Ch 12: Prep-U

A mental health nurse presenting an educational program on rape for high school students responds to the statement, "Women cry rape often times just to get even with the guy," by offering which answer? "If a man is falsely accused, the woman is prosecuted by the law." "Actually, fewer than 2% of all reported rapes are found to be false." "I'm not sure where you heard that but statistically it isn't true." "I don't believe that's true but even if it were it doesn't excuse the real rapes that occur."

"Actually, fewer than 2% of all reported rapes are found to be false."

Which statement made by a client raises the greatest concern that the client may be experiencing relationship violence? "He was so much nicer when we started dating." "He doesn't like it when I go out with my girlfriends." "I don't know what else I can do to keep him from getting angry at me." "His father physically abused his mother for years."

"I don't know what else I can do to keep him from getting angry at me." A warning sign of relationship violence is feeling that you must change your life or yourself so you won't anger him or her. The remaining statements, while troublesome, are not as clearly associated with behaviors of violence.

Question 10 of 10 The nurse is providing care to client who is currently in a sexually abusive relationship. To best manage the development of additional comorbid disorders, what question(s) should the nurse ask this client? Select all that apply. "Do you have a safety and escape plan in place?" "What community resources related to HIV and pregnancy are you aware of?" "What are the early symptoms of posttraumatic stress disorder (PTSD)?" "What do you do to avoid angering your abuser?" "Are you aware of self-defense strategies to physically protect oneself?"

"What community resources related to HIV and pregnancy are you aware of?" "What are the early symptoms of posttraumatic stress disorder (PTSD)?" "Are you aware of self-defense strategies to physically protect oneself?" "Do you have a safety and escape plan in place?" Information should focus on effective safety and health promotion interventions including relevant health screenings, early symptom identification, and safety plans. Physical self-defense strategies may be acquired but they are an established method of assuring safety in abusive situations. The anger is unpredictable, unavoidable, and outside the control of the abused.

A nurse is assessing a client in a community clinic who reports feeling anxious lately because she is considering leaving her marriage. The client describes a long history of partner abuse associated with this relationship. How should the nurse respond to this client?

"You have the right to be safe and respected." When working with someone who is a victim of partner abuse, it is important that the nurse assertively support the client's decision. The affirmation of the client's decision can help to improve the client's self-confidence as she begin the process of leaving her partner. It is important the nurse refrain from recommending couple's counseling or imply doubt about the client's situation. The nurse will likely not be involved in every step of the client's process of leaving the relationship, as the client will use a variety of resources outside the nurse-client relationship, nor should the nurse take charge and do everything for the client or imply that this will happen.

The nurse is aware that fewer than half of rapes and sexual assaults are reported. Which are some of the reasons people do not report being sexually assaulted? Select all that apply. The person is concerned about the financial issues associated with the hospitalization. The client is embarrassed of the assault. The perpetrator may use coercion or threats to control the victim. They have a fear of being blamed for the incident. The victim is responsible for the attack.

1. The client is embarrassed of the assault. 2. They have a fear of being blamed for the incident. 3. The perpetrator may use coercion or threats to control the victim. Fewer than half of rapes and sexual assaults are reported, generally because of shame, embarrassment, concern about not being believed or fear of being blamed for the assault. Knowing the attacker may also be a factor that inhibits reporting. The majority of sexual violence is perpetrated by intimate partner or acquaintances and does not involve weapons or severe physical violence. The perpetrator may use coercion, threats, or substances to control the victim. The nurse needs to understand these reasons to develop a therapeutic relationship to assist in the care of the client victim.

What percentage of women can expect to be a victim of an ongoing unwanted pursuit from stalking? 40-48% 50-60% 12-32% 5-10%

12-32% Women are 12-32% and men 17% who can expect to be victims of ongoing unwanted pursuit.

