The Point Chapter 12, Chapter 12: PrepU, Mental Health test #3 Chapter 12 Abuse and Violence, Abuse and violence prepU, Ch 12: Prep-U, Chapter 12 Abuse and Violence Questions, Chapter 12: Abuse and Violence

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

A mental health nurse is interviewing a child for suspected abuse. The parent states that the child is having disciplinary problems at school and stutters when approached. From the listed behavioral indicators, the nurse would suspect which type of abuse? Physical Sexual Financial Emotional

Emotional

Emotional Explanation: A behavioral profile of an emotionally abused child includes stuttering, enuresis, overeating, disciplinary problems, and failure to thrive. The scenario does not refer to physical, financial, or sexual abuse.

T/F: Adolescent suicide has not been correlated with bullying.

False

Spouse battering, child abuse, elder abuse, and marital rape are examples of _________violence.

Family

In a toddler, which injury is most likely the result of child abuse? A hematoma on the occipital region of the head A small, isolated bruise on the right lower extremity A 1-inch forehead laceration Several small, circular burns on the child's back

Several small, circular burns on the child's back

A client runs to the urgent care center because the spouse is at home drinking and waving a gun around while yelling at the children. Which action should the nurse take first?

contact the police

True or False? - rape is not sexual crime, rather a exertion of power, control, infliction of pain or punishment.

true

Which characteristics are found in violent families? Select all that apply. Abuse of power and control Social isolation Alcohol use disorder Adequate support systems

Abuse of power and control Alcohol use disorder Social isolation

What assessment data, related to a 77 year old client, would be considered the highest risk for possible elder abuse? Widowed, female Requires assistance with food preparation Diagnosed with mild dementia Lives with adult daughter

Diagnosed with mild dementia

Which statement about intimate partner violence (IPV) is accurate? Knowledge deficits and biases of health care professionals limit its detection. Screening tools to help the practitioner identify IPV are quite lengthy. Failure of victims to seek medical treatment is the primary reason for the underdetection of IPV. Victims do not often have physical injuries.

Knowledge deficits and biases of health care professionals limit its detection.

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 may not consider behaviors such as slapping or shoving as abuse.

repeated and persistent attempts to impose unwanted communication or contact with another personStalking

Stalking

The nurse's suspicion that a child has been sexually abused is supported by what assessment data? Select all that apply. The vulva appears edematous The anal area is bruised There are frequent ear infections The urinalysis reports a bacterial infection The child reports "itching down there"

The anal area is bruised The child reports "itching down there" The vulva appears edematous The urinalysis reports a bacterial infection

The psychiatric nurse recognizes that a male rape victim is less likely to report the crime due to which reason? Fear of being accused of engaging in socially inappropriate or illegal activities leading to the rape The impact it will have on his family The social ramifications of possibly contracting AIDS The belief that his masculinity will be in question

The belief that his masculinity will be in question

A nurse is screening a new client for intimate partner violence (IPV). What aspect of this woman's current circumstances is the most significant risk factor? The client's family lives on less than $1,000 per month. The client immigrated less than 5 years ago. The client has four children. The client has no extended family in the area.

The client's family lives on less than $1,000 per month. Explanation: Low income is a salient risk factor for IPV. Recent immigration, larger than average numbers of children, and a lack of extended family are not noted as major risk factors.

The nurse must allow the older adult mother to decide whether she wants to leave the situation.

Which would not increase the likelihood that an older adult will incur physical abuse? 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 lives with a son who receives financial aid.

The older adult is independent with activities of daily living.

The nurse's suspicion that a child has been sexually abused is supported by what assessment data? Select all that apply. The urinalysis reports a bacterial infection The child reports "itching down there" The vulva appears edematous There are frequent ear infections The anal area is bruised

The urinalysis reports a bacterial infection The child reports "itching down there" The vulva appears edematous The anal area is bruised

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.

T/F: Depression and suicidal behavior are common in survivors of abuse.

True

Which is an inaccurate picture of the cycle of abuse that occurs over time? Violent episodes are less frequent The period of remorse disappears Violent episodes are more frequent Severity of the injuries worsen

Violent episodes are more frequent

A nurse is preparing a presentation for an adolescent and young adult community group about stalking. Which group would the nurse identify as having the highest risk of being stalked?

Women, ages 18 to 24 years

A nurse is preparing a presentation for an adolescent and young adult community group about stalking. Which group would the nurse identify as having the highest risk of being stalked? Men, ages 24 to 28 years Boys and young men, ages 12 to 21 years Girls and young women, ages 10 to 18 years Women, ages 18 to 24 years

Women, ages 18 to 24 years

The psychiatric nurse recognizes that a male rape victim is less likely to report the crime due to which reason? a. The belief that his masculinity will be in question b. The social ramifications of possibly contracting AIDS c. Fear of being accused of engaging in socially inappropriate or illegal activities leading to the rape d. The impact it will have on his family

Which type of child abuse can be most difficult to treat effectively? a. Emotional b. Neglect c. Physical d. Sexual

The nurse is planning care for a client who is a victim of violence. Which of the following should the nurse identify as goals for this client's plan of care? Select all that apply. a. ensure safety b. prevent injury c. restore health d. prevent disease e. stop the violence

a b c e

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. a. The client is vague about the injuries on the body. b. The client came to the clinic right after the injuries occurred. c. The client minimizes the severity of the injuries. d. The client has a history of frequent visits to the emergency department for injuries. e. The client voices statements about having control over current status.

a c d

Examples of child maltreatment include a. calling the child stupid for climbing on a fence and getting injured. b. giving the child a time-out for misbehaving by hitting a sibling. c. failing to buy a desired toy for Christmas. d. spanking an infant who won't stop crying. e. watching pornographic movies in a child's presence. f. withholding meals as punishment for disobedience.

a d e f

A female client comes to an urgent care clinic and says, "I've just been raped." What should the nurse do? a. Allow the client to express whatever she wants b. Ask the client if staff can call a friend or family member for her c. Offer the client coffee, tea, or whatever she likes to drink d. Get the examination completed quickly to decrease trauma to the client e. Provide the client privacy—let her go to a room to make phone calls f. Stay with the client until someone else arrives to be with her

a. Allow the client to express whatever she wants b. Ask the client if staff can call a friend or family member for her f. Stay with the client until someone else arrives to be with her

Women in battering relationships often remain in those relationships as a result of faulty or incorrect beliefs. Which of the following beliefs is valid? a. If she tried to leave, she would be at increased risk for violence b. If she would do a better job of meeting his needs, the violence would stop c. No one else would put up with her dependent clinging behavior d. She often does things that provoke the violent episodes

a. If she tried to leave, she would be at increased risk for violence

Date rape, also known as_____________ rape, can occur on a first date or when the two individuals have known each other for some time.

