Maternity Ch. 8 Violence against women
1) The nurse is planning care for a client who is the victim of rape. Which psychosocial nursing diagnoses does the nurse include in the client's plan of care? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Fear 2. Fatigue 3. Powerlessness 4. Risk for infection 5. Readiness for enhanced knowledge
Answer: 1, 3 Explanation: When planning the psychosocial care for a client who is the victim of rape, the nurse would include the nursing diagnoses of fear and powerlessness in the plan of care. Fatigue, risk for infection, and readiness for enhanced knowledge are not diagnoses that the nurse would include in the plan of care for a client who is the victim of rape.
1) The nurse is providing care for a female client who is the victim of sexual assault. Which sexually transmitted infections (S T Is) does the nurse anticipate medication prescriptions to prevent? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Syphilis 2. Gonorrhea 3. Chlamydia 4. Bacterial vaginosis 5. Herpes simplex virus
Answer: 2, 3, 4 Explanation: A client who is the victim of sexual assault is at the greatest risk for contracting gonorrhea, chlamydia, and bacterial vaginosis. The nurse would anticipate medication prescriptions for these S T Is. While the client is also at risk for syphilis and herpes simplex virus, these S T Is are not as common; therefore, the nurse would not anticipate medication prescriptions for these S T Is.
1) A female comes into the emergency department seeking treatment for possible rape. The patient recalls having a cocktail with friends at a local club but woke up in an alley three blocks away from the business. For which date rape drugs should the nurse prepare to have this patient tested? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Atropine 2. Ketamine 3. Scopolamine 4. Flunitrazepam 5. Gamma hydroxybutyrate
Answer: 2, 3, 4, 5 Explanation: Flunitrazepam (Rohypnol), a potent sedative-hypnotic has received considerable attention as the "date rape drug of choice" since the late 1990s. Typically, Rohypnol, which dissolves easily and is odorless, is slipped into the drink of an unsuspecting woman. Gamma hydroxybutyrate (G H B), ketamine, and scopolamine have also been identified as date rape drugs that are used to incapacitate a woman. Atropine is not identified as being a date rape drug.
1) The nurse is providing care to a female client in the acute phase of recovery following a sexual assault. Which nursing actions are appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Clarifying feelings 2. Creating a safe environment 3. Supporting advocacy efforts 4. Establishing a trusting relationship 5. Providing care for significant others
Answer: 2, 5 Explanation: During the acute phase of recovery following a sexual assault, the appropriate nursing actions include creating a safe environment and providing care for significant others. Clarifying feelings is an appropriate nursing action during the reorganizational phase of recovery following a sexual assault. Supporting advocacy efforts is an appropriate nursing action during the integration and recovery phases of recovery following a sexual assault. Establishing a trusting relationship is an appropriate nursing action during the outward adjustment phase following a sexual assault.
The nurse is assisting with the collection of evidence for a female client who is the victim of sexual assault. Which actions by the nurse are appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Drawing blood to test for gonorrhea 2. Placing each piece of clothing in a plastic bag 3. Pulling hair from the head and pubic region as evidence 4. Collecting a urine sample if drug-facilitated rape is suspected 5. Obtaining informed consent prior to photographing the injured areas
Answer: 3, 4, 5 Explanation: When collecting evidence for a female client who is the victim of sexual assault, the nurse will assist in pulling hair from the head and pubic region as evidence, collect a urine sample if drug-facilitated rape is suspected, and obtain informed consent prior to photographing the areas of injury. The nurse would draw blood to test for syphilis, not gonorrhea. The nurse would place each piece of the client's clothing into a paper bag, which is sealed and labeled. A plastic bag is not appropriate.
1) The nurse is participating in the collection of evidence from a victim of rape. In which order should the evidence be collected from this victim? 1. Oral swabs are obtained 2. Blood samples are drawn for syphilis 3. Hair samples and fingernail scrapings taken 4. Clothing is removed and bagged for evidence 5. Swabs of body stains and secretions are taken
Answer: 4, 5, 1, 3, 2 Explanation: When collecting evidence from a rape victim, the victim's clothing is removed and placed in a paper bag. Swabs of body stains and secretions are taken. Then oral swabs are obtained. Hair samples and fingernail scrapings are taken. Blood samples are then drawn to evaluate for syphilis.
