211-CH12-EXAM2-ABUSE/VIOLENCE

-asking the victim to recall the events of the rape -STD/HIV testing -prophylactic treatment for STDs -prophylaxis to prevent pregnancy -referral to a rape crisis center or counselor in addition to medical treatment **everything EXCEPT offering a shower immediately; want to get the rape kit done BEFORE the victim showers b/c it could wash away evidence of the assault

(SATA) Select all that might be offered as part of assessment and treatment for someone who comes to the ER stating that they have been raped: -asking the victim to recall the events of the rape -offering a shower and change of clothes immediately -STD/HIV testing -prophylactic treatment for STDs -prophylaxis to prevent pregnancy -referral to a rape crisis center or counselor in addition to medical treatment

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.

1.Examples of child maltreatment include (SATA) 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.

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

1.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.

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.

2.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.

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

2.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.

b.Inability to manage personal finances

3.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

a.Emotional

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

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

5.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.

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. (p. 196)

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

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

A 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 Munchausen's syndrome by proxy Ineffective supervision Child neglect

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.

-Allow the client to make decisions regarding care whenever possible

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? -Allow the client to make decisions regarding care whenever possible -Inform the client that the assessment must be completed as soon as possible -Inform the client that charges will have to be pressed against the perpetrator -Educate the client about attending a support group as soon as possible

remove all other clients from the day room. **rationale - The nurse's first priority is to consider the safety of the clients in the therapeutic setting. Checking for an as-needed drug order and calling the physician are appropriate responses after ensuring the safety of other individuals. Because the client poses a danger to self and others, restraints may be used; however, less restrictive interventions should be attempted first.

A client refuses the evening dose of haloperidol and then becomes extremely agitated in the day room while other clients are watching television. The client begins cursing and throwing furniture. The nurse's first action is to: check the client's medical record for an order for an as-needed dose of medication for agitation. place the client in full leather restraints. call the physician and report the behavior. remove all other clients from the day room.

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

carefully assess the children for signs of trauma.

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.

-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.

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 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 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

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

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? -A top nursing priority would be to legally remove the son from the home. -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. -Placement for the older adult woman in a nursing home within the community is crucial.

Ask the client whether he is thinking about killing himself.

A nurse is caring for a white, 30-year-old man whose wife has recently died. The client has been diagnosed with clinical depression and is demonstrating insufficient coping skills. Which action by the nurse would be most important? Refer the client for long-term psychotherapy. Determine the client's risk of psychosis. Determine whether anyone in the client's family has had depression. Ask the client whether he is thinking about killing himself.

Major depression **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, anxiety disorders, dissociative identity disorder, major depression, or substance abuse.

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

-"He tells me that he is sorry and that he will never hit me again." Phases of Cycle of Violence: 1- tension-building phase (arguments; complaints from abuser) 2- violent episode ends the tension phase 3- honeymoon phase (abuser remorseful and romantic)

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."

Women, ages 18 to 24 years are at highest risk of being stalked

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? -Boys and young men, ages 12 to 21 years -Men, ages 24 to 28 years -Girls and young women, ages 10 to 18 years -Women, ages 18 to 24 years

The client's family lives on less than $1,000 per month. **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. ?????????????????????????????????????? ***confused by PrepU's answer to this one b/c pg. 188 cultural considerations says that immigrant women are MOST at risk...so idk.....***

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.

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 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 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

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. (p. 198)

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

"It can take at least a year or more to get back to where you were before." **It often takes one or more year for survivors of rape to regain previous levels of functioning. It is important to remind clients that it is possible to return to previous levels of functioning. (p 198)

A nurse is working with a client who is a survivor of rape. The client asks the nurse, "It's been 6 months since it happened. Why can't I get back into doing the things I did before?" What is the nurse's best response? "Life is different for you now, you will gradually accept that." "It can take at least a year or more to get back to where you were before." "You are a victim. You need to give yourself some time." "Let's talk about what happened to you again. It can help."