acquaintance

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

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? a. Providing reassurance to the client that the care team and the police will prioritize the client's care b. Collecting specimens from the client for use as evidence c. Assisting with diagnostic tests to determine the extent of the client's injuries d. Asking the client to describe the perpetrator in detail and documenting the client's statement

A client runs to the urgent care center because the spouse is at home drinking and waving a gun around while yelling at the children. Which action should the nurse take first? b. contact the police c. assess the client for injuries d. call for an ambulance for transport to the hospital e. call a family member to pick up the children

Which assessment finding might indicate elder self-neglect? a. Hesitancy to talk openly with nurse b. Inability to manage personal finances c. Missing valuables that are not misplaced d. Unusual explanations for injuries

Which is the best action for the nurse to take when assessing a child who might be abused? a. Confront the parents with the facts, and ask them what happened. b. Consult with a professional member of the health team about making a report. c. Ask the child which parent caused this injury. d. Say or do nothing; the nurse has only suspicions, not evidence.

Which is true about domestic violence between same-sex partners? a. Such violence is less common than that between heterosexual partners. b. The frequency and intensity of violence are greater than between heterosexual partners. c. Rates of violence are about the same as between heterosexual partners. d. None of the above.

ignoring and excluding a target individual, has recently emerged as one of the more common and damaging forms of bullying is called what? a. neglect b. ostracism c. physical abuse d. psychological abuse (emotional abuse) e. rape

Which of the following assessment findings might indicate elder self-neglect? a. Hesitancy to talk openly with nurse b. Inability to manage personal finances c. Missing valuables that are not misplaced d. Unusual explanations for injuries

b. Inability to manage personal finances

A client runs to the urgent care center because the spouse is at home drinking and waving a gun around while yelling at the children. Which action should the nurse take first? assess the client for injuries contact the police call a family member to pick up the children call for an ambulance for transport to the hospital

contact the police

A nurse is preparing a presentation for an adolescent and young adult community group about stalking. Which group would the nurse identify as having the highest risk of being stalked? a. Boys and young men, ages 12 to 21 years b. Men, ages 24 to 28 years c. Girls and young women, ages 10 to 18 years d. Women, ages 18 to 24 years

The nurse is preparing a teaching plan for a client who experiences intimate partner violence. Which topics should the nurse include? Select all that apply. nutritional support access to shelters HIV testing employment counseling sleep hygiene

nutritional support access to shelters HIV testing sleep hygiene

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. attending day care 5 days a week. observed to be anxious and rejecting adult attention. parented by a single parent.

observed to be anxious and rejecting adult attention.

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

observed to be anxious and rejecting adult attention. Explanation: 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 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 assessment question should the nurse ask of a client suspected of being ostracized by a school bully?

"Do you feel like a part of a group in school?"

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." "His father physically abused his mother for years." "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."

"I don't know what else I can do to keep him from getting angry at me." Explanation: 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.

Which statement, made by a nurse who experienced sexual abuse as as a child, demonstrates being best prepared to work with sexual abuse and trauma survivors? "Survivors of sexual assault deserve the best care I can give them." "I've put the incident behind me and seldom think of it." "Working with survivors of sexual trauma is very fulfilling work." "I've been supported by health care professionals and now I want to support other survivors."

"I've been supported by health care professionals and now I want to support other survivors."

A nursing instructor teaching about sexual assault identifies a need for further instruction when one of the students makes which statement? "Sexual assault involves nonconsenting sexual activity." "Fondling can be a type of sexual assault." "Sexual assault occurs about once every 2 minutes in the United States." "It is not considered rape if it occurs with same-sex couples."

"It is not considered rape if it occurs with same-sex couples."

A nurse is preparing to gather a health history of a client. Which questions can elicit disclosure if a client has been abused? Select all that apply. "Some other women I have cared for have described problems like yours. If this is happening to you, can we talk about it." "It looks like someone has hurt you. Tell me about it." "When there are arguments at home, have you ever been hurt or afraid?" "It appears that you are distracted. Let me know when you are ready to discuss the incident." "I don't believe you. Why don't you tell me the truth?"

"When there are arguments at home, have you ever been hurt or afraid?" "It looks like someone has hurt you. Tell me about it." "Some other women I have cared for have described problems like yours. If this is happening to you, can we talk about it."

Approximately what percentage of women rape victims are raped by someone they know? 35% 45% 65% 55%

65%

Approximately what percentage of women rape victims are raped by someone they know? 65% 35% 45% 55%

65% Explanation: Approximately two-thirds of women are raped by people they know, including spouses, boyfriends, friends, or acquaintances. Among young women, about 50% of rapes are date rapes

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?

Abandonment

A nurse is caring for a child who had experienced sexual abuse. Which are expected behaviors of a child who has experienced sexual abuse? Select all that apply. High self-esteem Open and honest discussion about history Avoidance of sexually related content Secretiveness of behaviors Distorted view of sex

Avoidance of sexually related content Secretiveness of behaviors Distorted view of sex

During an interview, a client reveals to the nurse, "I was sexually abused as a child." Based on this information, which finding would the nurse most likely anticipate being revealed during the assessment? Select all that apply. Client has difficulty establishing interpersonal relationships Client has a history of substance abuse Client has difficulty establishing a mutually satisfying sexual relationship Client exhibits antisocial tendencies Client engages in self-harming behaviors

Client has difficulty establishing interpersonal relationships Client has a history of substance abuse Client has difficulty establishing a mutually satisfying sexual relationship Client engages in self-harming behaviors

Which is an inaccurate picture of the cycle of abuse that occurs over time? Violent episodes are less frequent Violent episodes are more frequent The period of remorse disappears Severity of the injuries worsen

Correct response: Violent episodes are less frequent Explanation: Over time, the violent episodes are more frequent, the period of remorse disappears altogether, and the level of violence and severity of injuries worsen.

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.

A nurse is gathering information about a health history of a person who has experienced violence. Which are important caring behaviors a nurse should implement during the interview? Select all that apply. Secure open communication. Maintain a nonjudgmental attitude. Discuss the nurse's personal feelings on victims of violence. Ask questions regarding religious background and preference. Establish trustworthiness.

Establish trustworthiness. Maintain a nonjudgmental attitude. Secure open communication.