1) The nurse is helping a victim of domestic violence create a safety plan. In which order should the nurse recommend that the steps of the plan be completed? 1. Decide where to go regardless of the day or time 2. Establish a code word that is shared with family and friends 3. Have money, identification, and bank account information prepared 4. Determine a planned escape route with emergency telephone numbers 5. Pack a change of clothes, toilet articles, and keys stored away from the home
Answer: 5, 3, 1, 2, 4 Explanation: The patient should pack a change of clothes including toilet articles and an extra set of car and house keys stored away from her house with a friend or neighbor; have money, identification papers, and bank account information prepared; have a plan for where she will go, regardless of the day or time; establish a code word for danger that is shared with family and friends; and have a planned escape route and emergency telephone numbers
1) The nurse is identifying a plan to help a rape victim work through the phases of recovery. In which order should the nurse perform the following actions to help this victim? 1. Clarify the victim's feelings 2. Establish a trusting relationship 3. Acknowledge the victim's success 4. Provide advocacy as requested by the victim 5. Allow the victim to grieve and express feelings
Answer: 5, 4, 2, 1, 3 Explanation: The order in which nursing actions should be provided to a victim during the phases of rape recovery include allowing the victim to grieve and express feelings during the acute phase; provide advocacy as identified by the victim during the outward adjustment phase; establish a trusting relationship and clarify the victim's feelings during the reorganizational phase; and acknowledge the victim's success during the integration and recovery phase
1) The nurse is providing care to a client who is the victim of sexual assault. Which assessment finding does the nurse anticipate during the disorganization phase of rape trauma syndrome? A) Anxiety B) Insomnia C) Dyspepsia D) Depression
Answer: A Explanation: A) Anxiety is an expected clinical manifestation that occurs during the disorganization phase of rape trauma syndrome. B) Insomnia is an expected clinical manifestation that often occurs during the reorganization phase of rape trauma syndrome. C) Dyspepsia is an expected clinical manifestation that often occurs during the reorganization phase of rape trauma syndrome. D) Depression is an expected clinical manifestation that often occurs during the reorganization phase of rape trauma syndrome.
1) Which is a known characteristic of domestic violence batterers? A) Feeling inferior to others B) Working in a low-paying job C) Having a low socioeconomic status D) Being diagnosed with posttraumatic stress disorder
Answer: A Explanation: A) Domestic violence batterers often have feelings of insecurity, inferiority, powerlessness, and helplessness that conflict with their assumptions of male supremacy. B) Batterers come from all occupations, not just from low-paying jobs. C) Batterers come from all socioeconomic strata. A diagnosis of posttraumatic stress disorder is not a known characteristic of domestic violence batterers
1) A woman has come to the emergency department with multiple bruises on her body and a small laceration over her upper lip. She says she fell down the stairs while doing housework. Which observation would most cause the nurse to suspect that the client has been a victim of battering? A) The client is hesitant to provide details about how the injuries occurred. B) The client was accompanied to the emergency department by her mother instead of her partner. C) The client has sought care quickly after the incident. D) The client does not seem to be in pain.
Answer: A Explanation: A) Hesitation to provide detailed information about the injury and how it occurred is a common sign of abuse. B) Who accompanies the client to the emergency department is not a significant sign for abuse. C) Often a woman delays seeking care when there has been abuse. D) Pain level is not indicative of abuse. The experience of pain and how it is expressed is often a cultural issue.
