Class 27 and 28

Which of the following are myths surrounding rape? (select all that apply): A. Women are usually raped by a stranger. B. Women do not "ask" to be raped by their behavior or dress. C. Most rapes occur away from home areas such as alleys and behind buildings. D. Documented rape cases include women from 8 to 70 years old. E. Rape is an expression of aggression and anger. F. Rape is usually an impulsive, spur-of-the-moment decision by the rapist. G. Unless the assailant is armed, most women should be able to get away and avoid the rape.

A, C, D, F, G. These are all myths regarding rape. The other options are true.

During the immediate post-rape period what verbal nursing intervention would best lower client anxiety and increase feelings of safety? A. "You are safe here. I will stay with you while you have your examination." B. "I know you feel confused. We will make all the necessary decisions for you." C. "Please tell me as much about the details of the rape as you can remember." D. "When you leave you will be given follow-up appointments for pregnancy and sexually transmitted disease screening."

A. "You are safe here. I will stay with you while you have your examination." The presence of the nurse is reassuring, especially when the client is experiencing disorganization and the environment is confusing.

What reaction is most commonly displayed by rape victims in the immediate aftermath of the rape? A. Disorganization B. Philosophical acceptance C. Total withdrawal from reality D. Display of seductive actions

A. Disorganization The acute phase of rape trauma syndrome occurs immediately after the assault and may last for a few weeks. This stage is seen by emergency department personnel. Nurses are the ones most involved in dealing with these initial reactions. During this phase, a great deal of disorganization is common in the person's lifestyle and somatic symptoms.

Which statistic concerning rape is true? A. Most male rape victims do not report the crime. B. Male rape is perpetrated by homosexual men. C. The peak incidence of rape occurs in the 25 to 29 age group. D. Most rapes occur after abductions.

A. Most male rape victims do not report the crime. Option A is the only true statement.

Rape is best described as A. an act of violence using sex as the weapon. B. assault by a stranger on an unsuspecting victim. C. sexual desire satisfied inappropriately. D. an act prompted by early childhood neglect.

A. an act of violence using sex as the weapon. Rape is a violent crime. Sex is only the medium for perpetrating the crime.

The emergency department nurse planning care for a rape victim must realize that the emotional reaction displayed by many rape victims during the initial assessment and treatment is A. fear. B. eagerness. C. suspicion. D. disinterest.

A. fear. Rape is an act of violence, and sex is the weapon used by the perpetrator. Rape engulfs its victims in fear and anxiety, resulting in withdrawal for some and causing severe panic reactions in others. After being traumatized, the person who has been raped often carries an additional burden of shame, guilt, fear, anger, distrust, and embarrassment.

Which statement would be an appropriate long-term outcome for a rape client? The client will A. integrate the rape event and resume an optimal level of functioning. B. identify and develop coping skills necessary to reduce level of anxiety. C. blame the rapist rather than blame herself for the situation. D. repress feelings of shame, embarrassment, and self-blame.

A. integrate the rape event and resume an optimal level of functioning. This is the ideal long-term result of treatment for rape trauma syndrome, that life will go on and the client will return to the usual pre-trauma level of functioning.

Care planning for the rape victim is facilitated if the nurse understands that rape trauma syndrome is actually a variant of A. posttraumatic stress disorder. B. a maturational crisis. C. a dissociative disorder. D. generalized anxiety disorder.

A. posttraumatic stress disorder. Most of those who have been raped are eventually able to resume their previous lives after supportive services and crisis counseling. However, many carry with them a constant emotional trauma: flashbacks, nightmares, fear, phobias, and other symptoms associated with posttraumatic stress disorder.

To provide discharge treatment and support, the nurse should realize that the most common sequela(e) of acquaintance rape is the development of A. symptoms of sexual distress. B. anxiety and fear of men. C. a paranoid psychosis. D. an eating disorder.

A. symptoms of sexual distress. Women who have been raped by acquaintances frequently develop symptoms that prevent them from participating in normal sexual relations. Sexual distress is more common among women who have been sexually assaulted by intimates; fear and anxiety are more common in those assaulted by strangers. Depression occurs in both groups.

Three weeks after a client was raped she tells the nurse, "I am going crazy. I have nightmares and wake up screaming. Then during the day all sorts of thoughts about the rape intrude into whatever I am concentrating on. I can't get anything done at work." The nurse should reply A. "Becoming mentally ill is a frightening thought for you?" B. "These are a normal response to stress and will decrease with time and therapy." C. "You are right to be concerned. I can give you a referral for treatment." D. "Would it help if you took some time off from work and stayed home?"