"Acute stress disorder is a possibility, which might develop into PTSD." **In PTSD, the symptoms occur 3 months or more after the trauma, which distinguishes PTSD from acute stress disorder, which may have similar types of symptoms but lasts 3 days up to 1 month (p 207)

A nurse's colleague expresses sympathy for a client who is traumatized following a terrorist attack 1 week earlier. The colleague states, "I'm certain that the client has posttraumatic stress disorder (PTSD)." What is the nurse's best response? "Acute stress disorder is a possibility, which might develop into PTSD." "If the client doesn't receive treatment right away, the client might not recover from the PTSD." "It's more likely that the client is experiencing anxiety, which will likely decrease with time." "Actually, she won't meet the diagnostic criteria for PTSD until 3 months after the attack."

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

The client alluded to "ending this misery" in a conversation with a colleague

A police officer was diagnosed with posttraumatic stress disorder after attending to a violent crime scene. What aspect of the client's current health status would most likely warrant inpatient treatment? The client alluded to "ending this misery" in a conversation with a colleague The client has twice attempted a return to work, without success The client's care provider has increased the dose of paroxetine twice in 2 months The client admits that the client often lashes out verbally at the client's spouse and children

-Be reluctant to report abuse because of shame or fear of retaliation **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 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.

-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."

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 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." -The client and client's child are recent immigrants to the United States. -The client self-describes and describes the client's child as "not well-off, but not terribly poor either."

"Do you feel safe at home?"

An obviously pregnant woman appears for her first prenatal visit. She reports a headache and generalized abdominal pain which has persisted over the past couple months. Which question should the nurse prioritize after determining the client is approximately 24 weeks' gestation, appears nervous, and is reluctant to have a full physical assessment? "Do you have a family history of thyroid disease?" "Have you been taking a prenatal vitamin?" "Do you feel safe at home?" "How much activity have you been able to fit into your schedule?"

caregiver role **Elders are often reluctant to report abuse, even when they can, because the abuse usually involves family members whom the elder wishes to protect. Victims also often fear losing their support and being moved to an institution.

Elder abuse is the maltreatment of older adults by family members or others in a _______________ role. Persons who abuse elders are almost always in a _________________ role, or the elders depend on them in some way

1- tension-building phase (arguments; complaints from abuser) 2- violent episode ends the tension phase 3- honeymoon phase (abuser remorseful and romantic) *cycle repeats itself over and over; honeymoon phase grows shorter and violence grows more extreme each time it happens

Name the 3 stages of the cycle of violence in the order in which they occur.

Access to community resources for referral

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

Characteristics of Violent Families: •Abuse of power and control •Intergenerational transmission process **Social isolation & Alcohol or other drug abuse are both characteristics of violent families (p 187)

SATA - Characteristics of Violent Families -Bountiful social network -Abuse of power and control -Home is free of alcohol/substance use -Intergenerational transmission process

"That must have been terrifying" or "Sounds like you were afraid for your life" **NEVER ask "why" questions

SATA - Select all the appropriate responses that a nurse can make when listening to a client recall a story of abuse: -"Why have you stayed with him so long if he is so abusive?" -"That must have been terrifying" -"Why haven't you left him yet?" -"Sounds like you were afraid for your life" -"Why do you let him abuse your children like that?"

-take care to maintain the client's personal space -assess the client's anxiety level -ask permission before touching him or her for any reason (p 187) **the nurse may not always be aware of a history of abuse when initially working with a client, he or she should apply these cautions to all clients in the mental health setting.

SATA - What nurses should do when working with clients who are victims of abuse, or who are suspected victims of abuse: -take care to maintain the client's personal space -assess the client's anxiety level -ask the family members who are present about abuse in the home -ask permission before touching him or her for any reason

false - It is essential to ask everyone whether they are safe at home or in their relationship. If the nurse asks only people seen as "likely victims," he or she will be stereotyping and may well miss someone who really needs help

T/F: Consider assessment - The nurse should only ask 'likely victims', or those with risk factors whether they are safe at home or in their relationship.