1) The client has been a victim of a violent, sadistic rape. She is crying and asks the nurse, "Why would someone do something like that?" The nurse should explain that which of the following is the primary purpose of sadistic rape? A) Take pleasure from the victim's struggle and pain B) Express feelings of rage C) Feel a sense of power or mastery D) Relieve intolerable anxiety
Answer: A Explanation: A) In sadistic rape, the assailant has an antisocial personality and delights in torture and mutilation. In this type of rape, the victim and assailant are generally strangers, and the assault is planned. Sadistic rapes cause the most injuries, including homicide. B) In anger rape, the sexual assault is used to express feelings of rage and to retaliate for what the attacker perceives as wrongs against him. These perceived wrongs most often have nothing to do with the rape victim. Considerable brutality and degradation can characterize this type of rape. Attacks on older women often are a form of anger rape. C) In power rape, the purpose of the assault is control or mastery. The assailant uses sexual intercourse to place a woman in a powerless position so that he can feel dominant, potent, and strong. He often believes that his victim enjoys the assault, and he exerts only the amount of force necessary to subdue his victim. Often power rape is a planned stranger attack, but most acquaintance rapes are also power rapes. The vast majority of all rapes are motivated by this need for power and control. D) Anxiety is not associated with a type of rape.
1) What is the most important aspect of care for the nurse to remember when screening a woman for partner abuse? A) Ensuring privacy and confidentiality B) Conveying warmth and empathy C) Asking specific, direct questions about abuse D) Clarifying her myths about battering
Answer: A Explanation: A) Screening for women experiencing domestic violence must be done privately, with only the nurse and the client present, in a safe and quiet place. B) Warmth and empathy are helpful, but confidentiality is more important. C) General questions about possible abuse both will facilitate trust building and are more likely to obtain accurate information, but privacy to obtain this information is the first priority. D) Clarifying myths is not essential during screening.
1) Which action by the nurse is appropriate when providing care to a female client who is the victim of domestic violence? A) Providing adequate time for the client to tell her story B) Reporting the incident to the police to protect the client C) Telling the spouse about the client's accusations of abuse D) Stressing to the client that the abuse could have been avoided
Answer: A Explanation: A) The nurse should allow the client adequate time to work through her story, problems, and situation at her own pace. B) The nurse would not report the incident to the police to protect the client. Reporting the abuse is associated with the risk for further abuse towards the client. C) It is not appropriate for the nurse to tell the client's spouse about the accusations of abuse. This is a breach of confidentiality. D) It is not therapeutic for the nurse to stress to the client that the abuse could have been avoided.
1) The nurse is providing care to a female client who is the victim of domestic violence. Which referral by the nurse is most appropriate? A) Group therapy B) Physical therapy C) Nutrition therapy D) Occupational therapy
Answer: A Explanation: A) Victims of domestic violence require counseling and advocacy from the nurse. The most appropriate referral for this client is group therapy. B) Physical therapy is not an appropriate referral for this client. C) Nutrition therapy is not an appropriate referral for this client. D) Occupational therapy is not an appropriate referral for this client.
1) If a woman returns to an abusive situation, the nurse should encourage her to develop an exit, or safety, plan for herself and her children, if she has any. What should the plan include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Identify friends and family who know about the situation and will help her. B) Call the police if violence begins. C) Pack a change of clothes for herself and the children. D) Have a plan for where she will go. E) Have a planned escape route.
Answer: A, C, D, E Explanation: A) She should identify friends and family who know about the situation and will help her. Ask that she establish a code word for danger with those family and friends. B) She should ask a neighbor to call the police if violence begins. C) She should pack a change of clothes for herself and the children, including toilet articles and an extra set of car and house keys stored away from her house with a friend or neighbor. D) She should have a plan for where she will go, regardless of the day or time. E) She should have a planned escape route and emergency telephone numbers she can call.
1) Among women who have been sexually assaulted, which of the following are the most frequently diagnosed sexually transmitted infections (S T Is)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Bacterial vaginosis B) H I V C) Chlamydia D) Syphilis E) Gonorrhea
Answer: A, C, E Explanation: A) Among women who have been sexually assaulted, trichomoniasis, bacterial vaginosis, gonorrhea, and chlamydia are the most frequently diagnosed sexually transmitted infections (S T Is). B) H I V is not one of the most frequently diagnosed S T Is following a sexual assault. C) Among women who have been sexually assaulted, trichomoniasis, bacterial vaginosis, gonorrhea, and chlamydia are the most frequently diagnosed sexually transmitted infections (S T Is). D) Syphilis is not one of the most frequently diagnosed S T Is following a sexual assault. E) Among women who have been sexually assaulted, trichomoniasis, bacterial vaginosis, gonorrhea, and chlamydia are the most frequently diagnosed sexually transmitted infections (S T Is).