A nurse who provides care in a large, urban emergency department has worked with numerous victims of various forms of abuse as well as those who are abusers. The nurse recognizes that persons who commit abuse are most likely what? Over 50 years of age Of low socioeconomic means Delusional and/or psychotic Past victims of abuse themselves

Past victims of abuse themselves

n clients who do not completely recover from the trauma of rape, which mental illness is mostlikely to develop? Post-traumatic stress syndrome Delirium Borderline personality disorder Anxiety disorders

Post-traumatic stress syndrome

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

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. A 6-year-old is being seen for the 5th time for a urinary tract infection b. A baby with contrecoup injuries to the brain c. A 3-month-old with a fractured femur d. A 15-month-old with shortness of breath after peanut ingestion e. A 3-year-old with a deep finger laceration

a b c

What are some types of behavior that the nurse would recognize as qualifying as psychological abuse? Select all that apply. a. Criticizing b. Ridiculing c. Threatening a victim's dog d. Asking for time alone when frustrated e. Using assertive language

a b c

Which type of child abuse can be most difficult to treat effectively? a. Emotional b. Neglect c. Physical d. Sexual

a. Emotional

Which of the following is the best action for the nurse to take when assessing a child who might be abused? a. Confront the parents with the facts and ask them what happened b. Consult with a professional member of the health team about making a report c. Ask the child which of his parents caused this injury d. Say or do nothing; the nurse has only suspicions, not evidence

b. Consult with a professional member of the health team about making a report

The _______________ phase in the cycle of violence is a period in which the perpetrator expresses remorse and regret.

honeymoon

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.

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? "I don't believe that's true but even if it were it doesn't excuse the real rapes that occur." "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."

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

Which assessment question should the nurse ask of a client suspected of being ostracized by a school bully? "Do you feel like a part of a group in school?" "Do you smoke or use drugs?" "Can you go to the school principal with personal problems?" "Have you talked to your parents about your problems at school?"

"Do you feel like a part of a group in school?"

A client states to the nurse, "My husband hits me. I want to leave him, but I have to be sure that I can leave and won't have to go back." Which question does the nurse ask during the psychosocial interview to assess the client's social network? "Did you experience any form of abuse when you were a child?" "Does your husband blame you for his abusive behavior?" "Do you have any friends who can provide emotional support?" "Does your husband criticize and belittle you?"

"Do you have any friends who can provide emotional support?"

The nurse can assess potential victims of domestic violence by asking which question? "What is your history of physical injuries?" "Do you need the number of a shelter?" "Has a past or current partner ever caused you to be afraid?" "What did you do right before your partner hit you?"

"Has a past or current partner ever caused you to be afraid?"

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? "He tells me that he is sorry and that he will never hit me again." "He threw me against the wall and started punching my face." "He calls me stupid and incompetent, asking himself why he ever married me." "He yells at me for not having dinner waiting for him when he comes home."

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

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." "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." "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."

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.

Which statement, made by a nurse who experienced sexual abuse as as a child, demonstrates being best prepared to work with sexual abuse and trauma survivors? "I've put the incident behind me and seldom think of it." "Working with survivors of sexual trauma is very fulfilling work." "I've been supported by health care professionals and now I want to support other survivors." "Survivors of sexual assault deserve the best care I can give them."

"I've been supported by health care professionals and now I want to support other survivors." Explanation: Nurses with a personal history of abuse or trauma must seek professional assistance to deal with these issues before working with survivors of trauma or abuse. Such nurses can be very effective and supportive of other survivors but only after engaging in therapeutic work and accepting and understanding their own trauma. The nurse should not repress the memories of the trauma but rather engage in the work needed to accept the incident. The other options present true statements but none are associated with being prepared to provide the necessary care.

A nurse is assessing a survivor of intimate partner violence. During the interview, the nurse determines that the survivor's partner is using power and control over the client through coercion and threats. Which client statement would lead the nurse to suspect this? "My partner always tells me that the abuse never happened." "My partner tells me who I can and cannot see." "My partner tells me that he or she will tell child services I'm a bad parent." "My partner acts like the master of the castle and I'm the servant."

"My partner tells me that he or she will tell child services I'm a bad parent." Explanation: The statement about telling child services that the client is a bad parent reflects coercion and threats. The statement about the abuse never happening reflects power and control through minimizing, denying, and blaming. The statement about whom the client can and cannot see reflects power and control through the use of isolation. The statement about the partner being the master of the castle reflects power and control through the use of privilege.

A client has been in a physically abusive relationship for more than a decade. Which statement best demonstrates that the client understands of how fear can influence a reluctance to leave such a relationship? "No one would believe me if I tell them how terrible life has been." "I do not have a job or anyway to support myself and my kids." "The kids love my partner and my partner has been a good parent to them." "My partner would hunt me down and kill me for sure."

"My partner would hunt me down and kill me for sure."

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 preparing to gather a health history of a client. Which questions can elicit disclosure if a client has been abused? Select all that apply. "Some other women I have cared for have described problems like yours. If this is happening to you, can we talk about it." "When there are arguments at home, have you ever been hurt or afraid?" "It looks like someone has hurt you. Tell me about it." "It appears that you are distracted. Let me know when you are ready to discuss the incident." "I don't believe you. Why don't you tell me the truth?"

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. "Would you like information on relaxation and sleep hygiene?" "Would you like information on community resources related to HIV and pregnancy?" "What do you do to avoid angering your abuser?" "Do you know any self-defense strategies to physically protect yourself?" "Do you have a safety and escape plan in place?"

"Would you like information on community resources related to HIV and pregnancy?" "Would you like information on relaxation and sleep hygiene?" "Do you have a safety and escape plan in place?"

"You have the right to be safe and respected."

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? "Relationship counseling can be very helpful." "I wonder if your perceptions of the relationship are accurate." "You have the right to be safe and respected." "I am here to help you through every step of this process."

"You have the right to be safe and respected."

"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.

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." "Relationship counseling can be very helpful." "I wonder if your perceptions of the relationship are accurate." "I am here to help you through every step of this process."

"You have the right to be safe and respected." Explanation: 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, imply doubt about the client's situation, or take charge and do everything for the client.

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?

12-32%

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%

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

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

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 nursing student learning about intimate partner violence (IPV) correctly identifies the percentage of deaths attributed to IPV to be what?

70% women and 30% men

A nursing student learning about intimate partner violence (IPV) correctly identifies the percentage of deaths attributed to IPV to be what? 90% women and 10% men 50% women and 50% men 70% men and 30% women 70% women and 30% men

70% women and 30% men

A nursing student learning about intimate partner violence (IPV) correctly identifies the percentage of deaths attributed to IPV to be what? 70% women and 30% men 70% men and 30% women 50% women and 50% men 90% women and 10% men

70% women and 30% men Explanation: Approximately 70% of victims killed by IPV are women and 30% are men.