FALSE Of deaths from intimate partner violence, 70% were females and 30% were males

T/F: Deaths from intimate partner violence are equal between men and women who are victims of abuse.

true - Although same-sex battering mirrors heterosexual battering in prevalence, its victims receive fewer protections (p. 188)

T/F: Domestic violence occurs in same-sex relationships with the same statistical frequency as in heterosexual relationships

true. (p. 197)

T/F: It is generally accepted that rape is not a sexual crime but rather the perpetrator's exertion of power, control, infliction of pain, or punishment for perceived wrongs

true. 65% of rapes committed by someone the victim knows

T/F: More rapes are committed by someone that the victim KNOWS, compared to rapes committed by a stranger.

true All 50 states have laws, often called mandatory reporting laws, that require nurses to report suspected abuse. The nurse alone or in consultation with other health team members (e.g., physicians or social workers) may report suspected abuse to appropriate local governmental authorities. (p 193)

T/F: Nurses are mandate reporters who are responsible for reporting suspected child abuse with accurate and thorough documentation of assessment data. This applies to all 50 states.

true - ask ALL women about abuse, not just suspected victims (p. 200)

T/F: Nurses should ask all women about abuse. Some will be offended and angry, but it is more important not to miss the opportunity of helping.

false - Nurses with personal histories 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 effective and supportive of other survivors but only after engaging in therapeutic work and accepting and understanding their own trauma. (p 200)

T/F: Nurses with a personal history of trauma should avoid working with victims of abuse because their own history of abuse can negatively impact their ability to deal with victims of abuse.

false - the rapist is likely someone the victim knows

T/F: Rape most commonly occurs between strangers.

false - The generalist nurse should not pursue investigation with the child; it may do more harm than good (p 193) **they need to report it to an agency who has people trained in how to ask questions without further traumatizing the child.

T/F: The generalist nurse should pursue investigation with the child whom they suspect to be abused. The generalist nurse should ask many questions of the child, even if they seem uncomfortable, to really determine if abuse is present.

false - These are unusual injuries for the child's age and level of development; these injuries would be warning signs of child abuse. Another example would be - parent of an infant with a severe skull fracture may report that he or she "rolled off the couch," even though the child is too young to do so or the injury is much too severe for such a shortfall.

T/F: These injuries would be appropriate for the child's age and developmental level - fractured femur in a 2-month-old or a dislocated shoulder in a 2-year-old

false - The nurse should allow the victim to proceed at his or her own pace and not rush through any interview or examination procedures

T/F: When someone comes to the ER claiming they have been raped, the nurse knows to get the examination completed quickly to decrease trauma to the client.

true. p 196

T/F: abuse reporting for elders or dependent adults is not mandatory in all states and territories.

sexual abuse Often, sexually abused children talk or behave in ways that indicate more advanced knowledge of sexual issues than would be expected for their ages. **key is to be aware/recognize things that are NOT appropriate for a child's developmentalstage/ age

The following would lead the nurse to suspect what type of abuse? "urinary tract infections; bruised, red, or swollen genitalia; tears of the rectum or vagina; and bruising"

child crying and appearing sad

The nurse asks the parent of a school-age child about intimate partner violence in the home. Which assessment finding caused the nurse to complete this assessment? -child crying and appearing sad -child exhibiting reluctance to play with other children -parent encouraging the child to help with household chores -parent limiting the amount of time the child watches television

The client may be attempting to block the witnessed event to reduce anxiety. **The client is most likely experiencing conversion disorder after witnessing a violent act. In this case, the client may be trying to protect the self, either consciously or unconsciously, from the fear or anxiety from the event. The assessment and subsequent testing did not reveal any other cause of speech impairment, which indicates the client does not have vocal cord paralysis or any dysfunction related to the brain's speech center.

The nurse is assessing a client who has been unable to speak after witnessing a murder. The assessment and subsequent testing reveal no physical abnormality that may cause speech impairment. What is the most likely cause of this speech impairment in the client? The client may have vocal cord paralysis. The client may not want to speak. The client may be attempting to block the witnessed event to reduce anxiety. The client may have dysfunction of the speech center of the brain.

-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.

Gain the client's trust. **It is most important for the nurse to gain the trust of the victim. This will allow the nurse to obtain the most information to appropriately help the client. The nurse may notify the authorities and test for pregnancy if the client is a victim. The client will be assessed, but it isn't the priority.

