OB - Chapter 9 Violence and Abuse

A nurse is performing a routine physical for a 7-year-old girl who is thin, unwashed, and dressed in rags. Although it is winter time, she has no coat with her. Her teenaged brother in the waiting room, however, is dressed in trendy clothes and looks healthy and well-fed. Which of the following should the nurse most strongly suspect regarding this girl? a) Physical neglect b) Sexual maltreatment c) Psychological maltreatment d) Physical maltreatment

Physical neglect

The nursing student is studying violence and abuse against the older woman. While researching it, she learns that laws require health care professionals to report elder or vulnerable person abuse. How many states currently have these laws? a) 40 b) 52 c) 50 d) 32

50

A nursing student studying sexual violence makes the following statement in class, "A man who has sex with his wife even though she did not want it cannot be charged with sexual abuse." Is this statement true or false? a) False b) True

False

The first phase of the abuse cycle is characterized by: a. The woman provoking the abuser to bring about battering b. Tension building and verbal or minor battery c. A honeymoon period that lulls the victim into forgetting d. An acute episode of physical battering

Tension building and verbal or minor battery

A nurse is conducting an awareness session on sexual abuse, and she is explaining the psychological profile of an average abuser. Which trait is often displayed by abusers? a) They belong to the low-income group. b) They are usually physically imposing. c) They have parents who are divorced. d) They exhibit antisocial behaviors.

They exhibit antisocial behaviors.

A nurse is working in a community hospital situated in an area with a history of grievous assaults on women, including rape. The nurse discovers that most rape victims come to the hospital but leaves without seeking medical tx. Which of the following interventions should the nurse perform to ensure that rape victims get legal and medical aid?

ensure that the appropriate law enforcement agencies are apprised of the incident

The nurse who counsels women who suffer from abuse understands that abuse can come in different forms that include which of the following? (Check all that apply.) a) sexual abuse b) spiritual abuse c) physical abuse d) financial abuse e) emotional abuse

sexual abuse physical abuse financial abuse emotional abuse

statutory rape

the act of unlawful sexual intercourse by an adult with someone under the age of consent, even if the minor is a willing and voluntary participant in the sexual act

What is the leading cause of death in pregnant women? a) Amniotic fluid embolism b) Undiagnosed cardiac condition c) Pulmonary embolism d) Intimate partner violence

Intimate partner violence

Which of the following is FALSE regarding emergency contraception (EC)? a) EC will disrupt an established pregnancy if taken within 72 hours. b) EC simply contains the same hormones that are found in birth control pills. c) EC works by preventing fertilization, ovulation, or implantation. d) EC is most effective if it is taken within 12 hours of rape.

EC will disrupt an established pregnancy if taken within 72 hours.

The nursing instructor is discussing violence and abuse that is seen in women with a student. She realizes that the student needs further instruction when the student states which of the following? a) Nurses will come in contact with violence no matter what health care setting they work. b) Violence against women is on the rise in the United States. c) Nurses will come in contact with sexual abuse no matter what health care setting they work. d) Nurses only come in contact with violence in the ER.

Nurses only come in contact with violence in the ER.

The nurse is talking to a female client who is a survivor of intimate partner violence. The woman relates that her husband has been told that he has the characteristics of an antisocial personality disorder. The woman also informs the nurse that her husband has an extensive criminal record. The nurse interprets this information and suspects that the woman's husband would most likely demonstrate which behavior? a) A risk for moderate to severe violence with people both within and outside his family b) Intermittent remorse for the violence and abuse that he commits c) Symptoms of depression along with harboring feelings of inadequacy d) Purposefully remain socially isolated from people other than those in his family

A risk for moderate to severe violence with people both within and outside his family

When describing an episode, the victim reports that she attempted to calm her partner down to keep things from escalating. This behavior reflects which phase of the cycle of violence? A) Battering B) Honeymoon C) Tension-building D) Reconciliation

Ans: C Feedback: During the first phase, tension-building, the woman attempts to keep the situation from exploding based on her belief that the partner's anger is legitimately directed at her. The battering phase involves the explosion of violence. The honeymoon or reconciliation phase is manifested by a period of calm, loving, contrite behavior on the part of the batterer. The batterer may be genuinely sorry for the pain he caused.