A nurse is working in the emergency department. Which situation would lead the nurse to suspect possible abuse of a client? Select all that apply. A 3-month-old with a fractured femur A 6-year-old is being seen for the 5th time for a urinary tract infection A 15-month-old with shortness of breath after peanut ingestion A baby with contrecoup injuries to the brain A 3-year-old with a deep finger laceration

A 6-year-old is being seen for the 5th time for a urinary tract infection A baby with contrecoup injuries to the brain A 3-month-old with a fractured femur Re-occurring urinary tract infections signal the possibility of sexual abuse of the child. The nurse must assess for further signs of abuse both with parents present and without. A fracture of the femur in a 3-month-old is uncommon given the infant's age and level of development. Contrecoup injuries of the brain in a baby should generate suspicion that the baby has been shaken. A 15-month-old with an allergic reaction to a peanut ingestion and a 3-year-old with a deep finger laceration should not signal abuse to the assessor. The problems are commonly seen in the pediatric emergency room.

A nurse is aware of the high incidence of intimate partner violence (IPV) and actively seeks opportunities to screen women for IPV. Which female client represents the best opportunity for assessing for IPV? A client who has brought her young son to the emergency department because he fell at the playground and may have an arm fracture A client who expressed interest in joining a grief support group following the death of her husband A client who is currently exploring long-term care options for her elderly father A client who is in the third trimester of pregnancy and who is having biweekly prenatal appointments at a clinic

A client who is in the third trimester of pregnancy and who is having biweekly prenatal appointments at a clinic Women who are pregnant have frequent contact with the health care system, creating a useful opportunity for IPV screening. None of the other listed situations precludes screening, but none are as ideal as frequent appointments at a consistent setting.

Which assessment finding can help the nurse differentiate a child experiencing child neglect rather than child abuse?

A young child is admitted to the hospital with hypothermia because the child is inadequately dressed.

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

Abandonment The six types of elder abuse are physical (injury by hitting, kicking, pushing, slapping, burning, and so on); sexual (unconsented sexual act); emotional (harm of self-worth or emotional well-being); neglect (failure to meet the older adult's basic needs of shelter, food, and so on); abandonment (leaving an older adult alone and no longer providing care); and financial (illegally misusing money, property, or assets).

Nurses at an urban emergency department seek to develop a plan to help women involved in abusive relationships. Which component is critical to the success of the plan? Access to community resources for referral Written educational materials An intimate partner violence (IPV) counselor A quality of life assessment tool

Access to community resources for referral Much of the support and treatment that will be needed for women in abusive relationships is needed in the community. Having access to these resources is the most critical aspect to ensuring effective and sustainable support for women in abusive situations. An IPV counselor in the emergency department will only be available for support when there is an acute situation for which the client has come to hospital. Such a component is effective but not a long-term option to support people in abusive relationships. A quality of life assessment tool is effective for assessment, but this is only the initial part of the plan. Written educational materials are important to enhance knowledge for women in abusive situations; however, community support services are needed to ensure follow through and sustainability.

A 27-year-old has been brought to the emergency department by emergency medical services following a violent sexual assault that took place in the parking garage of the client's building. Which task would fall most clearly within the scope of practice of a forensic nurse? Providing reassurance to the client that the care team and the police will prioritize the client's care Collecting specimens from the client for use as evidence Asking the client to describe the perpetrator in detail and documenting the client's statement Assisting with diagnostic tests to determine the extent of the client's injuries

Collecting specimens from the client for use as evidence While a forensic nurse would certainly attempt to reassure a client such as this one, a priority forensic nursing task would be collecting specimens for use as evidence. This would supersede assisting with diagnostics, which falls within the scope of any registered nurse. The police, not a nurse, would be responsible for taking the client's statement.