1) When a woman seeks care for an injury, the nurse should be alert to which clues of abuse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) Defensive injuries B) Immediate reporting of symptoms or seeking care for injuries C) Lack of eye contact D) Providing too much detailed information about the injury E) Vague complaints without accompanying pathology
Answer: A, C, E Explanation: A) Defensive injuries may be a sign of abuse. B) Delayed reporting of symptoms or seeking care for injuries may be a sign of abuse, not immediate reporting and seeking care. C) Lack of eye contact may be a sign of abuse. D) Hesitation in providing detailed information about the injury and how it occurred may be a sign of abuse. E) Vague complaints without accompanying pathology may be a sign of abuse.
1) A client comes to the reproductive health clinic and reports that she woke up in a strange room this morning, her perineal area is sore, and she can't clearly remember what happened the previous evening. The client says she is afraid that she was a victim of a drug-facilitated sexual assault. Which statement should the nurse include when discussing this possibility with the client? A) "Drinking alcohol can lead to uninhibited sexual behavior, which is not the same as rape." B) "Some men use drugs mixed into a drink to subdue a potential victim prior to a rape." C) "It is rare that a woman doesn't remember what happened if she is actually raped." D) "We need to check for forensic evidence of rape before we can be sure what happened."
Answer: B Explanation: A) Although one effect of alcohol consumption is decreased inhibition, which can lead to less cautious sexual behavior, if a woman is drugged, the sexual act is nonconsensual and is therefore classified as rape. B) Drug-facilitated sexual assault occurs when a drug such as Rohypnol, which dissolves easily and is odorless, is slipped into the drink of an unsuspecting woman. C) Rohypnol, which dissolves easily and is odorless, can be slipped into the drink of an unsuspecting woman and causes amnesia of the attack. D) Forensic evidence is collected for possible legal prosecution of the attacker, but the absence of collectable evidence does not eliminate the possibility of rape.
1) A female client presents in the emergency department (E D) after being sexually assaulted at a party. Which assessment finding indicates that the client may have been drugged? A) Attending the party with a large group of friends B) Accepting a beverage from a stranger at the party C) Dancing and kissing several men during the party D) Drinking large amounts of alcohol during the party
Answer: B Explanation: A) Attending a party with a large group of friends is not an assessment finding that would indicate the client may have been drugged. B) Accepting a drink from someone else or drinking a drink that was left unattended would indicate the client may have been drugged. C) Dancing and kissing several men during the party is not an assessment finding that would indicate the client may have been drugged. D) Drinking large amounts of alcohol at the party is not an assessment finding that would indicate the client may have been drugged. Having one or two drinks and then suddenly feeling very drunk would be an indicator that the client had been drugged.
1) Which myth regarding rape will the community health nurse include in a teaching session within the community? A) Rape is a type of sexual assault. B) Women lie about rape as an act of revenge. C) Both men and women can be victims of rape. Rape is one of the most underreported violent crimes
Answer: B Explanation: A) Rape is a type of sexual assault. This is not a myth regarding rape. B) One myth regarding rape is that women lie about rape as an act of revenge. This is appropriate for the nurse to include in the teaching session. C) Both men and women can be victims of rape. This is not a myth regarding rape. Rape is one of the most underreported violent crimes. This is not a myth regarding rape
1) The nurse is presenting a session on intimate partner violence. Which statement by a client indicates a need for further education? A) "My daughter is not to blame for the violence in her marriage." B) "Everyone experiences anger and hitting in a relationship." C) "Abusers can be either husbands or boyfriends or girlfriends." D) "The 'honeymoon period' follows an episode of violence."