Nurses sometimes have difficulty assessing women for violence. Which of the following refers to the screen protocol to use to be the most thorough? a) The RACE model b) The FACE model c) The SBAR model d) The SAVE model

The SAVE model

A nurse is caring for a client who was raped at gunpoint. The client does not want any photos taken of her injuries. The client also does not want the police to be informed about the incident even though state laws require reporting life-threatening injuries. Which intervention should the nurse perform to document and report the findings of the case? a) Document only descriptions of medical interventions taken b) Use direct quotes and specific language c) Respect the client's opinion and avoid informing the police d) Obtain photos to substantiate the client's case in a court of law

Use direct quotes and specific language dont take pictures without informed consent. Document refusal of client to be photographed

The generation-to-generation continuum of violence refers to the fact that a) Children who grow up in abusive homes almost always become abusers themselves unless they have professional intervention b) Children who grow up in an abusive home are less likely to be abusers themselves because they see first hand the devastation that violence can cause c) Violence is an innate behavior, and children become abusers because of external factors in their environment more often than in their family d) Violence is a learned behavior, and children who witness abuse are more likely to become abusers themselves

Violence is a learned behavior, and children who witness abuse are more likely to become abusers themselves

When caring for an abused woman, the nurse uses the ABCDES framework to provide interventions. Which of the following are components of this framework? Select all that apply. a) Plan of action and resources for safety for when the woman decides to leave b) Clear documentation of the nurse's perception of the abuse c) Expression of the belief that there may be a reason for the violence d) Education about the cycle of violence and its escalation e) Maintenance of confidentiality of the information reported f) Reassurance that the woman is not alone in this situation

• Plan of action and resources for safety for when the woman decides to leave • Maintenance of confidentiality of the information reported • Reassurance that the woman is not alone in this situation • Education about the cycle of violence and its escalation

If the following data was collected on a group of children, which of the following would most likely be evaluated as possibly related to child abuse? Select all that apply. a) A child who has a spiral fracture in the femur. b) A child who has chronic nausea and diarrhea. c) A child whose blood work shows evidence of anemia. d) A child whose X-ray shows bone fractures in various stages of healing. e) A child whose CT scan shows a cerebral hemorrhage.

• A child who has a spiral fracture in the femur. • A child whose X-ray shows bone fractures in various stages of healing. • A child whose CT scan shows a cerebral hemorrhage.

A nurse is interviewing a client who is a survivor of abuse. The client is telling the nurse about how the violence occurred. Which statement would the nurse interpret as reflecting phase 3 of the cycle of violence? a) "He calls me stupid and incompetent, asking himself why he ever married me." b) "He threw me against the wall and started punching my face." c) "He tells me that he is sorry and that he will never hit me again." d) "He yells at me for not having dinner waiting for him when he came home."

"He tells me that he is sorry and that he will never hit me again."

A woman has just confided in the nurse that her partner slapped and kicked her that morning. What is the best response by the nurse? a) "Oh my goodness, I cannot believe that happened to you. You poor thing, I feel terrible for you." b) "It's very brave of you to tell me all this. Help is available if you choose it." c) "Maybe he didn't mean to do it. Have you talked with him about it?" d) "Is this the first and only time he has done anything?"

"It's very brave of you to tell me all this. Help is available if you choose it."

A nurse is presenting a program to a church group about domestic violence. During the presentation, a member of the audience asks the nurse to explain what "intergenerational transmission of violence" means because he has seen that phrase used in the media. Which of the following responses by the nurse would be most appropriate? a) "Domestic violence seems to skip every other generation when it is traced in families." b) "People who grow up in violent home situations tend to be involved in domestic violence situations as an adult." c) "Recent research has identified a gene that is responsible for transmission of a risk for violent behavior that is passed on from generation to generation." d) "People who are violent are that way because of the various neurochemical imbalances in their brains."

"People who grow up in violent home situations tend to be involved in domestic violence situations as an adult."

Which of the following statements might empower abuse victims to take action? a. "You deserve better than this." b. "Your children deserve to grow up in a two-parent family." c. "Try to figure out what you do to trigger his abuse and stop it." d. "Give your partner more time to come to his senses about this."

"You deserve better than this."

Which of the following nursing actions would be least helpful for a client who is a victim of violence? A) Assist the client to project her anger. B) Provide information about a safe home and crisis line. C) Teach her about the cycle of violence. D) Discuss her legal and personal rights.

Ans: A Feedback: The goal of intervention is to enable the victim to gain control by providing sensitive, predictable care in an accepting setting. Assisting the client to project her anger would not be helpful when the woman needs support and education.

A nurse suspects that a 6-year-old girl is being sexually maltreated by her father, based on some comments made by the girl. Which of the following methods would be most effective in confirming the nurse's suspicion? a) Assess the girl for unexplained fractured bones b) Check for any sexual perpetrators listed in the area under Megan's law c) Ask the girl's mother what she knows of the father's activities d) Ask the girl to draw a picture of what happened

Ask the girl to draw a picture of what happened

A pregnant client and her husband are at their first prenatal visit. While performing the admission history, the nurse notes several new and old bruises on the woman's neck and body. She is silent and withdrawn. The husband answers all the questions. Based on these observations, the nurse suspects intimate partner violence. Which of the following is the most appropriate nursing intervention at this time? a) Ask the woman if she would like her husband to wait outside in the lobby. b) Ask the husband to wait in the lobby while the client is being examined. c) Ask the couple if they would like to see a social worker. d) Ask the husband if he feels the client has been depressed throughout the pregnancy.