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 6-year-old is being seen for the 5th time for a urinary tract infection A 3-month-old with a fractured femur A baby with contrecoup injuries to the brain A 3-year-old with a deep finger laceration A 15-month-old with shortness of breath after peanut ingestion

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

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 6-year-old is being seen for the 5th time for a urinary tract infection A 3-year-old with a deep finger laceration A 3-month-old with a fractured femur A 15-month-old with shortness of breath after peanut ingestion A baby with contrecoup injuries to the brain

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

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 is currently exploring long-term care options for her elderly father A client who expressed interest in joining a grief support group following the death of her husband A client who is in the third trimester of pregnancy and who is having biweekly prenatal appointments at a clinic 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 is in the third trimester of pregnancy and who is having biweekly prenatal appointments at a clinic

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 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? An intimate partner violence (IPV) counselor Access to community resources for referral A quality of life assessment tool Written educational materials

Access to community resources for referral Explanation: 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.

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 client is brought to the Emergency Department by a family member that reports being sexually assaulted while leaving work. What action by the nurse would best promote placing control back to the client? Inform the client that charges will have to be pressed against the perpetrator Allow the client to make decisions regarding care whenever possible Educate the client about attending a support group as soon as possible Inform the client that the assessment must be completed as soon as possible

Allow the client to make decisions regarding care whenever possible Explanation: The nurse can best offer support by allowing decisions to be made about care, who to call, and allow the care to be delivered at a pace that is comfortable for the client. It is the clients decision about whether or not to file charges and testify against the perpetrator. Educating the client about attending a support group may be done after the assessment and would be important but does not directly offer the support that is needed at this time. The assessment can be very traumatic for the client and should not be hurried or rushed through.

A school nurse is aware that a student has requested aspirin three times during the past week because his "back hurts." The nurse has noticed that he often wears long-sleeved sweaters and sweatshirts even in warm weather. The nurse suspects that the student may be the victim of physical abuse. The nurse is preparing to ask the child about his ongoing backache. Which of the following would the nurse anticipate being reported by the child if he was being abused? Carefully explain that his mother disciplines him because she loves him. Give the same reason his sister would give were she asked to explain his injuries. His father is beating him on a regular basis. Be reluctant to report abuse because of shame or fear of retaliation

Be reluctant to report abuse because of shame or fear of retaliation Explanation: Most survivors do not report violence to health care providers without specifically being asked about it. Survivors may be reluctant to report abuse because of shame and fear of retaliation, especially if the victim depends on the abuser as a caregiver. In addition, children may fear they will not be believed.

When attempting to preserve evidence from a possible rape with no report of oral sex, the female victim should be instructed that which self-care activities are permitted? Brushing her teeth Douching Showering Changing clothes

Brushing her teeth Explanation: To preserve possible evidence, the physical examination should occur before the women has showered, brushed her teeth, douched, changed her clothes, or had anything to drink.If there is no report of oral sex, then rinsing the mouth or drinking fluids can be permitted immediately.

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 Assisting with diagnostic tests to determine the extent of the client's injuries Asking the client to describe the perpetrator in detail and documenting the client's statement

Collecting specimens from the client for use as evidence Explanation: 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 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.

Correct response: "Do you feel like a part of a group in school?" Explanation: Ostracism, ignoring and excluding a target individual, has recently emerged as one of the more common and damaging forms of bullying. The victim experiences threats to belonging, self-esteem, meaningful existence, and sense of control. Ostracism may pose an even greater threat to children's adjustment than bullying. Those who bully are more likely to have poor grades and to use alcohol and tobacco. None of the remaining options are directly associated with the issue of ostracizing.

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? "He threw me against the wall and started punching my face." "He yells at me for not having dinner waiting for him when he comes home." "He calls me stupid and incompetent, asking himself why he ever married me." "He tells me that he is sorry and that he will never hit me again."

Correct response: "He tells me that he is sorry and that he will never hit me again." Explanation: During phase 3 of the cycle, the perpetrator becomes kind, contrite, and loving, begging for forgiveness and promising never to inflict abuse again. The actual violence occurs in phase 2. Yelling at the client for not having dinner ready and calling her stupid and incompetent reflect phase 1, or tension building.

Correct response: "I don't know what else I can do to keep him from getting angry at me." Explanation: 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.

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." "Relationship counseling can be very helpful." "I wonder if your perceptions of the relationship are accurate." "I am here to help you through every step of this process."

Correct response: "You have the right to be safe and respected." Explanation: 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, imply doubt about the client's situation, or take charge and do everything for the client.

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

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

Approximately what percentage of women rape victims are raped by someone they know? 65% 35% 45% 55%

Correct response: 65% Explanation: Approximately two-thirds of women are raped by people they know, including spouses, boyfriends, friends, or acquaintances. Among young women, about 50% of rapes are date rapes.

Correct response: 70% women and 30% men Explanation: Approximately 70% of victims killed by IPV are women and 30% are men.

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 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 A 15-month-old with shortness of breath after peanut ingestion A 3-year-old with a deep finger laceration

Correct response: 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 Explanation: 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.

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

Correct response: Abandonment Explanation: 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).

Which characteristics are found in violent families? Select all that apply. Adequate support systems Abuse of power and control Alcohol use disorder Social isolation

Correct response: Abuse of power and control Alcohol use disorder Social isolation Explanation: Abuse of power and control, alcohol use disorder, and social isolation are characteristics of violent families, as is an intergenerational transmission process. Adequate support systems are not a characteristic of a violent family.

Correct response: Allow the client to make decisions regarding care whenever possible Explanation: The nurse can best offer support by allowing decisions to be made about care, who to call, and allow the care to be delivered at a pace that is comfortable for the client. It is the clients decision about whether or not to file charges and testify against the perpetrator. Educating the client about attending a support group may be done after the assessment and would be important but does not directly offer the support that is needed at this time. The assessment can be very traumatic for the client and should not be hurried or rushed through.

A nurse is caring for a child who had experienced sexual abuse. Which are expected behaviors of a child who has experienced sexual abuse? Select all that apply. Avoidance of sexually related content Secretiveness of behaviors Open and honest discussion about history High self-esteem Distorted view of sex

Correct response: Avoidance of sexually related content Secretiveness of behaviors Distorted view of sex Explanation: A victim of prolonged sexual abuse will develop low self-esteem, a feeling of worthlessness, and a distorted view of sex. The child may become withdrawn, distrustful, or suicidal. Other characteristics of children who have been sexually abused include an unusual interest or avoidance of sexually related content, seductiveness, refusal to go to school, delinquency, secretiveness, and unusual aggressiveness.

A school nurse is aware that a student has requested aspirin three times during the past week because his "back hurts." The nurse has noticed that he often wears long-sleeved sweaters and sweatshirts even in warm weather. The nurse suspects that the student may be the victim of physical abuse. The nurse is preparing to ask the child about his ongoing backache. Which of the following would the nurse anticipate being reported by the child if he was being abused? His father is beating him on a regular basis. Be reluctant to report abuse because of shame or fear of retaliation Give the same reason his sister would give were she asked to explain his injuries. Carefully explain that his mother disciplines him because she loves him.