A psychiatric-mental health nurse is conducting a program for a women's group. When describing psychological abuse, which information would the nurse address? Select all that apply. Criticism Isolating a person from family Uncontrollable spending Insults Public ridicule

Criticism Insults Public ridicule Isolating a person from family Psychological abuse includes behaviors such as criticizing, insulting, humiliating, or ridiculing someone in private or in public. It can also involve actions such as destroying another's property, threatening or harming pets, controlling or monitoring spending and activities, or isolating a person from family and friends.

A female client states that she has been receiving numerous text and phone messages from a co-worker. Which type of harassment should be documented in the nurse's notes? Harassment Cyberstalking Isolation Jealousy

Cyberstalking Stalking is a pattern of repeated unwanted contact, attention, and harassment that often increases in frequency. Cyberstalking is the use of the Internet, e-mail, or other telecommunications technology to harass or stalk another person. The nurse should document the conversation in the nurse's notes.

A client discloses to a nurse therapist that the client has been verbally abusive to the client's 6-year-old child and belittles the child routinely. Which form of abuse best describes the client's treatment of the child? Neglect Emotional abuse Physical abuse Sexual abuse

Emotional abuse Emotional abuse includes acts such as name-calling, belittling, screaming, yelling, destroying property, making threats, refusing to speak to the child, or ignoring the child.

Nurses working with rape trauma victims need to be aware of their own attitudes about rape and sexual assault. Which rationale best explains why? Nurses can learn from the experiences of clients and thus help prevent becoming victims of assault themselves. Giving back the survivor as much control as possible is important. Nurses need to be able to sympathize with their clients. The attitudes of individual nurses reflect on the overall profession.

Giving back the survivor as much control as possible is important. Knowing how to recognize when personal feelings are likely to interfere with optimal care is part of the nurse's professional responsibility. Giving back the survivor as much control possible is important by allowing the client to make decisions about who to call, what to do next, and what the client would like done in relation to the crime. The nurse's role in helping the survivor regain control is an essential part of recovery.

A nurse is caring for a young adult in the mental health clinic. The client tells the nurse that the client was physically neglected as a child. The nurse should assess the client for symptoms of what? Major depression Panic disorder Schizophrenia Narcissistic personality disorder

Major depression

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

Men may not consider behaviors such as slapping or shoving as abuse. Men are sometimes hesitant to report victimization or may not consider behaviors such as shoving or slapping "abuse." Nearly one in four women and one in nine men are victims of IPV at some point in their lives. Women are much more likely than men to be seriously injured as a result of IPV and to require medical treatment. IPV in same-sex couples occurs with at least the same frequency as in heterosexual relationships, but individuals with same-sex partners may not be afforded the same support. The reaction to IPV may differ by gender.

A nurse is working with a child whose parents have subjected him to neglect and emotional maltreatment, which primarily took the form of unavailability and general disinterest in his welfare. The nurse should expect that a child subjected to this type of maltreatment would experience problems in which of the following? Multiple intellectual, physical, behavioral, and emotional arenas Emotional and intellectual functioning Behavioral and emotional functioning Behavioral and physical functioning

Multiple intellectual, physical, behavioral, and emotional arenas Maltreated children tend to have difficulties in social, behavioral, emotional, and intellectual functioning, as well as physical growth and development.

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

Recognizing the signs of danger One of the most important teaching goals is to help survivors develop a safety plan. The first step in developing such a plan is helping the survivor recognize the signs of danger. Changes in tone of voice, use of alcohol and other drugs, and increased criticism may indicate that the perpetrator is losing control. Detecting early warning signs helps survivors to escape before battering begins. The next step is to devise an escape route. This involves mapping the house and identifying where the battering usually occurs and what exits are available. The survivor needs to have a bag packed and hidden, but readily accessible, containing what is needed to get away. If children are involved, the adult survivor should make arrangements to get them out safely. That might include arranging a signal to indicate when it is safe for them to leave the house and to meet at a prearranged place. A safety plan for a child or dependent older adult might include safe places to hide and important telephone numbers, including 911, police and fire departments, and other family members and friends.