Ask the husband to wait in the lobby while the client is being examined.

A nurse is assessing a boy who was recently found to have been molested by a neighbor. Which of the following characteristics is most likely in a pedophile? a) Physically abusive b) Violent c) Emotional fixation at a childhood level d) Homosexual

Emotional fixation at a childhood level

Question: Place the three phases of intimate partner violence in the order in which they occur. 1. Acute violence phase 2.Tension-building phase 3.Honeymoon phase

Tension-building phase, Acute violence phase, Honeymoon phase

The nurse is assisting with a physical exam on a child who has been admitted with a diagnosis of possible child abuse. Which of the following findings might alert the nurse to this possibility that the child may have been abused? a) The child has a fractured bone. b) The child has a burn that has not been treated. c) The child has bruises on the knees and elbows. d) The child is hyperactive and angry.

The child has a burn that has not been treated.

A young mother brings her 6-month-old in for an examination, appearing listless and inattentive of her child. She sets the child in the floor and reads and sends text messages on her phone. The child appears underweight and lethargic. Which finding would confirm the nurse's suspicion that this child is experiencing failure to thrive? a) The child rests her head on the nurse's shoulder and cuddles with her after the examination b) The child is below the fifth percentile for weight and height c) The child resists when the nurse takes her vital signs d) The child cries when the nurse picks her up

The child is below the fifth percentile for weight and height

The nurse has learned that the number one factor that will motivate a woman to escape an abusive relationship is which of the following? a) fear of harm to herself b) fear of death c) fear of harm to other family members d) fear of harm to her unborn child

fear of harm to her unborn child

A client is receiving treatment for injuries sustained during a fight with her partner. The nurse observes that the partner visits her daily in the hospital and appears very solicitous and contrite. When questioned, the client tries to convince the nurse that her partner always apologizes and brings gifts after a fight. Which information should the nurse provide this client? a) "Your partner seems to be genuinely contrite." b) "Although your partner seems sorry, often they will repeat this behavior in the future." c) "Sometimes people do things that cause them to be a victim of physical abuse." d) "You should try not to upset your partner in the future."

"Sometimes people do things that cause them to be a victim of physical abuse."

A client comes to a local community health care facility for a routine check-up. While talking to the nurse, the client happens to mention that every time she has a serious fight with her husband, he forces her to have intercourse with him. The client seems to be very disturbed when revealing this to the nurse. Which is an appropriate response by the nurse? a) "Your husband is just trying to reconcile using intimacy." b) "It's okay in cases of fights where you're really at fault." c) "This behavior is considered sexual abuse." d) "Such behavior is considered normal in a married couple."

"This behavior is considered sexual abuse."

The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse in which of the following situations? a) A 6-year-old with a greenstick fracture of the wrist, which the caregiver reports was caused when the child fell while ice-skating b) A 7-year-old with a spiral fracture of the humerus, which the caregiver reports was caused when the child was hit with a bat swung by a Little League teammate c) A 10-year-old with a simple fracture of the femur, which the caregiver reports was caused when the child fell down a set of stairs d) A 9-year-old with a compound fracture of the tibia, which the caregiver reports was caused when the child attempted a flip on a skateboard

A 7-year-old with a spiral fracture of the humerus, which the caregiver reports was caused when the child was hit with a bat swung by a Little League teammate

Which of the following would be considered child abuse? Select all that apply. a) A caregiver intentionally is demeaning to a child. b) A caregiver neglects a child's physical needs. c) A caregiver lets a child participate in school activities and the child gets injured. d) A caregiver allows siblings to talk inappropriately to each other.

A caregiver intentionally is demeaning to a child. A caregiver neglects a child's physical needs.

The nurse is talking to a female client who is a survivor of intimate partner violence. The woman relates that her husband has been told that he has the characteristics of an antisocial personality disorder. The woman also informs the nurse that her husband has an extensive criminal record. The nurse interprets this information and suspects that the woman's husband would most likely demonstrate which behavior? a) A risk for moderate to severe violence with people both within and outside his family b) Symptoms of depression along with harboring feelings of inadequacy c) Purposefully remain socially isolated from people other than those in his family d) Intermittent remorse for the violence and abuse that he commits

A risk for moderate to severe violence with people both within and outside his family

A nurse is working with a victim of intimate partner violence and helping her develop a safety plan. Which of the following would the nurse suggest that the woman take with her? (Select all that apply.) A) Driver's license B) Social security number C) Cash D) Phone cards E) Health insurance cards

Ans: A, B, C, E Feedback: When leaving an abusive relationship, the woman should take her driver's license or photo ID, social security number or green card/work permit, birth certificates, any court papers or orders, credit cards, cash, and health insurance cards. The woman should avoid phone cards because they leave a trail to follow.