B. "These are a normal response to stress and will decrease with time and therapy." These symptoms are part of the response to rape trauma and parallel symptoms experienced by other victims of post-traumatic stress disorder.

When a client tells the nurse she was raped by her date several weeks ago, the most likely reason for taking so long to report the incidence is her A. embarrassment about having a physical examination. B. feelings of guilt for somehow having caused it. C. initial fear that no one would believe her. D. worry over contracting a sexually transmitted disease.

B. feelings of guilt for somehow having caused it. Many rape victims feel that they are somehow at fault for the rape and harbor feelings of guilt. This guilt stands in the way of reporting the rape to the authorities.

A sexual assault victim asks to be given "the morning-after pill" to prevent conception. The nurse does not believe in abortion. The action the nurse should take is to A. refer the woman for social services counseling. B. report and document the request. C. ask the supervising nurse to reassign the client. D. ask the client to reevaluate her request after 24 hours.

B. report and document the request. The nurse's ethical beliefs should never interfere with client rights. The nurse should report and document the client's request. If the drug is ordered, however, the nurse can request that another nurse administer the drug.

The nurse is meeting with a woman who was raped the previous week. The nurse's client education plan includes talking about the possibility of experiencing intrusive thoughts, increased motor activity, and fears and phobias in the next few weeks. The reason for this intervention is A. to help the client redevelop a sense of control over herself. B. that anticipatory guidance allows planning to decrease stress. C. that talking about feelings reduces their intensity. D. that self-destructive behaviors develop out of negative feelings.

B. that anticipatory guidance allows planning to decrease stress. Anticipatory guidance helps the client understand what to expect. When the expected occurs it is not as great a shock. Knowing what to expect also allows the client to plan for ways to cope.

Nicole is a 28-year-old married patient who comes to the emergency department after being raped on her way home from work. You have been with her as she cries and talks about what happened. She asks you, "What if I am pregnant?" Your response is guided by the knowledge that: A. the risk of pregnancy after rape is high, up to 50%. B. the risk of pregnancy after rape is high, up to 50%. C. reproductive functions shut down during a violent attack, and as a result pregnancy does not occur. D. Nicole may be worried about how her spouse will accept the baby.

B. the risk of pregnancy after rape is high, up to 50%. About 5% of women who are raped become pregnant as a result (Rape, Abuse & Incest National Network, 2008). Pregnancy prophylaxis can be offered in the emergency department after the results of the pregnancy test are available. The risk of pregnancy is not high after rape. Reproductive functions do not shut down during a violent attack. The patient may be worried about her spouse's reaction; however at this time most important consideration is to give the patient pertinent education regarding rape and pregnancy.

It has been 6 months since Nicole was raped, and she has undergone counseling. Which statement by Nicole would indicate that an important outcome has been met? A. "I keep having nightmares about the rape and I can't sleep at night." B. "My husband has been very supportive during this whole thing." C. "I am not going to let that rapist be in control of my life. I know things will keep getting better." D. "I am not pressing charges because I want this whole thing to be over with so I can move on."

C. "I am not going to let that rapist be in control of my life. I know things will keep getting better." This option expresses empowerment and hope for the future. Long-term outcome includes the absence of any residual symptoms after the trauma and would be indicated by healing of physical injuries, relief of anger in nondestructive ways, comfort in relationships, and feelings of empowerment and expression of hope. Having nightmares and not sleeping indicates that the patient is still going through acute stress related to the rape. The fact that the husband is supportive is a positive statement regarding her husband but doesn't express her own indicators of recovery. Not pressing charges may indicate that the patient may not be dealing with the event in a healthy way by avoiding the trauma.

When the nurse finishes addressing a group of college women about rape, the following comments are heard during the discussion period. Which comment calls for additional teaching by the nurse? A. "It makes sense that rape is a crime of violence, not a crime of sex." B. "Who would have guessed that most rape victims know the rapist?" C. "So if you dress conservatively, your risk of being raped is small." D. "I always thought rapes happened at night, but now I know that isn't true."

C. "So if you dress conservatively, your risk of being raped is small." Rapes have little to do with whether the victim dresses seductively because rape is a crime of violence rather than a crime of sex.

Which statement reflects a truth about rape? A. Some women want to be raped. B. Rapists are oversexed. C. Most rapes are planned. D. Most women are raped by strangers.