Which provides the most appropriate example of neglect according to the definition of the term? Disciplining a 6-year-old child for "sassing" by putting tape on the child's mouth. Correcting a child in front of the entire class for copying homework. Criticizing a child frequently for being overweight and restricting the child's diet. Rejecting a 3-year-old who cries and seek affection after falling

Rejecting a 3-year-old who is crying and seeking affection after the child stumbles and falls Neglect is an act of omission that involves a failure by a parent or other adult to meet a dependent's basic needs, such as by providing appropriate emotional care. Rejecting a crying 3-year-old who seeks comfort after falling is an example of neglect. Harsh or humiliating discipline is an act of commission in which the adult actively inflicts physical or psychological harm. Attempting to improve a child's emotional or physical well-being in a misguided and harmful manner does not fit the definition of neglect.

The nursing student learning about intimate partner violence correctly identifies its prevalence in same-sex couples as what? Twice as often as in heterosexual couples Same frequency as in heterosexual couples Three times more frequent as in heterosexual couples Half as frequent as in heterosexual couples

Same frequency as in heterosexual couples Intimate partner violence in same-sex couples occurs with at least the same frequency as in heterosexual relationships, but people with same-sex partners may not be afforded the same support.

A client comes to the clinic for an evaluation. The nurse assesses the client and suspects that the client is a victim of abuse. Which finding would support the nurse's suspicion? Select all that apply. The client minimizes the severity of the injuries. The client came to the clinic right after the injuries occurred. The client has a history of frequent visits to the emergency department for injuries. The client is vague about the injuries on the body. The client voices statements about having control over current status.

The client is vague about the injuries on the body. The client minimizes the severity of the injuries. The client has a history of frequent visits to the emergency department for injuries. Findings that would support a suspicion of abuse include vagueness about any injuries and how they occurred, a delay in seeking treatment for the injuries, minimizing or denying about the severity of the injuries, history of frequent visits to the emergency department for injuries, and feelings of a loss of control or powerlessness.

A nurse is caring for a family in which the elderly mother has been a victim of abuse and neglect by her son 48 years of age. Which of the following would be most important for the nurse to keep in mind before interviewing the family? The main focus of the nurse's actions should be on improving the elderly mother's self-esteem. The nurse must allow the older adult mother to decide whether she wants to leave the situation. A top nursing priority would be to legally remove the son from the home. Placement for the older adult woman in a nursing home within the community is crucial.

The nurse must allow the older adult mother to decide whether she wants to leave the situation. Removing children and older adults from their families or caregivers often is necessary to ensure immediate safety. If the home of an abused or neglected child or older adult cannot be made safe, the nurse must facilitate the involvement of other professionals in placing the child or older adult in a foster home or nursing home. Still, intervening in cases of elder abuse is not a clear-cut issue. When an older adult's decision making is not impaired (competence is the legal term), he or she must be allowed an appropriate degree of autonomy in deciding how to manage the problem, even if the choice is to remain in the abusive situation. Forcing someone to do something against his or her wishes is in itself a form of victimization and denies autonomous decision making.

Which would not increase the likelihood that an older adult will incur physical abuse? The older adult lives with a son who receives financial aid. An older adult reports frequent multiple bruises that are related to falls. The older adult is independent with activities of daily living. The older adult has difficulty with mobility and can become confused.

The older adult is independent with activities of daily living. The correct option indicates that the older adult enjoys independence, an attribute that is not commonly seen in those older adults who experience physical abuse. Common factors that predispose older adult clients to physical abuse include having chronic medical or mental health conditions, living with a familial caregiver who is a male and has financial problems, and the reluctance to report abuse despite the presence of signs such as multiple bruises.

Which statement is true regarding children being raised in a home where they have witnessed intimate partner violence? It has little impact on child functioning. Female children are more likely to experience depression. They are at increased risk for being abused. They have higher rates of schizophrenia.