Correct response: Be reluctant to report abuse because of shame or fear of retaliation Explanation: Most survivors do not report violence to health care providers without specifically being asked about it. Survivors may be reluctant to report abuse because of shame and fear of retaliation, especially if the victim depends on the abuser as a caregiver. In addition, children may fear they will not be believed.

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 Assisting with diagnostic tests to determine the extent of the client's injuries Asking the client to describe the perpetrator in detail and documenting the client's statement

Correct response: Collecting specimens from the client for use as evidence Explanation: 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.

What are some types of behavior that the nurse would recognize as qualifying as psychological abuse? Select all that apply. Criticizing Ridiculing Threatening a victim's dog Asking for time alone when frustrated Using assertive language

Correct response: Criticizing Ridiculing Threatening a victim's dog Explanation: Psychological abuse includes behaviors such as criticizing, insulting, humiliating, or ridiculing someone in private or 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. Asking the client for time alone when frustrated or using assertive language reflect healthy, adaptive communications skills during conflict management. These are not examples of psychological abuse.

What assessment data, related to a 77 year old client, would be considered the highest risk for possible elder abuse? Lives with adult daughter Diagnosed with mild dementia Requires assistance with food preparation Widowed, female

Correct response: Diagnosed with mild dementia Explanation: While the risk of elder abuse exists in all the options provided, such abuse is more likely when the elder client has chronic mental and/or physical health problems that limit there ability to express their concerns and/or describe their current living conditions.

Correct response: Emotional Explanation: A behavioral profile of an emotionally abused child includes stuttering, enuresis, overeating, disciplinary problems, and failure to thrive. The scenario does not refer to physical, financial, or sexual abuse.

A nurse manager is working with the nursing staff of a busy community-based walk-in clinic that provides care to a large number of survivors of domestic violence. When helping the staff provide care, which information would be most important for the nurse manager to convey to the staff? Importance of measuring the clients' progress in small steps Expectation that survivors will accept change right away Encouragement for staff discussion about specific clients to gain support Identification of consequences from changes made by survivors as minimal

Correct response: Importance of measuring the clients' progress in small steps Explanation: Nurses must become accustomed to measuring gains in small steps when working with survivors. Making any changes in significant relationships has serious consequences and can be done only when the adult survivor is ready. It is easy to become angry or discouraged with survivors, so it is important not to communicate such feelings. Discussing such feelings with other staff provides a way of dealing with them appropriately. In such discussions with supervisors or other staff, it is a must to protect the patient's confidentiality by discussing feelings around issues, not particular patients.

Which type of abuse includes name calling and belittling? Psychological abuse Physical abuse Sexual abuse Sodomy

Correct response: Psychological abuse Explanation: Name calling and belittling are examples of psychological abuse. Physical abuse ranges from shoving and pushing to severe battering and choking. Sexual abuse includes assaults during sexual relations such as pulling hair, slapping, hitting, and rape. Sodomy is anal intercourse.

Which statement requires additional education regarding the truth about rape? Rape is a crime of passion. No person wants to be raped. No person deserves to be raped. Rape can occur between married individuals.

Correct response: Rape is a crime of passion. Explanation: Rape is a crime of violence and humiliation of the victim expressed through sexual means. The remaining options present accurate information about the act of rape so no further education or correction is needed.

Correct response: Recognizing the signs of danger Explanation: 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.

During an interview, a 6-year-old child tells a nurse that the child is often left alone at home by the child's parents. Which action should the nurse take? Continue with the interview and ignore the accusations. Report the child's information to the child protection agency. Tell the parents about the accusations. Do nothing—the nurse should not get involved in any possible criminal investigation.

Correct response: Report the child's information to the child protection agency. Explanation: If a child reports family violence, in this case, by neglect, the nurse has a legal responsibility to report the abuse to child protection agencies.

Which type of rapist derives erotic gratification from the victim's suffering? Sadistic rapist Power rapist Anger rapist Premeditated rapist

Correct response: Sadistic rapist Explanation: Sadistic rapists derive erotic gratification from the victim's suffering. Power rapists often attack people their own age and use intimidation and minimal physical force to control their victims. Their assaults are premeditated. Anger rapists use extreme force and restraint that results in physical injury to the victim. There is not a type of rapist called premeditated.

Correct response: The client's family lives on less than $1,000 per month. Explanation: Low income is a salient risk factor for IPV. Recent immigration, larger than average numbers of children, and a lack of extended family are not noted as major risk factors.

The nurse provides care to individuals who have been sexually assaulted during their childhood. Which characteristic is most commonly noted by the nurse during an assessment of such clients? Overly self-confident Unusually aggressive Overly social Too trustful

Correct response: Unusually aggressive Explanation: A child who is a survivor of prolonged sexual abuse will develop low self-esteem, as well as developing feelings of worthlessness, and become socially withdrawn, distrustful, or suicidal. Other characteristics of children who have been sexually abused include becoming unusually aggressive.

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? neglect physical emotional abandonment

Correct response: abandonment Explanation: 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.

Correct response: anger retaliation Explanation: 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.

A middle-aged client with young children has been the victim of intimate partner violence (IPV). When providing initial care to this family, the nurse should: carefully assess the children for signs of trauma. determine what initially caused the violence to begin. teach the client life skills for moving on from the relationship. reassure the client that this will never happen again.

Correct response: carefully assess the children for signs of trauma. Explanation: Children are inevitable victims in an IPV situation and must be assessed and cared for accordingly. The nurse must avoid false reassurance. It is unnecessary, and often impossible, to identify specific causes for IPV. Relationship skills can be addressed in follow-up care.

The nurse is approached by a teacher who suspects a student is being neglected after observing changes in the student's behavior. The teacher asks the nurse what other behaviors to watch for. Which symptoms of neglect should the nurse include in the discussion ? Select all that apply. fighting with other students deteriorating grades in school smoking a cigarette after school saving lunch items to take home for later refusing to answer when called on in class

Correct response: fighting with other students deteriorating grades in school smoking a cigarette after school refusing to answer when called on in class Explanation: Children who are abused or neglected are at risk for physical, emotional, and behavioral problems. They may have problems getting along with others leading to fights. Cognitive development may be impaired causing academic difficulties. They are at risk for substance abuse such as cigarettes. They may have low self-esteem and not want to participate in class. Saving food for later could indicate food insecurity which not identified as a problem associated with abuse or neglect.