C. Most rapes are planned. Many myths about rape exist. Most rapes are not impulsive, spur-of-the-moment acts, but are carefully planned and orchestrated.

Nicole alternates between sobbing and being quiet and withdrawn. Which of the following illustrates best practice in giving care to a patient who has just been sexually assaulted? A. Sympathetic: "I'm so sorry for what you have been through." B. Reassuring: "Don't worry. It's hard now, but everything will be alright." C. Supportive: "I am going to stay with you. We can talk as long as you want to." D. Assertive: "Let's talk about new coping skills you can use."

C. Supportive: "I am going to stay with you. We can talk as long as you want to." The most effective approach for counseling in the emergency department or crisis center is to provide nonjudgmental care and optimal emotional support. Sympathy is not a therapeutic response and does not focus on the patient. Telling the patient not to worry is false reassurance. It is too soon to try to learn new coping skills because the patient is in an acute stress phase.

A rape victim in the emergency department keeps repeating, "I don't know why he did it." Although the nurse does not necessarily give the answer at this juncture, the nurse correctly identifies the motivation for most perpetrators of rape as A. anxiety relief. B. an overwhelming sexual desire. C. a desire to dominate and humiliate. D. a wish to be apprehended and punished.

C. a desire to dominate and humiliate. Power and domination, as well as humiliation of the victim, are the motivations for rape. In this scenario the nurse understands that rape is not a sexual act. Rape is a violent expression of aggression, anger, and the need for power.

A client who comes to the emergency department states she has just been raped. She displays a blank face and a rather calm appearance. During the assessment interview she seems unable to believe the event really happened. The nurse can assess this behavior as the client demonstrating a(an) A. defense mechanism that involves lying about the rape. B. behavioral reaction to the rape. C. emotional affective response to the rape. D. somatic reaction to stress from the rape.

C. emotional affective response to the rape. Emotional/Affective responses to rape can include fear of separation, abandonment, and for personal safety; anger or outrage; helplessness, hopelessness, or powerlessness; sadness or grief; denial, disbelief, or numbness; and guilt and distrust.

The nurse responding to the hotline call of a rape victim advises her to go to the nearest emergency department for treatment. When the woman states, "I'll think it over while I take a shower," the nurse A. questions her regarding the circumstances of the rape. B. advises her not to take too long before seeking treatment. C. explains that doing so could destroy evidence. D. asks if she may call a police woman to accompany her to the hospital.

C. explains that doing so could destroy evidence. Showering, washing, and changing clothes will destroy evidence such as semen and hairs shed from the perpetrator's body. Victims should be advised regarding what to do to preserve evidence.

In the acute phase of rape trauma syndrome, nursing interventions should focus on A. teaching stress management techniques to the client. B. helping the client's family clarify feelings. C. providing client support and safety. D. ensuring case management.

C. providing client support and safety. Helping the client feel safe and giving emotional support are two important interventions to combat the disorganization common during the acute phase of rape trauma syndrome.

It has now been 1 year since Nicole's rape. Which of the following statements by Nicole would indicate that she has recovered from the trauma? A. "I don't walk home anymore because I am terrified it may happen again." B. "I am sleeping better but still only get about 5 hours of sleep at night because of bad dreams about the rape." C. "I realize that I was partly to blame for the rape because of walking in an unsafe neighborhood." D. "My husband and I are having sex again and I enjoy it.

D. "My husband and I are having sex again and I enjoy it. Sexual assault survivors are considered to be recovered if they are relatively free of any signs or symptoms of acute stress disorder and posttraumatic stress disorder. Signs of recovery include sleeping well with few instances of nightmares or dreams, being only mildly fearful, positive self-regard, and returning to prerape sexual functioning and interest. The closer the survivor's lifestyle is to how it was before the rape, the more complete the recovery has been. Not walking home because of being terrified indicates a high level of fear. Only sleeping 5 hours at night indicates sleeping is still seriously disturbed. Stating that she is partly to blame indicates that the patient is placing the blame for the rape on herself instead of the perpetrator.

A sexual assault victim tells the nurse, "I should have tried to fight him off! But I was so terrified that I could not move. I should have tried harder." A supportive response for the nurse to make would be A. "Try not to think about it. Put it out of your mind." B. "We each behave in characteristic ways in a crisis. That was your way." C. "Do you think others will think badly of you for not trying to fight?" D. "The way you behaved was the right thing to do at the time."

D. "The way you behaved was the right thing to do at the time." The victim should always be told that staying alive was the priority and that whatever she did to that end was the right thing to do.