The nursing instructor overhears students discussing their recent lecture topic of abuse and realizes that they need clarification when she hears a student say which of the following? a) Violence against lesbian relationships may go unreported for fear of harassment. b) Abuse occurs only in heterosexual relationships. c) Violence against gay relationships may go unreported for fear of harassment. d) Abuse occurs in both heterosexual and homosexual relationships.

Abuse occurs only in heterosexual relationships.

A nurse is caring for a rape victim who was just brought to the local emergency care facility. Which interventions should the nurse perform to minimize risk of pregnancy in this client? a) Wait for first signs of pregnancy before taking action b) Administer prescribed double dose of emergency contraceptive pills c) Apply spermicidal cream or gel near the vaginal area upon arrival d) Administer prescribed regular oral contraceptive pills

Administer prescribed double dose of emergency contraceptive pills -first dose within 72 hours - second dose 12 hours after first dose

When providing care to a victim of abuse, which of the following would the nurse do? a) Provide an overview of the procedures to be done. b) Make the decisions for the woman. c) Take the lead in providing the interventions quickly. d) Allow the woman to participate in her care.

Allow the woman to participate in her care.

When developing a presentation for a local community organization on violence, the nurse is planning to include statistics on intimate partner abuse and its effects on children. In what percentage of the cases in which a parent is abused are the children battered also? A) 50% to 75% B) 25% to 50% C) 10% to 25% D) Less than 5%

Ans: A Feedback: In 50% to 75% of cases when a parent is abused, the children are abused as well.

After teaching a group of students about sexual abuse and violence, the instructor determines that the teaching was successful when the students describe incest as involving which of the following? A) Sexual exploitation by blood or surrogate relatives B) Sexual abuse of individuals over age 18 C) Violent aggressive assault on a person D) Consent between perpetrator and victim.

Ans: A Feedback: Incest is any type of sexual exploitation between blood relatives or surrogate relatives before the victim reaches 18 years of age. Rape is a violent, aggressive assault on the victim's body and integrity. Rape is a legal rather than a medical term. It denotes penile penetration of the vagina, mouth, or rectum of the female or male without consent. It may or may not include the use of a weapon.

When a nurse suspects that a client may have been abused, the first action should be to: A) Ask the client about the injuries and if they are related to abuse. B) Encourage the client to leave the batterer immediately. C) Set up an appointment with a domestic violence counselor. D) Ask the suspected abuser about the victim's injuries.

Ans: A Feedback: The first step is to screen for abuse and identify the connection between the woman's injuries and abuse. Once abuse is detected, the nurse should immediately isolate the woman to provide privacy and prevent retaliation by the abuser. Encouraging the woman to leave the batterer immediately is not realistic. Setting up an appointment with a counselor would be appropriate once the abuse is detected and the woman is safe. Questioning the suspected abuser might worsen the situation.

When the nurse is alone with a client, the client says, "It was all my fault. The house was so messy when he got home and I know he hates that." Which response would be most appropriate? A) "It is not your fault. No one deserves to be hurt. " B) "What else did you do to make him so angry with you?" C) "You need to start to clean the house early in the day." D) "Remember, he works hard and you need to meet his needs."

Ans: A Feedback: The nurse needs to communicate nonjudgmental support and explain that no one deserves to be abused. Doing so helps to establish trust and rapport. Asking the woman what she did to make the partner so angry, telling her to clean the house earlier in the day, and telling her that she needs to meet his needs all shift the blame to the victim and are thus inappropriate.

After teaching a class on sexual violence, the instructor determines that the teaching was successful when the class identifies which of the following as a type of sexual violence. (Select all that apply.) A) Female genital cutting B) Bondage C) Infanticide D) Human trafficking E) Rape

Ans: A, B, C, D, E Feedback: Female genital cutting, bondage, infanticide, human trafficking, and rape are all examples of sexual violence.

In addition to providing privacy, which of the following would be most appropriate initially in situations involving suspected abuse? A) Allow the client to have a good cry over the situation. B) Tell the client, "Injuries like these don't usually happen by accident." C) Call the police immediately so they can question the victim. D) Ask the abuser to describe his side of the story first.

Ans: B Feedback: Communicating support through a nonjudgmental attitude and telling her that no one deserves to be abused are the first steps in establishing trust and rapport. Allowing the client to cry is appropriate after the client is safe, her privacy is protected, and the nurse has emphasized that there is a problem. Notifying the police is done once the assessment reveals suspicion or actual indications of abuse. Asking the abuser to describe his side of the story is inappropriate.

A nurse is reading a journal article about sexual abuse. Which age range would the nurse expect to find as the peak age for such abuse? A) 7-10 years B) 8-12 years C) 14-18 years D) 18-22 years

Ans: B Feedback: Current estimates indicate that 1 of 5 girls is sexually abused, and the peak ages of such abuse are from 8 to 12 years of age. At every age in the life span, females are more likely to be sexually abused by father, brother, family member, neighbor, boyfriend, husband, partner or ex-partner than by a stranger or anonymous assailant.