Answer: B Explanation: A) This statement recognizes that the blame for her assault lies with her assailant, not with the victim. B) Violence is not a normal part of intimate relationships. Domestic violence, also called intimate partner violence (I P V), is defined as a pattern of coercive behaviors and methods used to gain and maintain power and control by one individual over another in an adult intimate relationship. This statement indicates that the client has likely been a victim of domestic violence herself. C) Batterers come from all racial, ethnic, and religious groups and all professions, occupations, and socioeconomic strata. Batterers can also be either male or female. An acute episode of battering is followed by the tranquil phase, or honeymoon period, which is characterized by extremely loving, kind, and contrite behaviors by the batterer
1) The nurse is conducting a health maintenance assessment for a new female client who recently moved to the city. Which finding would indicate the need for further assessment for intimate partner violence? A) A miscarriage two years ago noted during the reproductive history. B) A sprained ankle one year ago noted during the health history interview. C) A history of delaying treatment for a concussion and fractured extremity. A scar noted on the abdomen from a previous surgery during the physical examination
Answer: C Explanation: A) A miscarriage two years ago that is noted in the reproductive history would not cause the nurse to further assess the client for intimate partner abuse. B) Sprains and strains are not associated with intimate partner abuse. C) A client who delays treatment for a concussion or fractured extremity would indicate the need for further assessment for intimate partner violence. A scar from an old injury, not from a surgical procedure, would indicate the need for further assessment for intimate partner violence
1) The nurse is helping a victim of domestic abuse to develop a safety plan. Which client action would require intervention by the nurse? A) Asking a neighbor to call police if violence begins B) Establishing a code word for danger with family and friends C) Keeping a bag packed in the home in case the need to leave arises D) Having a planned escape route and emergency phone numbers if violence occurs
Answer: C Explanation: A) Asking a neighbor to call the police if violence begins is an appropriate client action that would not require intervention from the nurse. B) Establishing a code word for danger with family and friends is an appropriate client action that would not require intervention from the nurse. C) Keeping a bag packed in the home if the need arises to leave would require intervention from the nurse. The bag should be kept at the home of a neighbor or family member. If the abuser finds the bag the client's risk for injury may increase. D) Having a planned escape route and emergency phone numbers if violence occurs is an appropriate client action that would not require intervention from the nurse.
1) The nurse has been talking to a woman about the reorganization phase following a rape. Which response would indicate that the client understands this phase? A) "By using denial and suppression in this phase, I will eventually be able to accept what has happened to me." B) "During this time, I won't talk much about the rape, because I am examining my inward feelings regarding the rape." C) "During this time, I will repeatedly replay the role of the victim until I come to terms with the experience." D) "My perception of a normal sexual relationship will be similar to my perception prior to the rape."
Answer: C Explanation: A) Denial and suppression indicate the client is experiencing the outward adjustment phase of rape trauma syndrome. B) Denial and suppression indicate the client is experiencing the outward adjustment phase of rape trauma syndrome. C) During reorganization, a victim adjusts her self-concept to include the rape. D) Sexual relationships often develop dysfunction after rape.
1) The emergency department nurse is admitting a client who has been sexually assaulted. The nurse is explaining how the physical evidence will be collected. Which statement by the client indicates that teaching has been effective? A) "All the evidence will be kept in a locked cupboard until the police arrive." B) "You collect urine samples to make sure the rapist did not get me pregnant." C) "The evidence you collect might be able to identify the rapist." D) "Blood samples are taken to help identify whether the rapist had H I V."
Answer: C Explanation: A) The evidence must remain in the hands of the nurse until handed directly to the police. B) Urine should be collected in cases in which a drug-facilitated sexual assault is suspected. C) D N A can be obtained from collected evidence to identify the rapist. D) Blood is drawn to test for syphilis and to determine the woman's blood type, and additional blood may be drawn for a pregnancy test.