The nurse is caring for a client believed to be a victim of human trafficking. What action is most important for the nurse to perform? Notify the authorities. Gain the client's trust. Test for pregnancy. Assess for bruising.

putting the client down calling the client names making the client feel guilty **Behaviors that suggest that someone is experiencing emotional abuse include putting the person down, name-calling, and making the person feel guilty. (p 192)

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. putting the client down calling the client names making all the decisions making the client feel guilty limiting contact with others

highest incidence of rape is in girls and women 16 to 24 years of age (p. 196 Psych Book)

The nurse knows that what groups is most at risk to be victims of rape? *give age group and sex (no race mentioned)

Unusually aggressive

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

-neglect

Type of abuse: "malicious or ignorant withholding of physical, emotional, or educational necessities for the child's well-being includes refusal to seek health care or delay doing so; abandonment; inadequate supervision; reckless disregard for the child's safety; punitive, exploitive, or abusive emotional treatment; spousal abuse in the child's presence; giving the child permission to be truant; or failing to enroll the child in school." -physical abuse -sexual abuse -neglect -psychological abuse

psychological abuse

Type of abuse: includes verbal assaults, such as blaming, screaming, name-calling, and using sarcasm; constant family discord characterized by fighting, yelling, and chaos; and emotional deprivation or withholding of affection, nurturing, and normal experiences that engender acceptance, love, security, and self-worth -physical abuse -sexual abuse -neglect -psychological abuse

sexual abuse **can also include exploitation like making child pornography

Type of abuse: sexual acts performed by an adult on a child younger than 18 years. Examples include incest, rape, and sodomy performed directly by the person or with an object, oral-genital contact, and acts of molestation such as rubbing, fondling, or exposing the adult's genitals -physical abuse -sexual abuse -neglect -psychological abuse

physical abuse

Type of abuse: unreasonably severe corporal punishment or unjustifiable punishment such as hitting an infant for crying or soiling his or her diapers; burning, biting, cutting, poking, twisting limbs, or scalding with hot water -physical abuse -sexual abuse -neglect -psychological abuse

Criticizing Ridiculing Threatening a victim's dog

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

An expression of intense anger or helplessness in order to block emotional pain

What does the nurse recognize as the most likely explanation for the self-mutilating behaviors that occur with borderline personality disorder? The result of an inherited disorder that manifests itself as an incapacity to tolerate stress An expression of intense anger or helplessness in order to block emotional pain Use of projective identification to reduce anxiety A constitutional inability to regulate affect that predisposes clients to psychic disorganization

*patterns of violence are perpetuated from one generation to the next through role modeling and social learning *family violence is a learned pattern of behavior *men who abuse are likely to have been victims of violence themselves as children *women who grew up in abusive homes are more likely to expect/tolerate abuse in adult relationship

What is the "intergenerational transmission process"?

The first part of treatment for child abuse or neglect is to ensure the child's safety and well-being *may involve removing the child from the home, with help of the appropriate government agency of course

What is the FIRST part of treatment for child abuse and neglect?

flunitrazepam (Rohypnol)

What is the generic and trade name for the illegal drug commonly known to be used for "date rape drug"?

immigrant women **cultural consideration box on p. 188

What specific group/demographic is most likely to be a victim of domestic violence?

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.

8-12 years (Mat-Peds book)

Which age range is the peak age for sexual abuse? 7-10 years 8-12 years 14-18 years 18-22 years

-Insulting -Humiliating -isolating a person from family

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

Abuse of power and control Alcohol use disorder Social isolation **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.

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

"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." "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."

Rape is a crime of passion. **Rape is a crime of violence and humiliation of the victim expressed through sexual means

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.

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

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."

Abandonment

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

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

Which would not increase the likelihood that an older adult will incur physical abuse? 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. An older adult reports frequent multiple bruises that are related to falls.

"Tell me why you would want to hurt yourself." **assess for a plan and the means to carry out the plan! This information is necessary for helping prevent a suicide attempt

While interviewing a depressed adolescent, it is revealed that the client has considered hurting oneself. What question is the nurse's priority? "Tell me exactly how you would hurt yourself." "Tell me why you would want to hurt yourself." "Do your parents know that you want to hurt yourself?" "Have you discussed this with anyone else?"

To preserve possible evidence, the physical examination should occur before the victim has showered, brushed teeth, douched, changed clothes, or had anything to drink. This may not be possible because the victim may have done some of these things before seeking care. If there is no report of oral sex, then rinsing the mouth or drinking fluids can be permitted immediately. (p. 197)

Why can't the nurse offer the client whose been raped a coffee, tea, or whatever she likes to drink upon her arrival at the ER?