The school health nurse is asked to see a child who has been coming to school with no lunch for the past week. The child tells the nurse, "I don't get a lunch this week, I have been wetting the bed." The nurse identifies that this child is experiencing which type of abuse? physical sexual neglect psychological

Correct response: neglect Explanation: Neglect, in this case, is the malicious withholding of a physical necessity for this child's well-being. For this child, the neglect is intended to be punitive for bed wetting. The nurse would need to investigate further and take the necessary action in reporting this as abuse. Sexual abuse refers to sexual acts performed by an adult on a child under the age of 18. In this case, the evidence does not support that the child is being sexually abused. Physical abuse refers to a deliberate physical assault by an adult on the child such as burning, biting, poking, or twisting a limb. Psychological abuse refers to verbal assaults such as blaming, screaming, name-calling, and using sarcasm. The child has not reported that this is occurring, therefore, this is most likely a situation in which the form of abuse is neglect.

Correct response: observed to be anxious and rejecting adult attention. Explanation: 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.

When the school nurse is assessing an adolescent who reports trouble sleeping, which characteristics of the client indicate there may be violence in the home? (Select all that apply.) the client's father monitors contact with friends feeling social pressure to use alcohol feeling left out of peer group has a family history of alcohol abuse must go straight home after school each day

Correct response: the client's father monitors contact with friends has a family history of alcohol abuse must go straight home after school each day Explanation: Having contact with friends monitored by the father indicates there is an abuse of power and control in the home. Having to go straight home after school indicates the client is being forced into social isolation. In addition, there is a family history of alcohol abuse. These are all characteristics of violent families. Adolescents commonly report feelings of being left out and experiencing social pressures to experiment with drugs and alcohol. These are not characteristics of violent families.

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 Insults Public ridicule Isolating a person from family Uncontrollable spending

Criticism Insults Public ridicule Isolating a person from family Explanation: 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 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.

What are some types of behavior that the nurse would recognize as qualifying as psychological abuse? Select all that apply. Ridiculing Criticizing Threatening a victim's dog Using assertive language Asking for time alone when frustrated

Criticizing Ridiculing Threatening a victim's dog

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

Cyberstalking Explanation 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 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.

Diagnosed with mild dementia Explanation: While the risk of elder abuse exists in all the options provided, such abuse is more likely when the elder client has chronic mental and/or physical health problems that limit there ability to express their concerns and/or describe their current living conditions.

A nurse is gathering information about a health history of a person who has experienced violence. Which are important caring behaviors a nurse should implement during the interview? Select all that apply Establish trustworthiness. Maintain a nonjudgmental attitude. Ask questions regarding religious background and preference. Secure open communication. Discuss the nurse's personal feelings on victims of violence.

Establish trustworthiness. Maintain a nonjudgmental attitude. Secure open communication. Explanation: Establishing a trusting nurse-client relationship is one of the most important steps in caring for any person experiencing violence. Survivors are unlikely to disclose sensitive information unless they perceive the nurse to be trustworthy and nonjudgmental. Important considerations in establishing open communication are ensuring confidentiality and providing a quiet, private place in which to interact. The nurse must continually monitor personal feelings toward the perpetrator and survivor, especially in cases of child abuse or in situations where the person decides to remain in an abusive relationship. Seeking value clarification by the nurse may prevent negative feelings from influencing the nurse-client relationship that could lead to a nontherapeutic interaction and perhaps re-traumatize the survivor. The nurse should not ask about religious background or disclose personal feelings about the victim.

A nurse is gathering information about a health history of a person who has experienced violence. Which are important caring behaviors a nurse should implement during the interview? Select all that apply. Establish trustworthiness. Secure open communication. Discuss the nurse's personal feelings on victims of violence. Ask questions regarding religious background and preference. Maintain a nonjudgmental attitude.

Establish trustworthiness. Secure open communication. Maintain a nonjudgmental attitude.

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. The attitudes of individual nurses reflect on the overall profession. Nurses need to be able to sympathize with their clients. Giving back the survivor as much control as possible is important.

Giving back the survivor as much control as possible is important. Explanation: 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.

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.

In violent families, which environment may be the most dangerous place for victims? Work Home School Church

Home

The mental health nurse should discuss an emergency plan for leaving an abusive situation when the client is able to do which of the following? Select all that apply. Identify safe places to go Keep emergency money available Compile a list of important phone numbers Have access to a car key or other transportation Compose a note to explain departure

Identify safe places to go Keep emergency money available Have access to a car key or other transportation Compile a list of important phone numbers

A frightened young woman calls the emergency department and tearfully tells the nurse, "I've been raped! Please help me!" Before telling the client what to do, the nurse would need to know if

If the client was injured, was in a safe place, and had transportation available

A frightened young woman calls the emergency department and tearfully tells the nurse, "I've been raped! Please help me!" Before telling the client what to do, the nurse would need to know if If the client knew her assailant, knew her location, and had notified the police If she has insurance, if she could get to the hospital by herself, and if pregnancy is a possibility If the client was injured, was in a safe place, and had transportation available If she had bathed, douched, or changed clothes

If the client was injured, was in a safe place, and had transportation available

A frightened young woman calls the emergency department and tearfully tells the nurse, "I've been raped! Please help me!" Before telling the client what to do, the nurse would need to know if... If the client was injured, was in a safe place, and had transportation available If the client knew her assailant, knew her location, and had notified the police If she has insurance, if she could get to the hospital by herself, and if pregnancy is a possibility If she had bathed, douched, or changed clothes

If the client was injured, was in a safe place, and had transportation available Explanation: If the client is injured, she may need immediate medical attention; if she is in a safe place, she can talk to the nurse on the phone. All other questions can wait until the client's safety is ensured.

Importance of measuring the clients' progress in small steps

A nurse manager is working with the nursing staff of a busy community-based walk-in clinic that provides care to a large number of survivors of domestic violence. When helping the staff provide care, which information would be most important for the nurse manager to convey to the staff? Encouragement for staff discussion about specific clients to gain support Importance of measuring the clients' progress in small steps Identification of consequences from changes made by survivors as minimal Expectation that survivors will accept change right away

Importance of measuring the clients' progress in small steps

Which are forms of psychological abuse? Select all that apply. Insulting Humiliating Incest Rape isolating a person from family

Insulting Humiliating isolating a person from family

Which are forms of psychological abuse? Select all that apply. Insulting Incest isolating a person from family Rape Humiliating

Insulting Humiliating isolating a person from family

Which statement about intimate partner violence (IPV) is accurate? -Screening tools to help the practitioner identify IPV are quite lengthy. -Knowledge deficits and biases of health care professionals limit its detection. -Failure of victims to seek medical treatment is the primary reason for the underdetection of IPV. -Victims do not often have physical injuries.

Knowledge deficits and biases of health care professionals limit its detection. Explanation: The literature confirms that a significant factor in the underdetection of IPV rests with professional behavior. Health care practitioners often fail to identify and intervene with abused women. The underlying dynamics of poor screening practices are complex and include both biases and knowledge deficits.