Anticipatory teaching of a rape victim should include information that a common survivor problem that often develops during the long-term reorganization phase of rape trauma syndrome is A. denial of the event. B. headaches and fatigue. C. shock and numbness. D. intrusive thoughts.

D. intrusive thoughts. Just as in posttraumatic stress disorder, intrusive thoughts haunt the rape victim in the weeks and months during which long-term reorganization is occurring. Knowing that this is a common occurrence is reassuring to the client, who often is frightened by the symptom.

Which statement made by a parent of a child diagnosed with Tourette's syndrome would be assessed as a risk factor for family violence? a. "My husband lost his job, and it seems all our savings are going to pay for our son's expensive medication and all the other things he needs." b. "Our son is really a good little boy, but he needs to be disciplined both at home and in school." c. "We shouldn't be, but we are ashamed of our son's disorder and his inability to control the tics in public." d. "We have become active in the support group but still find the suggestions extremely difficult to put into practice."

a. "My husband lost his job, and it seems all our savings are going to pay for our son's expensive medication and all the other things he needs." Job loss, financial problems, and a child who is "different" and has special needs should alert the nurse to the risk for family violence, because all these factors contribute to a crisis situation.

Which factor is of least importance as a victim of spousal abuse constructs an escape plan? a. How the victim will explain her decision to leave b. Where the victim will go to be safe c. How the victim will arrange for transportation d. What the victim will need to take with her when she leaves

a. How the victim will explain her decision to leave Any abused person has been threatened. This is a given and does not enter into the details of the escape planning.

A battered woman has been referred to a women's shelter. When the woman's abuser demands to be told where she is, the nurse a. refuses to provide any information. b. gives him the telephone number, but not the address, of the shelter. c. informs him that no information can be given for a minimum of 24 hours. d. calls law enforcement to arrest the husband for the assault and battery of his wife.

a. refuses to provide any information. The nurse must respect the client's right to confidentiality. Whether the questioner asks pleadingly or in a demanding way, the answer must be the same.

The risk of elder abuse in a home is best determined by assessing a. the vulnerability of the elder and the stress of the caregiver. b. the amount of disruption the elder causes in the home. c. how much actual physical assistance the elder needs on a daily basis. d. the financial contribution of the elder and the caregiver's early life experience with abuse.

a. the vulnerability of the elder and the stress of the caregiver. Abuse occurs across all segments of society and is reinforced by the society and the culture. The actual occurrence of violence requires (1) a perpetrator, (2) someone who by age or situation is vulnerable (e.g., children, women, men, the elderly, mentally ill persons, and physically challenged persons), and (3) a crisis situation.

Nurses working in emergency departments and walk-in clinics should be aware that some victims of violence may present: a. with vague physical complaints such as insomnia or pain. b. with extreme anger and unpredictable behavior. c. with many family members there to support them. d. with psychosis and/or mania as a result of long-term abuse.

a. with vague physical complaints such as insomnia or pain. Patients may present with symptoms that may be vague and can include chronic pain, insomnia, hyperventilation, or gynecological problems. Attention to the interview process and setting is important to facilitate accurate assessment of physical and behavioral indicators of family violence. Presenting with extreme anger is possible but not as common as presenting with vague physical complaints. Having many family members there is unlikely as many victims keep their history of being battered a secret. It is not known that psychosis or mania is a result of physical violence, and this would not be a usual presenting complaint.

Lauren brings her 4-year-old daughter, Mikayla, to the emergency department and states that Mikayla has been "acting funny." Lauren states, "She touches her vagina and rubs herself down there all the time and she never did that before. She drew me a picture showing two people with one on top of the other and said they were 'doing sex' and I saw her acting that out with her dolls too. I didn't know where else to go." Based on Lauren's description, you suspect that: a. this is normal developmental behavior in a 4-year-old child. b. Mikayla has been sexually abused. c. Lauren needs education in parenting skills. d. Mikayla has been exposed to graphic sexual images on television.

b. Mikayla has been sexually abused. Sexualized behavior is one of the most common symptoms of sexual abuse in children. Younger children may draw sexually explicit images, demonstrate sexual aggression, or act out sexual interactions in play, for example, with dolls. Masturbation may be excessive in sexually abused children. It is not normal developmental behavior for a 4-year-old child. The other options may be true, but sexual abuse is more likely and must be investigated.