Which of the following would the nurse describe as a characteristic of the second phase of the cycle of violence? A) The batterer is contrite and attempts to apologize for the behavior. B) The physical battery is abrupt and unpredictable. C) Verbal assaults begin to escalate toward the victim. D) The victim accepts the anger as legitimately directed at her.

Ans: B Feedback: During the second phase of the cycle of violence, the violence explodes and the batterer loses control physically and emotionally. During the honeymoon or third phase, the batterer is contrite and attempts to apologize for the behavior. During the first phase or tension-building phase, verbal or minor battery occurs and the woman often accepts her partner's building anger as legitimately directed toward her.

A nurse is presenting a discussion on sexual violence at a local community college. When describing the incidence of sexual violence, the nurse would identify that a woman has which chance of experiencing a sexual assault in her lifetime? A) One in three B) One in six C) Two in 15 D) Three in 20

Ans: B Feedback: The National Center for Prevention and Control of Sexual Assault estimates that one out of six women will be sexually assaulted sometime in her life, and two thirds of these assaults will not be reported.

A nurse is caring for a woman who was recently raped. The nurse would expect this woman to experience which of the following first? A) Denial B) Disorganization C) Reorganization D) Integration

Ans: B Feedback: The acute phase of rape recovery is disorganization characterized by shock, fear, disbelief, anger, shame, guilt and feelings of uncleanliness. This is followed by denial (outward adjustment), reorganization, and finally integration and recovery.

A battered pregnant woman reports to the nurse that her husband has stopped hitting her and promises never to hurt her again. Which of the following is an appropriate response? A) "That's great. I wish you both the best." B) "The cycle of violence often repeats itself." C) "He probably didn't mean to hurt you." D) "You need to consider leaving him."

Ans: B Feedback: The cycle of violence typically increases in frequency and severity as it is repeated over and over again. The woman needs to understand this.

When describing the cycle of violence to a community group, the nurse explains that the first phase usually is: A) Somehow triggered by the victim's behavior B) Characterized by tension-building and minor battery C) Associated with loss of physical and emotional control D) Like a honeymoon that lulls the victim

Ans: B Feedback: The cyclic behavior begins with a time of tension-building arguments, progresses to violence, and settles into a making-up or calm period.

A nurse is assessing a rape survivor for post-traumatic stress disorder. The nurse asks the woman, "Do you feel as though you are reliving the trauma?" The nurse is assessing for which of the following? A) Physical symptoms B) Intrusive thoughts C) Avoidance D) Hyperarousal

Ans: B Feedback: The question is used to assess the woman for intrusive thoughts that reflect the client reexperiencing the trauma. Physical symptoms would be assessed with questions about sleeping, eating, palpitations and other problems. Avoidance would be reflected in questions involving withdrawal socially, avoiding situations that remind the woman of the rape. Hyperarousal would be noted by irritability and an exaggerated startle response.

The nurse is presenting a class at a local community health center on violence during pregnancy. Which of the following would the nurse include as a possible complication? A) Hypertension of pregnancy B) Chorioamnionitis C) Placenta previa D) Postterm labor

Ans: B Feedback: Women assaulted during pregnancy are at risk for chorioamnionitis, placental abruption, preterm labor, stillbirth, miscarriage, uterine rupture, and injuries to the mother and fetus. Hypertension of pregnancy is not associated with violence during pregnancy.

A group of nurses are researching information about risk factors for intimate partner violence in men. Which of the following would the nurses expect to find related to the individual person? (Select all that apply.) A) Dysfunctional family system B) Low academic achievement C) Victim of childhood violence D) Heavy alcohol consumption E) Economic stress

Ans: B, C, D Feedback: Individual risk factors associated with intimate partner violence include young age, heavy drinking, low academic achievement, and experience of or witnessing of violence as a child. Dysfunctional family system and economic stress are risk factors associated with the relationship.

A group of students are preparing a class discussion about rape and sexual assault. Which of the following would the students include as being most accurate? (Select all that apply.) A) Most victims of rape tell someone about it. B) Few women falsely cry "rape." C) Women have rape fantasies desiring to be raped. D) A rape victim feels vulnerable and betrayed afterwards. E) Medication and counseling can help a rape victim cope.

Ans: B, D, E Feedback: The majority of women never tell anyone about a rape. Almost two thirds of victims never report it to the police. The victim feels vulnerable, betrayed, and insecure after a rape. Few women falsely cry "rape." Reality and fantasy are different and dreams have nothing to do with the brutal violation of rape. Medication can help initially, but counseling is usually needed.