Major depression

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 Schizophrenia Narcissistic personality disorder Panic disorder

Major depression Explanation: An important outcome of nursing intervention with survivors is appropriate treatment of any disorder resulting from abuse, such as acute stress disorder, posttraumatic stress disorder (PTSD), anxiety disorders, dissociative identity disorder, major depression, or substance abuse.

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.

Multiple intellectual, physical, behavioral, and emotional arenas

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? Behavioral and physical functioning Emotional and intellectual functioning Multiple intellectual, physical, behavioral, and emotional arenas Behavioral and emotional functioning

Multiple intellectual, physical, behavioral, and emotional arenas

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? Emotional and intellectual functioning Behavioral and physical functioning Behavioral and emotional functioning Multiple intellectual, physical, behavioral, and emotional arenas

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

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.

is the malicious or ignorant withholding of physical, emotional, or educational necessities to a dependent's well-being.

Neglect

An 8-month-old infant has been brought to the emergency department by the infant's teenage parent. The infant is unresponsive, and after initial assessment, the care team suspects shaken baby syndrome. When providing care for this infant, the nurse should prioritize which assessment? Cardiac assessment Genitourinary assessment Neurological assessment Respiratory assessment

Neurological assessment

An 8-month-old infant has been brought to the emergency department unresponsive by the infant's teenage parent and the care team suspects shaken baby syndrome. When providing care for this infant, the nurse should prioritize which assessment? Respiratory assessment Neurological assessment Cardiac assessment Genitourinary assessment

Neurological assessment Explanation: While there may be musculoskeletal damage as a result of shaken baby syndrome, the most serious damage is neurological.

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.

Which type of rapist derives erotic gratification from the victim's suffering? Sadistic rapist Power rapist Anger rapist Premeditated rapist

Sadistic rapist

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

Same frequency as in heterosexual couples

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 Half as frequent as in heterosexual couples Three times more frequent as in heterosexual couples

Same frequency as in heterosexual couples Explanation: 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.

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 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?

Shaken baby syndrome

Which is a pattern of repeated unwanted contact, attention, and harassment that often increases in frequency? Rape Physical abuse Incest Stalking

Stalking

A client comes to the clinic for a prenatal visit. While the client is in the examining room, her estranged husband appears and insists on seeing the client. The client tells the nurse that they are in the process of getting a divorce and she does not want to be around him. "He's been following me to work and at my home everyday." What should the nurse suspect? Intimate partner violence Stalking Sexual assault Neglect

Stalking is a pattern of repeated unwanted contact, attention, and harassment that often increases in frequency (CDC, 2016b). Stalking is a crime of intimidation. Stalkers harass and terrorize their victims through behavior that causes fear or substantial emotional distress. Stalking may include such behaviors as following someone, showing up at the person's home or workplace, vandalizing property, or sending unwanted gifts. Intimate partner violence is the mistreatment or misuse of one person by another in the context of an emotionally intimate relationship. In this case, the relationship is spousal, and 15-25% of pregnant women experience violence during pregnancy. Sexual assault is the act of forcing unwanted sexual activity on a person. In this case, the nurse should first suspect intimate partner violence and can further inquire if unwanted sexual activity is also a feature of the client's situation. Neglect is considered in the context of child abuse.

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. They have a fear of being blamed for the incident. The client is embarrassed of the assault. The perpetrator may use coercion or threats to control the victim. The victim is responsible for the attack.

The client is embarrassed of the assault. They have a fear of being blamed for the incident. The perpetrator may use coercion or threats to control the victim.

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 client is embarrassed of the assault. They have a fear of being blamed for the incident. The perpetrator may use coercion or threats to control the victim. The victim is responsible for the attack. The person is concerned about the financial issues associated with the hospitalization.

The client is embarrassed of the assault. They have a fear of being blamed for the incident. The perpetrator may use coercion or threats to control the victim. Explanation: 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 nto 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.

After a series of admissions to the emergency department over the past several months, an 80-year-old client's malnutrition, vague history, and pattern of physical injuries lead the nurse to suspect elder abuse. Which aspect of the client's situation may contribute to elder abuse? Select all that apply. The client's son describes the client as "needy, helpless, and pathetic." The client and client's child are recent immigrants to the United States. The client has no income or savings of the client's own. The client is physically dependent on the client's son since losing mobility. The client self-describes and describes the client's child as "not well-off, but not terribly poor either."

The client is physically dependent on the client's son since losing mobility. The client has no income or savings of the client's own. The client's son describes the client as "needy, helpless, and pathetic."

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 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 minimizes the severity of the injuries. The client voices statements about having control over current status. The client is vague about the injuries on the body.

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.

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 is vague about the injuries on the body. The client came to the clinic right after the injuries occurred. The client minimizes the severity of the injuries. The client has a history of frequent visits to the emergency department for injuries. 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. Explanation: 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 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.

The client's family lives on less than $1,000 per month.

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.

T/F: Intergenerational transmission process suggests that family violence is a pattern of behavior learned from one generation to the next.

True

T/F: Rape most commonly occurs in the victim's neighborhood, often inside or near the home.

True

T/F: The classification of sodomy as a crime can impede same-sex victims reporting partner abuse.

True

A nurse is giving a talk about child abuse to a local community group. When discussing risk factors for child abusers, which would the nurse identify as the most likely profile of the perpetrator of fatal child abuse? Unemployed young woman who dropped out of high school Middle-aged, wealthy businessman Young college graduate who recently gave birth to her first child Middle-aged woman with a college degree

Unemployed young woman who dropped out of high school Explanation: Perpetrators of fatal child abuse are most likely to be caregivers who are young, poorly educated, and living at or below poverty level. Young/poor/dumb

The nurse provides care to individuals who have been sexually assaulted during their childhood. Which characteristic is most commonly noted by the nurse during an assessment of such clients? Unusually aggressive Too trustful Overly self-confident Overly social

Unusually aggressive

Unusually aggressive Explanation: A child who is a survivor of prolonged sexual abuse will develop low self-esteem, as well as developing feelings of worthlessness, and become socially withdrawn, distrustful, or suicidal. Other characteristics of children who have been sexually abused include becoming unusually aggressive.

A nurse manager is working with the nursing staff of a busy community-based walk-in clinic that provides care to a large number of survivors of domestic violence. When helping the staff provide care, which information would be most important for the nurse manager to convey to the staff? a. Importance of measuring the clients' progress in small steps b. Expectation that survivors will accept change right away c. Encouragement for staff discussion about specific clients to gain support d. Identification of consequences from changes made by survivors as minimal

The nurse can assess potential victims of domestic violence by asking which question? a. "Has a past or current partner ever caused you to be afraid?" b. "What did you do right before your partner hit you?" c. "What is your history of physical injuries?" d. "Do you need the number of a shelter?"