1) When a woman who has been raped is admitted to the emergency department, the nurse caring for the woman knows that which of the following is the priority nursing intervention? A) Explaining exactly what will need to be done to preserve legal evidence B) Assuring the woman that everything will be all right C) Creating a safe, secure environment for her D) Contacting family members
Answer: C Explanation: A) The legal interventions would not take priority over safety at this time. B) Assuring the woman that everything will be all right is not the first priority nursing intervention in caring for a survivor of a sexual assault. C) The first priority in caring for a survivor of a sexual assault is to create a safe, secure environment. Contacting family members is important, but is not the priority nursing intervention
1) The nurse is teaching a class about domestic violence to enhance education within the community. Which statement regarding the cycle of violence should the nurse include in the presentation? A) "The tension-building phase lasts a few hours." B) "The batterer often feels remorse during the tension-building phase." C) "The acute battery incident is often triggered by an external event, such as the loss of a job." D) "The acute battery incident often finds the victim hoping the relationship will change for the better."
Answer: C Explanation: A) The length of the tension-building phase of the cycle of violence varies considerably across individual cases and can range from weeks to years. It is often the acute battery incident that lasts a few hours. B) The batterer often feels remorse during the tranquil phase or honeymoon period, not the tension-building phase. C) An acute battery incident is often triggered by an external event for the abuser, such as the loss of a job. D) The victim of abuse often hopes the relationship will improve in the tension-building phase, not during the acute battery incident.
1) The nurse is planning a community education presentation on battering. Which statement about battering should the nurse include? A) Battering occurs in a small percentage of the population. B) Battering is mainly a lower-class, blue-collar problem. C) Battered women are at greatest risk for severe violence when they leave the batterer. D) If the batterer stops drinking, the violence usually stops.
Answer: C Explanation: A) The statistics on reported cases underrepresent the true incidence. As many as one in three women may be the victim of assault by her partner in her lifetime; however, it is a widely underreported crime. B) Domestic violence occurs among all sectors of society. It happens to women of all socioeconomic statuses, races, ethnicities, and religious faiths. C) Battered women are at greatest risk for injury or domestic homicide when they leave the abuser. D) Battered women sometimes think that the abuse will stop if their partners stop drinking or using drugs. Unfortunately, this usually does not happen.
1) The nurse is preparing an educational seminar about the frequency of intimate partner violence against females. Using the chart below, which age group should the nurse identify as experiencing the most intimate partner violence in 2010? A) 12-17 B) 18-24 C) 25-34 D) 35-49
Answer: C Explanation: The group experiencing the most intimate partner violence against women in 2010 is the solid green line which represents the 25-34 age group. The solid red line is the 12-17 age groups. The dotted red line is the 18-24 age group. The dotted blue line is the 35-49 age group. And the solid orange line is the 50 or older age group.
1) The nurse is conducting a health maintenance assessment for a female client. Which neurologic data would cause the nurse to further assess for intimate partner abuse? A) Anxiety B) Depression C) Weight gain D) Tension headaches
Answer: D Explanation: A) Anxiety is a psychiatric, not neurologic, assessment finding that would cause the nurse to further assess for intimate partner abuse. B) Depression is a psychiatric, not neurologic, assessment finding that would cause the nurse to further assess for intimate partner abuse. C) Weight gain is a constitutional, not neurologic, assessment finding that would cause the nurse to further assess for intimate partner abuse. D) Tension headaches are a neurologic assessment finding that would cause the nurse to further assess for intimate partner abuse.
1) The client with limited English language skills has a black eye and bruises across her face and arms. The client's husband has been acting as an interpreter for her, and answers all of the questions the nurse asks, often without talking to his wife first. The nurse suspects the client has been a victim of domestic abuse. What should the nurse do next? A) Ask the husband whether he has beaten his wife. B) Ask the husband to have a female friend come in with his wife. C) Provide written materials in English for the client to read at home. D) Ask the husband to step out of the room, and obtain an interpreter.
Answer: D Explanation: A) Asking the abuser whether he has abused his spouse is useless, as most abusers see their behavior as appropriate. B) Asking the husband to have a female friend come with his wife is not the best action for the nurse to take next. C) Written proficiency develops after verbal fluency; therefore, written materials in English are inappropriate for this client. D) Screening for women experiencing domestic violence must be done privately. An interpreter should also be provided as necessary.