A nursing intervention directed at the psychological needs of an abused woman is to a. encourage the client to immediately leave the abuser. b. affirm that the client did not deserve or cause the abuse. c. provide a referral to social services for economic problems. d. facilitate contact with law enforcement to take legal action.

b. affirm that the client did not deserve or cause the abuse. Abused clients often believe that they are deserving of the abuse and, in some way, prompt the abuser to attack. They need specific reassurance that they did not deserve to be abused and they did not cause the attack.

When the nurse believes the cycle of abuse is escalating and that a woman may be in severe physical danger, the priority nursing intervention is to a. advise her to enter counseling at the mental health center. b. assist her to develop a plan to go to a shelter in case of a crisis. c. suggest she leave the abuser and go to a trusted friend's home. d. teach her to counter verbal abuse with assertive replies.

b. assist her to develop a plan to go to a shelter in case of a crisis. Every victim of abuse should have an escape plan, but one is particularly important when the nurse believes the client is in severe danger.

To best assure the safety of a 3-year-old child whose parent admits to finding it difficult to control their anger, the most appropriate short-term goal would be for the parent to a. understand the impact of violence on the child within 2 days. b. begin attending anger management training sessions within 2 weeks. c. state a willingness to attend a support group for physical abusers within 1 week. d. show remorse for their anger management issues within 2 days.

b. begin attending anger management training sessions within 2 weeks. Perpetrators of violence need help learning how to manage anger. A structured group is an excellent way to provide this teaching.

An abuse victim tearfully tells the nurse in the emergency department, "Don't tell my husband that you know he beats me because if he thinks anyone knows, he will beat me again." Based on this information, the most appropriate nursing diagnosis is a. chronic pain. b. fear. c. post-trauma syndrome. d. risk for self-directed violence.

b. fear. The client is expressing fear based on a known threat.

When there is reason to suspect that a child is being abused, the nurse must initially a. call the local police to report it. b. follow agency policy for reporting. c. confront the parent or parents. d. interrogate the child to obtain proof.

b. follow agency policy for reporting. Nurses are mandated reporters of child abuse. They must follow the rules set forth by the state regarding the steps to take to report child abuse.

The nurse performing the assessment of a wheelchair-bound client suspects that his wife's explanation of how he sustained facial contusions and a broken nose may not be entirely truthful. The nurse should a. confront the wife with the suspicion that her husband's injuries are the result of abuse. b. have the wife wait in the waiting room so her husband can be interviewed in private. c. report the husband's injuries to the police and ask for a confidential investigation. d. document the suspicion and follow a policy of "wait and see" whether he returns again.

b. have the wife wait in the waiting room so her husband can be interviewed in private. Suspected victims of abuse should always be interviewed in private. If the perpetrator is in the room, the victim cannot speak freely.

When treatment for injuries sustained during an incident of abuse is sought from the primary physician, the client is receiving a. primary prevention. b. secondary prevention. c. tertiary prevention. d. stop-gap therapy.

b. secondary prevention. Secondary prevention is synonymous with treatment.

After arranging for a sexual assault nurse examiner (SANE) to see Lauren and Mikayla for further assessment for abuse and proper reporting and follow-up, Lauren tells you she lives with her boyfriend, Darrin, who is not Mikayla's father. What statement by Lauren would make you suspect she is being emotionally abused? a. "Darrin has a good job and keeps control of all the finances but our electricity still got turned off last week." b. "I didn't tell Darrin I was coming because he is under so much stress at work I didn't want to add to it." c. "Darrin yells a lot and calls me names, but that's because I am so stupid and make so many mistakes." d. "Darrin is Latin American and has a fiery temper."

c. "Darrin yells a lot and calls me names, but that's because I am so stupid and make so many mistakes." Emotional abuse may be less obvious and more difficult to assess than physical violence, but it can be identified through indicators such as low self-esteem, reported feelings of inadequacy, and anxiety. Controlling the finances and having the electricity turned off describes the possibility of economic abuse. Not wanting to add to the boyfriend's stress does not describe an abusive situation. The spouse being Latin American with a temper would more likely hint at physical abuse rather than emotional.

Which child is at lowest risk for abuse? a. A 3-month-old who has colic and teenaged parents. b. A 4-year-old who has cerebral palsy and retarded parents. c. A 2-year-old who has leukemia and two working parents. d. A 5-year-old who has ADHD and a father who was abused as a child.

c. A 2-year-old who has leukemia and two working parents. Although the child in option C has a serious physical disorder, she is at lower risk than the child in option A, whose inconsolable crying can be frustrating; the child in option B, who will not be as independent as other children his age and who has parents who may not understand his needs; or the child in option D, whose hyperactivity can be annoying, especially to a parent who himself has been abused.