During a follow-up visit to the clinic, a victim of sexual assault reports that she has changed her job and moved to another town. She tells the nurse, "I pretty much stay to myself at work and at home." The nurse interprets these findings to indicate that the client is in which phase of rape recovery? A) Disorganization B) Denial C) Reorganization D) Integration

Ans: C Feedback: During the reorganization phase, the survivor attempts to make life adjustments by moving or changing jobs and uses emotional distancing to cope. The disorganization phase is characterized by shock, fear, disbelief, anger, shame, guilt, and feelings of uncleanliness. During the denial or outward adjustment phase, the survivor appears outwardly composed and returns to work or school and refuses to discuss the assault and denies the need for counseling. During the integration and recovery phase, the survivor begins to feel safe and starts to trust others.

Teaching for victims who are recovering from abusive situations must focus on ways to: A) Enhance their personal appearance and hairstyle B) Develop their creativity and work ethic C) Improve their communication skills and assertiveness D) Plan more nutritious meals to improve their own health

Ans: C Feedback: Providing reassurance and support to a victim of abuse is key if the violence is to end. Appropriate actions can help victims express their thoughts and feelings in constructive ways and strengthen their control over their lives. Although interventions related to personal appearance and creativity can enhance the woman's self-esteem, they are not helpful in dealing with the abuse. Planning nutritious meals helps to promote a healthy lifestyle but is ineffective in dealing with the abuse.

The primary goal when working with victims of intimate partner violence is to: A) Convince them to leave the abuser soon B) Help them cope with their life as it is C) Empower them to regain control of their life D) Arrest the abuser so he or she can't abuse again

Ans: C Feedback: The goal of intervention is to enable the victim to gain control over her life. Although the nurse can encourage the woman to leave the abuser, the choice to leave must be made by the woman. The nurse can provide support and assistance with coping, but the ultimate goal is for the woman to become empowered. Arresting the abuser does not necessarily stop the abuse.

Which approach would be most appropriate when counseling a woman who is a suspected victim of violence? A) Offer her a pamphlet about the local battered women's shelter. B) Call her at home to ask her some questions about her marriage. C) Wait until she comes in a few more times to make a better assessment. D) Ask, "Have you ever been physically hurt by your partner?"

Ans: D Feedback: If violence is suspected, the nurse must use direct or indirect questions to screen for abuse. Asking the woman if she has ever been physically hurt by her partner is most appropriate. Offering her a pamphlet, calling her at home, or waiting until she returns are inappropriate and do not validate the suspicion.

After teaching a class on date rape, the instructor determines that the teaching was successful when the class identifies which of the following as the most common date rape drug? A) Gamma hydroxybutyrate B) Liquid ecstasy C) Ketamine D) Rohypnol

Ans: D Feedback: Rohypnol is the most common date rape drug. Others include gamma hydroxybutyrate, or liquid ecstasy, and ketamine.

Which of the following statements would be most appropriate to empower victims of violence to take action? A) "Give your partner more time to come around." B) "Remember—children do best in two-parent families." C) "Change your behavior so as not to trigger the violence." D) "You are a good person and you deserve better than this."

Ans: D Feedback: To help the woman gain control over her life, the nurse should emphasize that abuse is never okay and that the woman did not deserve the abuse or ask for it. Telling the woman to give her partner more time, saying that children need two parents, and suggesting that she change her behavior do not promote control; rather, they attempt to excuse the partner's behavior.

A 16-year-old girl is seen in an emergency room following a rape. The management of a rape victim should be directed primarily toward a) teaching the child how to prevent further attacks. b) decreasing guilt and increasing self-esteem. c) assessing for sources of infection resulting from the rape. d) relieving physical discomfort and pain.

decreasing guilt and increasing self-esteem.

When a pregnant patient is abused during her pregnancy what complication is likely to occur after delivery due to the abuse? a) post-partum depression b) schizophrenia c) low birth weight d) edema

post-partum depression

When teaching a group of students about the cycle of violence, which behavior would the nurse describe as eventually disappearing as the violence becomes accelerated over time? a) Denial of the seriousness of the injuries b) Apologies for the pain and abuse c) Loss of control d) Excessive hostility and friction

Apologies for the pain and abuse

A woman comes to a local community health care facility with her partner. She has a broken arm and bruises on the face that she reports were caused by a fall. The nature of the injuries, however, causes the nurse to be convinced that this is a case of physical abuse. Which intervention should the nurse perform? a) Tell the partner to leave the room immediately b) Ask the partner directly if he was responsible c) Attempt to interview the woman in private d) Question the client about the injury in front of the partner

Attempt to interview the woman in private

Nurses at an urban emergency department seek to develop a plan to help women involved in abusive relationships. Which of the following components is critical to the success of the plan? a) A quality of life assessment tool b) An intimate partner violence (IPV) counselor c) Educational materials d) Avenues for referral

Avenues for referral

A nurse is conducting an awareness session on sexual abuse, and she is explaining the psychological profile of an average abuser. Which trait is often displayed by abusers? a) They have parents who are divorced. b) They are usually physically imposing. c) They exhibit antisocial behaviors. d) They belong to the low-income group.