1) The nurse is interviewing a client who has admitted to being a victim of domestic violence. What is the most typical description of how the domestic violence developed in a relationship? A) "He changed overnight. Everything was fine, and all of a sudden he flipped out and beat me up; he nearly killed me." B) "It was severe from the beginning. As soon as we got married, he began hitting me and threatening to kill me." C) "We've both always dated other people. I thought that was understood. He was as emotionally abusive in the beginning as he is now." D) "I don't know when it started, really. It was gradual. First, just yelling, blaming, and shoving. Then the beatings started; and now they're more frequent."
Answer: D Explanation: A) Domestic violence does not begin suddenly, and will always escalate. B) Typically, these forms of abuse begin slowly and subtly after some form of commitment, such as engagement, onset of a sexual relationship, or marriage. C) Typically, these forms of abuse begin slowly and subtly after some form of commitment, such as engagement, onset of a sexual relationship, or marriage. D) Typically, these forms of abuse begin slowly and subtly after some form of commitment, such as engagement, onset of a sexual relationship, marriage, pregnancy, or first childbirth.
1) The nurse is providing care to a female client who presents in the emergency department (E D) with multiple bruises and lacerations. The nurse suspects the client is the victim of domestic violence. Which action by the nurse is appropriate? A) Reporting the incident to the police to enhance safety B) Documenting domestic violence in the medical record C) Avoiding photographs of the injuries to prevent embarrassment D) Communicating the level of confidentiality that can be expected
Answer: D Explanation: A) Reporting domestic violence may be mandatory in some states. However, it is important to note that reporting domestic violence may increase the client's risk for further abuse, not enhance the client's safety. B) The nurse would document the client's injuries in the medical record and use the term "probable battering." To protect the client's confidentiality and safety, it is critical that the nurse not refer to domestic violence or abuse on any discharge papers. C) Photographs of the client's injuries can be of great value along with documentation of the extent of the injuries and noting of the client's exact words in the medical record. D) It is important for the nurse to explain the assessment process to the client and communicate the level of confidentiality that can be expected.
1) The nurse is preparing a female client for a scheduled pelvic examination. During the health history interview, the client states, "My husband constantly criticizes me and calls me stupid. I am afraid that he will begin to hit me one of these days." Which type of intimate partner violence is the client experiencing based on the assessment data? A) Sexual abuse B) Physical abuse C) Economic abuse D) Emotional abuse
Answer: D Explanation: A) Sexual abuse is forced sex, including vaginal, oral, or anal intercourse. This type of abuse also includes sexually demeaning treatment, forced use of objects, or forcing a woman to have sex with someone else against her will. B) Physical abuse may include acts such as pushing, shoving, slapping, hitting with a fist or object, kicking, choking, threatening with a gun or knife, or using a gun or knife against a woman. This type of abuse can also include forcing alcohol or drug use or denying a partner medical care. C) Economic abuse would include preventing a spouse or significant other from getting or keeping a job; making a spouse or significant other ask for money; controlling a spouse or significant other's money; destruction of property; or making all financial decisions for the spouse or significant other. D) Emotional abuse includes constant criticism, name calling, and unreasonable demands from a spouse or significant other. This type of abuse also includes damaging a spouse or significant other's relationship with a child and others who matter to him or her.
1) The nurse is teaching an in-service educational presentation about working with battered women. The nurse should explain that it is often frustrating for nurses to work with battered women for which reasons? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A) There is little the nurse can really do to help. B) Healthcare policies and practices are not supportive of abused women. C) Both husband and wife must agree to therapy. D) These women might return to the abusive situation. E) Women often believe that they are the cause of the abuse.
Answer: D, E Explanation: A) Healthcare providers can play a critical role in identifying and reducing violence, even in homicide prevention efforts. B) Since 1980, there have been a number of notable changes in healthcare policy and practices aimed at responding to violence against women. C) The abuser must seek behavior change therapy to accomplish permanent change. D) Women often believe that escape is futile, or escape and then return when the crisis is over. E) Women are often convinced by the abusers that it is their own behavior that causes the abuse.
