Emotional, Physical, Sexual, and Financial Abuse

Which statement made by an abuse victim during the nursing assessment requires immediate nursing intervention?

"I am so angry about the abuse that I would love to see my partner really suffer." Homicidal ideation, regardless of how serious, requires immediate intervention by the nurse to maintain the safety of the patient and others involved in the abuse.

The nurse continues to assess Mr. Blumberg about his physical abuse. Which statement made by the nurse best demonstrates empathy and caring?

"I am sorry this happened to you. The treatment team and I are here to help you."

The nurse teaches Mr. Blumberg to develop a safety plan in the event that his wife attacks him again. Mr. Blumberg demonstrates understanding of the nurse's teaching when he makes which statement?

"I need to put aside some money so I can take a cab to a hotel and stay there if this happens again."

The health care team has developed a plan of care for an 18-year-old woman who has been raped. Which statement made by the patient indicates that she understands the long-term effects the rape may have?

"I think I will worry more now than I used to." Anxiety can be a long-term effect of rape.

Ms. Harris is admitted to the hospital with a diagnosis of pneumonia. Which statement made by Ms. Harris during the nursing assessment would alert the nurse to possible financial abuse?

"I used to weigh more but since Henry has been doing the cooking, he makes only two small meals a day for me."

The interdisciplinary team meets with the mother of a sexually abused child to discuss the child's plan of care. Which statement made by the mother indicates that she understands the plan of care?

"I will always encourage my child to come to me with any concerns."

A young woman presents to the emergency department after being raped in the parking lot of a dance club the night before. The woman is upset and crying. How should the nurse first respond to the patient?

"I'll stay with you." Staying with the patient promotes safety and comfort. Safety is the nurse's first priority when caring for a rape victim.

Which are examples of predatory individuals who inflict financial abuse on the older adult?

A non-licensed professional who poses as a nurse to gain access to the older adult's home. A person who uses the obituary announcements to locate and connect with recent widows.

Match the stage of the cycle of violence with its characteristic.

Abuser verbally berates victim Tension-building stage Abuser repeatedly punches victim Acute battering stage Abuser apologizes to victim Honeymoon stage

Match the family member with the behavioral effect associated with abuse.

Antisocial behavior=Child Violent behavior=Adolescent Impulsive behavior = Adult

A 6-year-old who has been sexually abused by a next-door neighbor is brought to the emergency department by a grandfather. After building rapport with the child, which assessment question should the nurse ask the child in order to gather more information?

Can you tell me who you were visiting next door? This question is appropriate for the child's developmental level and allows the child to focus on one aspect of the event.

An adolescent who has been abused since childhood says to the nurse during the assessment, "I feel I have let everyone down." Which nursing diagnosis is most appropriate for this patient?

Chronic low self-esteem The patient's statement to the nurse is an indicator that the patient, who has suffered long-term abuse, has chronic low self-esteem. Feeling like a failure is common to those with low self-esteem.

Where on the body should a nurse focus when assessing for signs of possible physical abuse?

Face The face is a common site where the victim is slapped or hit. Head The head is a common site where the victim is punched, hit, or slammed. Arms Arms are a common site of physical abuse because the abuser typically grabs for the victim's arms to restrain the victim.

The nurse is assessing a young woman who has been raped. Which statement made by the nurse is most appropriate when considering care priorities?

I see that you have an open cut on your head. I'm going to get that cleaned up for you." Addressing the patient's physical need is the first priority to prevent infection and possible scarring.

A mother and child report being abused by the male head of household. The mother tells the nurse that she plans to return to the abusive home with her child. Which nursing diagnosis most accurately reflects the compromised safety of the child?

Impaired parenting The mother is exhibiting impaired parenting by returning her child to an unsafe environment.

Which are examples of emotional abuse that can have a negative effect on the abused patient?

Isolating Withholding affection

A rape victim meets with the interdisciplinary team 6 months after the rape. Which statement made by the patient indicates that she is showing signs of recovery?

My boyfriend and I are having sex again." Displaying pre-rape sexual functioning is a sign of recovery.

Which are examples of financial abuse?

Not paying the victim's bills Not paying the victim's bills, such as water and electricity, is an example of financial abuse. Preventing the victim from working Preventing the victim from working or making money is a form of financial abuse. Limiting the victim's access to assets Limiting the victim's access to assets and concealing financial information from the victim are examples of financial abuse.

The nurse develops Ms. Harris's plan of care. Which short-term goal is most appropriate for Ms. Harris?

Patient will verbalize contact information for legal assistance in removing abuser from victim's home.

Which long-term effect of abuse can be seen in abused children?

Phobias Phobias are a long-term effect of abuse seen in abused children.

The nurse is caring for a woman who was sexually assaulted by her prom date. The patient is experiencing a range of symptoms including anxiety and self-blame. Which nursing diagnosis ensures the most comprehensive plan of care for this patient?

Rape-trauma syndrome The diagnosis of rape-trauma syndrome encompasses most of the feelings and problems the patient is experiencing.

The nurse is reviewing a sexually abused child's assessment data to help formulate nursing diagnoses for the care plan. Which nursing diagnosis is the priority for this child?

Risk for injury related to sexual abuse

During which stage of the cycle of violence does the abuser use alcohol or drugs?

Tension-building stage The abuser may use alcohol or drugs during the tension-building stage in an attempt to reduce tension.

Which behavior would the nurse expect to see in an 8-year-old child who has been recently sexually abused?

The child complains of a headache.A headache is a physical symptom of sexual abuse. The child fidgets and squirms and asks to leave.Hyperactivity is a physical symptom of sexual abuse. The child asks to go to the bathroom several times.Genitourinary distress is a physical symptom of sexual abuse, and the child has asked to go the bathroom several times, which may be a sign of genitourinary distress.

The interdisciplinary team is evaluating an older adult who has been financially abused. Which factor causes the team to re-evaluate the effectiveness of the care plan?

The patient refuses to discuss the details of the abuse.

The nurse assigns the nursing diagnosis ineffective coping to an abuse victim. Which nursing outcome is most appropriate for this diagnosis?

The patient verbalizes two strategies to manage conflict appropriately.

Sexual abuse can affect which developing characteristics in a child? Select all that apply.

Values A child who is sexually abused may experience a change in values and beliefs such as believing the family home is a safe place. Attitudes A child who is sexually abused may exhibit a change in attitude, particularly regarding the ability to trust adults. Personality Sexual abuse can affect the formation of the child's personality. The child can become introverted, sullen, and irritable.

The nurse educates the adult children of an independent older man who has been the target of a financial scam. Which statement made by the children indicates understanding of the teaching?

We are going to take training classes to learn how to better protect our father."

The nurse is assessing a child who has been sexually assaulted. Which question is most appropriate to ask at the beginning of the assessment interview to encourage communication with the child?

Would you like to have your mommy here with you?" Asking the child if he or she would like a caregiver present during the interview is important because it puts the child at ease and facilitates the interview process.