The nurse should consider which as a possible indicator of child neglect? a. Malnourishment unrelated to illness b. Helplessness c. Angry outbursts d. Hesitance to talk openly

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

Women in battering relationships often remain in those relationships as a result of faulty or incorrect beliefs. Which belief is valid? a. If she tried to leave, she would be at increased risk for violence. b. If she would do a better job of meeting his needs, the violence would stop. c. No one else would put up with her dependent clinging behavior. d. She often does things that provoke the violent episodes.

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. A client who is in the third trimester of pregnancy and who is having biweekly prenatal appointments at a clinic b. A client who has brought her young son to the emergency department because he fell at the playground and may have an arm fracture c. A client who is currently exploring long-term care options for her elderly father d. A client who expressed interest in joining a grief support group following the death of her husband

a - rates of partner violence increase during pregnancy

A nurse is gathering information about a health history of a person who has experienced violence. Which are important caring behaviors a nurse should implement during the interview? Select all that apply. a. Establish trustworthiness. b. Maintain a nonjudgmental attitude. c. Ask questions regarding religious background and preference. d. Secure open communication. e. Discuss the nurse's personal feelings on victims of violence.

a b d

nurse is caring for a child who had experienced sexual abuse. Which are expected behaviors of a child who has experienced sexual abuse? Select all that apply. a. Avoidance of sexually related content b. Secretiveness of behaviors c. Open and honest discussion about history d. High self-esteem e. Distorted view of sex

a b e

A female client comes to an urgent care clinic and says, "I've just been raped." What should the nurse do? a. Allow the client to express whatever she wants. b. Ask the client if staff can call a friend or family member for her. c. Offer the client coffee, tea, or whatever she likes to drink. d. Get the examination completed quickly to decrease trauma to the client. e. Provide the client privacy; let her go to a room to make phone calls. f. Stay with the client until someone else arrives to be with her.

a b f

Examples of child maltreatment include a. calling the child stupid for climbing on a fence and getting injured b. giving the child a time-out for misbehaving by hitting a sibling c. failing to buy a desired toy for Christmas d. spanking an infant who won't stop crying e. watching pornographic movies in a child's presence f. withholding meals as punishment for disobedience

a. calling the child stupid for climbing on a fence and getting injured d. spanking an infant who won't stop crying e. watching pornographic movies in a child's presence f. withholding meals as punishment for disobedience

abandonment

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.

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.

A client comes to the clinic for a prenatal visit. While the client is in the examining room, her estranged husband appears and insists on seeing the client. The client tells the nurse that they are in the process of getting a divorce and she does not want to be around him. "He's been following me to work and at my home everyday." What should the nurse suspect? a. Intimate partner violence b. Stalking c. Sexual assault d. Neglect

A nurse is giving a talk about child abuse to a local community group. When discussing risk factors for child abusers, which would the nurse identify as the most likely profile of the perpetrator of fatal child abuse? a. Middle-aged woman with a college degree b. Unemployed young woman who dropped out of high school c. Middle-aged, wealthy businessman d. Young college graduate who recently gave birth to her first child

A nurse is presenting to a church group a program about domestic violence. During the presentation, a member of the audience asks the nurse to explain what "intergenerational transmission of violence" means because the person has seen that phrase used in the media. Which response by the nurse would be most appropriate? a. "People who are violent are that way because of the various neurochemical imbalances in their brains." 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. "Domestic violence seems to skip every other generation when it is traced in families."

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

The nurse provides care to individuals who have been sexually assaulted during their childhood. Which characteristic is most commonly noted by the nurse during an assessment of such clients? a. Overly self-confident b. Unusually aggressive c. Overly social d. Too trustful

the school health nurse is asked to see a child who has been coming to school with no lunch for the past week. The child tells the nurse, "I don't get a lunch this week, I have been wetting the bed." The nurse identifies that this child is experiencing which type of abuse? a. physical b. sexual c. neglect d. psychological

Which of the following is true about domestic violence between same-sex partners? a. Such violence is less common than that between heterosexual partners b. The frequency and intensity of violence are greater than between heterosexual partners c. Rates of violence are about the same as between heterosexual partners d. None of the above

c. Rates of violence are about the same as between heterosexual partners

carefully assess the children for signs of trauma. Explanation: Children are inevitable victims in an IPV situation and must be assessed and cared for accordingly. The nurse must avoid false reassurance. It is unnecessary, and often impossible, to identify specific causes for IPV. Relationship skills can be addressed in follow-up care.

The nurse provides care to a 4-month-old infant who presents to the emergency department (ED) with the parents at the advice of the pediatrician due to poor feeding and potential dehydration. Which finding noted by the nurse during the physical examination indicates the need to assess for child abuse? mild diaper rash dry mucous membranes sunken fontanelle ecchymosis to the arms

ecchymosis to the arms

The nurse provides care for a client who reports intimate partner violence (IPV). Which intervention does the nurse include in the client's plan of care to address safety planning? teaching about sleep hygiene techniques educating about perpetrator about behaviors indicative of losing control initiating the paperwork required for a guardianship providing the client with supplies to treat physical injuries

educating about perpetrator about behaviors indicative of losing control

neglect

neglect Explanation: Neglect, in this case, is the malicious withholding of a physical necessity for this child's well-being. For this child, the neglect is intended to be punitive for bed wetting. The nurse would need to investigate further and take the necessary action in reporting this as abuse. Sexual abuse refers to sexual acts performed by an adult on a child under the age of 18. In this case, the evidence does not support that the child is being sexually abused. Physical abuse refers to a deliberate physical assault by an adult on the child such as burning, biting, poking, or twisting a limb. Psychological abuse refers to verbal assaults such as blaming, screaming, name-calling, and using sarcasm. The child has not reported that this is occurring, therefore, this is most likely a situation in which the form of abuse is neglect.

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.

The nurse is concerned that a client may be experiencing emotional abuse. The nurse observes an interaction between the client and a family member. Which assessment findings related to the actions of the family member toward the client led the nurse to make this clinical determination? Select all that apply. calling the client names making all the decisions limiting contact with others making the client feel guilty putting the client down

putting the client down calling the client names making the client feel guilty

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.

Which child has the greatest risk for being the target of bullying at school? the child who is short for his or her age the child who wears hearing aids the child who just transferred to the school the child who recently immigrated to America

the child who wears hearing aids

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

The Point Chapter 12, Chapter 12: PrepU, Mental Health test #3 Chapter 12 Abuse and Violence, Abuse and violence prepU, Ch 12: Prep-U, Chapter 12 Abuse and Violence Questions, Chapter 12: Abuse and Violence

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