fillings that have been treated also indicate that the child is getting appropriate dental and medical care.
A community nurse is caring for a young man who reports having an abusive spouse. The nurse is performing teaching to promote safety for this patient. Which outcome would indicate effective teaching? The patient promises to control his temper to avoid getting into a fight. The patient states that he is no longer afraid of his partner. The patient creates a safety plan. The patient begins to write in a journal.
The patient creates a safety plan. Creating a safety plan indicates that the young man understood the teaching and took the appropriate steps. The patient also needs to understand that the abuse is not his fault (no matter how angry he gets). Not being able to communicate fears about the abuse may mean that the patient is in denial about what is happening. Journaling can be a helpful way to cope, but it does not help the patient stay safe.
The school nurse is assessing a third-grade child for symptoms of sexual abuse. Which behavioral manifestations support this concern? Stuttering, impulsivity, and being the team leader when playing games with peers Enuresis, impulsivity, and decline in school performance Hyperactivity, stuttering, and isolating self from peers on the playground Thumb-sucking, isolating self from peers on playground, and excessive fear of strangers
Thumb-sucking, isolating self from peers on playground, and excessive fear of strangers Behavioral symptoms of children who have been sexually abused include regression (thumb-sucking would be regressive behavior in a third-grade child, who is 8-9 years of age), clinging behaviors, lack of peer friendship, and crying out or showing fear when approached by strangers. Impulsivity, hyperactivity, stuttering, and leadership traits are not manifestations of abuse.
The nurse specializes in caring for victims of domestic violence and abuse and believes in the tenets of social learning theory. Which statement reflects this theory? Some families, cultures, and communities value the subordination of women through power and privilege. The cause of violence lies in the personality of the individual who commits abuse. The tendency to abuse, neglect, and become violent toward others is a result of genetic considerations and distortion in neurotransmitters. Violence related to abuse and neglect is a learned behavior.
Violence related to abuse and neglect is a learned behavior. Social learning theory suggests that violence related to abuse and neglect is a learned behavior. Violent individuals are conditioned to respond aggressively and violently. Neurobiological theory suggests that the tendency to abuse, neglect, and become violent toward others is a result of genetic considerations and distortion in neurotransmitters. Interpersonal theory suggests that the cause of violence lies in the personality of the individual who commits abuse; the perpetrator uses violence as a display of anger. Gender-bias theory proposes that some families, cultures, and communities value the subordination of women through power and privilege.