C

A nurse is assigned to care for a hospitalized 14 year old with gastroenteritis. The teen tells the nurse that a brother ran away about 2 months ago and hasn't been heard from since, a sister has a substance abuse problem, and both parents are fighting. What type of situation is this family displaying? a) Child neglect b) Child abuse c) Dysfunctional dynamics d) Impaired parenting

Dysfunctional dynamics

The primary goal of intervention in working with abused women is to: a. Set up an appointment with a mental health counselor for the victim b. Convince them to set up a safety plan to use when they leave c. Help them to develop courage and financial support to leave the abuser d. Empower them and improve their self-esteem to regain control of their lives

Empower them and improve their self-esteem to regain control of their lives

Which of the following are biologic indicators of posttraumatic stress disorder (PTSD)? a) Auditory hallucinations b) A feeling of unreality about oneself c) Memory difficulties d) Flashbacks

Flashbacks

When implementing an intervention for a woman in an abusive situation, what is the primary goal? a) For the woman to be able to stand up to her abuser b) For the woman to be removed from her abusive relationship c) For the woman to regain a sense of control in her life d) For the woman to be able to care for herself

For the woman to regain a sense of control in her life

In caring for a child who has been admitted after being sexually abused, which of the following interventions would be included in the child's plan of care? a) Encourage frequent family visits b) Weigh on the same scale each day c) Observe for signs of anxiety d) Test the urine for glucose upon admission

Observe for signs of anxiety

A nurse observes telltale signs of injuries from physical abuse on the face and neck of a female client. When questioned, the client tells the nurse that the injuries are the result of a physical attack by her partner and that she has developed palpitations thereafter. Which action should the nurse take to gain the trust of the client and enhance the nurse-client relationship? a) Tell the client to forget about the incident to avoid the trauma b) Inform the client that there is no connection between the violence and palpitations c) Offer referrals so the client can get help that will allow her to heal d) Confirm with the partner whether the client's story is true

Offer referrals so the client can get help that will allow her to heal

Which of the following is TRUE regarding intimate partner violence? a) Even though women seldom blame themselves for the abuse, they often cannot leave the relationship. b) One in four women will be a victim of violence. c) Abusers often have outward signs that they are abusers or have a mental illness. d) Women who are in an abusive relationship experience less abuse while they are pregnant.

One in four women will be a victim of violence.

A patient who has been seen in the clinic multiple times for counseling recently admitted to being abused by her husband over a period of five years. Today she states, "He has been so sweet to me the last six days that I think this time he has really changed. He even brought me flowers yesterday and said he loves me." How should the nurse respond to this? a) Over a period of time the honeymoon phase ends and abuse becomes accelerated and thus more dangerous. b) That was a very sweet gesture. c) It seems as if he really loves you. d) I certainly would not be sucked into that.

Over a period of time the honeymoon phase ends and abuse becomes accelerated and thus more dangerous.

Women recovering from abusive relationships need to learn ways to improve their: a. Educational level by getting a college degree b. Earning power so they can move to a better neighborhood c. Self-esteem and communication skills to increase assertiveness d. Relationship skills so they will be better prepared to deal with their partners

Self-esteem and communication skills to increase assertiveness

A patient who is abused fails to report the abuse MAINLY because of which of the following reasons? a) She feels lucky to be alive. b) She feels responsible for causing the incident. c) She does not want anyone to know. d) She thinks it will not happen again.

She feels responsible for causing the incident.

A female client has been admitted to the inpatient psychiatric facility with a diagnosis of posttraumatic stress disorder after a history of violence by her boyfriend. During the initial assessment interview, which assessment would be the priority? a) Hydration status b) Suicide risk c) Sleep patterns d) Nutritional status

Suicide risk

Walter is an 11-year-old boy who was raised in a home where his father beat his mother on a regular basis. Which of the following statements is true regarding children being raised in a home where they have witnessed intimate partner violence? a) They have higher rates of schizophrenia b) They are at increase risk for being abused c) It has little impact on child functioning d) Female children are more likely to experience depression

They are at increase risk for being abused

Homicide from intimate partner violence is the number-one cause of death in pregnant women. a) False b) True

True

A 13-year-old immigrant from Asia is admitted to the health care facility with vaginal bleeding. A genital examination reveals unhealed circumcision wounds. The client can understand limited English but cannot speak the language fluently. The service of an interpreter is employed. What are the points the nurse should keep in mind when interacting with this client? a) Allow the interpreter to question the client directly to assist with data gathering b) Use pictures and diagrams to supplement the questions and answers of the client's understanding c) Condemn the cultural practice and explain why it is wrong to the client d) She is still a child so convey important information in precise medical terms to ease understanding

Use pictures and diagrams to supplement the questions and answers of the client's understanding

Which of the following is FALSE regarding screening for intimate partner violence in women? a) Screening should be routinely done at every visit. b) Although women who are abused may exhibit certain behavior patterns, all women should be screened for intimate partner violence. c) Women tend to fit a profile of abuse, and victims tend to share similar physical characteristics. d) An elderly female may be a victim of intimate partner violence.