Which of the following is a likely behavior for a woman attempting to escape a chronically abusive relationship? a. Relying on alcohol to escape the emotional pain of abuse b. Adapting an aggressive attitude toward her abuser to scare him c. Considering ways to commit suicide d. Threatening to call the police if she is abused again

c. Considering ways to commit suicide A person experiencing violence may feel so trapped in a detrimental relationship, yet so desperate to get out, that suicide may seem the only answer. A suicide attempt may be the presenting symptom in the emergency department. At least 10% of abused women attempt suicide. The other reports are not realistic for a woman who is being abused.

Which statement reflects a fact about family violence? a. Ninety-five percent of abuse victims are women. b. The victim's behavior is often the cause of the violence. c. Violence occurs in families of all backgrounds. d. Alcohol and stress are the major causes of abuse.

c. Violence occurs in families of all backgrounds. Option C is a true statement. The others are false.

When interviewing an adult victim of abuse, the nurse's best approach is to be a. confrontational and assertive. b. gentle and direct. c. direct and professional. d. sympathetic and outraged.

c. direct and professional. Expressing strong emotion does not help the victim. A direct, honest, and professional manner of asking questions produces the best results.

A 4-year-old child tells the nurse, "I'm a bad boy. Daddy always says I'm not worth a second look." This situation can be an example of a. neglect. b. physical maltreatment. c. emotional violence. d. harsh parenting.

c. emotional violence. Emotional violence occurs when the child's self-esteem is attacked. It is as devastating to the child as physical abuse.

An elderly woman who has been abused by her caregiver daughter tells the nurse, "You don't have to worry about me. My daughter cried and apologized. She promised me she will never hit me again." The nurse can assess that this is the stage in the cycle of violence known as a. tension building. b. acute battering. c. honeymoon. d. escalation.

c. honeymoon. During the honeymoon stage, the perpetrator apologizes, promises never to abuse again, and tries to make up for the violence. This stage is usually brief.

The victim of abuse can expect the abuse to worsen when a. the perpetrator feels he is in complete control. b. the perpetrator is feeling remorseful for being abusive. c. the victim moves toward independence from the abuser. d. the victim submits to the domination of the perpetrator.

c. the victim moves toward independence from the abuser. When the abuser thinks he is losing control over the victim, the violence escalates.

What distinction can be made between abuse and neglect? a. Neglect occurs in the psychological domain; abuse occurs in the physical domain. b. Neglect is always physical; abuse can be verbal, physical, sexual, or emotional. c. Neglect is perpetrated against children; abuse victims can be children or adults. d. Neglect is a failure to provide; abuse is a failure to control aggression.

d. Neglect is a failure to provide; abuse is a failure to control aggression. Neglect is failure to provide necessary care, and abuse is physical maltreatment.

Which of the following persons has the highest risk factors for physical abuse? a. Emma, a 7-month-old baby who has colic and doesn't sleep through the night b. Roland, a 53-year-old man with cardiovascular disease living with his son c. Penny, a 28-year-old wife whose husband has a diagnosis of an anxiety disorder d. Rose, a 77-year-old woman living with her daughter and son-in-law

d. Rose, a 77-year-old woman living with her daughter and son-in-law Older women dependent on family members for care are at higher risk for abuse. The other options do not describe specific characteristics that put them at higher risk for abuse.

If it is determined that Mikayla has been sexually abused, what is the priority outcome for Mikayla? a. Mikayla's mother will learn coping techniques to support Mikayla. b. Mikayla will be able to verbalize exactly what happened to her. c. Mikayla will no longer act out sexually. d. The sexual abuse will cease.

d. The sexual abuse will cease. The highest priority in this case is that the abuse stops so that the patient can be safe and undergo recovery. The question is asked about the priority outcome for the victim, not the mother. Verbalizing exactly what happened is not a priority. The victim will most likely stop the sexualized behavior when the abuse has stopped and recovery is supported by age appropriate interventions.

An elderly client pays the bills because she fears that her family will make her live elsewhere if she doesn't "help out." The nurse assesses it as a. neglect. b. physical violence. c. psychological abuse. d. financial maltreatment.

d. financial maltreatment. Financial maltreatment occurs when the perpetrator takes financial advantage of the elderly person, often through the use of subtle threats of what unpleasant or frightening outcome will occur if the elder does not supply funds.