They are at increased risk for being abused. Children being raised in a home where they have witnessed intimate partner violence demonstrate higher levels of depression and lower levels of self-esteem; these effects are pronounced in boys especially. Children of battered women are at an increased risk for abuse. Exposure to intimate partner violence adversely affects a range of child functioning.

The nurse in the emergency room is assessing a client who was brought in by the police for evaluation after receiving a call from a neighbor. The client reports to the nurse that the person who has been cooking and helping around the house has not been home for days. Which type of abuse does the nurse suspect based on the client's statement? physical abandonment emotional neglect

abandonment Although abandonment can cause neglect and lead to physical and emotional abuse, abandonment is the primary type of abuse that this person is experiencing. The older person is calling for help because the caregiver has not been present for days. Neglect is the failure to meet basic needs of shelter and food. Physical abuse is causing injury by hitting, kicking, or pushing. Emotional abuse is injuring the person's self-worth and emotional well-being.

A young adult client female is assessed after being raped. The client reports being tied up and beaten while the perpetrator forced sexual intercourse. She recalls the perpetrator saying, "I will make you pay." What most accurately describes this category of rapist? anger retaliation power assertive anger excitement power reassurance

anger retaliation In this case, the most accurate description of this rapist is anger retaliation. In this category, the perpetrator wants to punish the victim and often causes substantial injury. The power assertive rapist desires to dominate and control the victim and may repeat with the same victim. The power reassurance rapist commits rape when the opportunity presents itself, such as when another crime is being committed. An anger excitement rapist acts out fantasies and can be strategic in carrying out the crime, for example, carries a rape kit.

The nurse assesses a client who comes to the emergency room for vaginal bleeding and swelling. The client reports she had sexual intercourse with her boyfriend the previous night and states, "It was consensual, but sometimes he is rough." The client begins to cry and looks away. What should the nurse suspect? sodomy neglect intimate partner violence family violence

intimate partner violence The client is experiencing sexual abuse in the context of a relationship with an intimate partner, also known as intimate partner violence. The physical injuries sustained as a result of sexual intercourse should generate suspicion that the client may have been raped by her boyfriend and further assessment for abuse is warranted. Sodomy is defined as anal intercourse. The client presents to the emergency room with vaginal bleeding and swelling indicating vaginal intercourse took place, not anal. Family violence takes place in the traditional family context and is directed at a spouse and/or the children who reside in the family unit. Neglect refers to the malicious or ignorant withholding of physical, emotional, or educational necessities for a child's well-being.

When assessing a 6-year-old child believed to be a victim of emotional abuse, the possibility is supported when the child is ... showing signs of developmental delays. observed to be anxious and rejecting adult attention. attending day care 5 days a week. parented by a single parent.

observed to be anxious and rejecting adult attention. While anxiety can be a sign of many different problems, an anxious child who rejects the attention of an adult may raise a red flag encouraging the nurse to assess further and possibly making a report. Developmental delays are not necessarily an indicator of emotional abuse, nor is attending day care on a regular basis. Being raised by a single parent is also not necessarily an indicator of emotional abuse.

A 3-year-old who has been seen in the emergency department for various fall-related injuries is being treated for apparent blindness in the left eye as a result of retinal hemorrhage. The nurse should suspect that which form of child abuse is part of the cause of the child's condition? Child neglect Shaken baby syndrome Munchausen's syndrome by proxy Ineffective supervision

shaken baby syndrome Despite its name, shaken baby syndrome has been documented in children up to 5 years of age. The physical findings usually include bruising from being grabbed firmly along with major head injury, such as subdural hematoma or cerebral edema. Nonfatal consequences include blindness due to retinal hemorrhage.

A client who has been victimized repeatedly by a spouse is angry and verbally lashing out on the nurse. Based on the client's behavior, which technique would the nurse use with this client? provide stories about survivors of abuse suggest reenacting the abuse instruct in relaxation techniques use "I feel" statements

use "I feel" statements