Women tend to fit a profile of abuse, and victims tend to share similar physical characteristics.

Rohypnol

a potent sedative drug of the benzodiazepine class. "forget pill" (date rape drug)

A 5-year-old girl is being admitted with a possible diagnosis of child abuse. The child has bruises in various places on her body that the caregiver attributes to the child recently beginning to play soccer. Bruises associated with child abuse would likely be found in which of the following areas of the body? a) elbows b) forehead c) knees d) thighs

thighs

A nurse is interviewing a rape victim who was assaulted 6 month ago. Which questions should the nurse ask the client to know the extent of physical symptoms of PTSD? Select all that apply. a) "Are you having trouble sleeping?" b) "Do you have heart palpitations or sweating?" c) "Do you ever feel as you are reliving the event?" d) "Do you feel numb emotionally?" e) "Have you felt irritable or experienced outbursts of anger?"

• "Are you having trouble sleeping?" • "Have you felt irritable or experienced outbursts of anger?" • "Do you have heart palpitations or sweating?" • "Do you ever feel as you are reliving the event?"

A nurse is caring for a pregnant client and discovers signs of bruises near her neck. On questioning, the nurse learns that the bruises were caused by her husband. The client tells the nurse that her husband had stopped abusing her some time ago, but this was the first time during the pregnancy that she was assaulted. She blames herself because she admits to not paying enough attention to her husband. Which facts about abuse during pregnancy should the nurse tell the client to convince her that the abuse was not her fault? Select all that apply. a) Most men exhibit violent reactions during pregnancy as a way of coping with the stress. b) Abuse is a result of insecurity and jealousy of the pregnancy and the responsibilities it brings. c) Abuse is a result of the perception of the partner that the baby will be a competitor after he or she is born. d) Abuse is a result of concern for the unborn child when the mother doesn't fulfill her responsibilities toward the newborn. e) Abuse is a result of resentment toward the interference of the growing fetus and change in the woman's shape.

• Abuse is a result of insecurity and jealousy of the pregnancy and the responsibilities it brings. • Abuse is a result of resentment toward the interference of the growing fetus and change in the woman's shape. • Abuse is a result of the perception of the partner that the baby will be a competitor after he or she is born.

Which of the following would the nurse identify as indicating emotional abuse? Select all that apply. a) Calling the victim names b) Throwing things at a victim c) Not allowing the victim to seek care for an injury d) Threatening to hit the victim e) Controlling how the family's money is spent f) Forcing the victim to perform a degrading act

• Calling the victim names • Threatening to hit the victim • Forcing the victim to perform a degrading act

A nurse is working in a local community health care facility where she frequently encounters victims of abuse. For which signs should the nurse assess to find out if a client is a victim of abuse? Select all that apply. a) Reported history of the injury is inconsistent with the presenting problem b) Injuries on the face, head, and neck c) Partner of the suspected victim seems relaxed and not overly worried d) Affected by STIs frequently e) Mental health problems such as depression, anxiety, or substance abuse

• Injuries on the face, head, and neck • Mental health problems such as depression, anxiety, or substance abuse • Reported history of the injury is inconsistent with the presenting problem

Which of the following are forms of emotional abuse? Select all that apply. a) Humiliating b) Incest c) Destroying another's property d) Insulting e) Rape

• Insulting • Humiliating • Destroying another's property

A group of nursing students is preparing a talk on violence against women and how to prevent it. They want to list characteristics of intimate partner violence and should include which of the following? (Check all that apply.) a) use and abuse of substances such as alcohol b) history of childhood abuse c) history of antisocial behavior d) negative affect (hostility and depression) e) current unemployment f) easy-going personality

• history of childhood abuse • use and abuse of substances such as alcohol • history of antisocial behavior • current unemployment • negative affect (hostility and depression)

The nurse working in the obstetrics clinic has been trained to pick up on warning signs of abuse during pregnancy. These include which of the following?(Select all that apply.) a) more weight gain than recommended b) unrealistic fears c) difficulty with physical exams d) weight fluctuations e) noncompliance with treatment f) poor attendance at prenatal visits

• poor attendance at prenatal visits • unrealistic fears • weight fluctuations • difficulty with physical exams • noncompliance with treatment

The nurse who works in a woman's health clinic correctly identifies two key objectives for 2020 National Health Goals that addresses violence against women as which of the following? (Check two.) a) reduce the annual rate of rape or attempted rape b) increase the rate of women's depression c) reduce the rate of physical assault by current or former intimate partners d) increase the rate of women's consumed calories

• reduce the rate of physical assault by current or former intimate partners • reduce the annual rate of rape or attempted rape