Ch. 28 Child/ Older Adult/ Intimate Partner Violence

19. An adult has a history of physical violence against family when frustrated, followed by periods of remorse after each outburst. Which finding indicates a successful plan of care? The adult:

expresses frustration verbally instead of physically.

5. The parents of a 15-year-old seek to have this teen declared a delinquent because of excessive drinking, habitually running away, and prostitution. The nurse interviewing the patient should recognize these behaviors often occur in adolescents who:

have been abused.

14. A survivor of physical spousal abuse was treated in the emergency department for a broken wrist. This patient said, Ive considered leaving, but I made a vow and I must keep it no matter what happens. Which outcome should be met before discharge? The patient will:

name two community resources for help.

20. Which referral will be most helpful for a woman who was severely beaten by intimate partner, has no relatives or friends in the community, is afraid to return home, and has limited financial resources?

A womens shelter

16. An older adult with Alzheimers disease lives with family in a rural area. During the week, the person attends a day care center while the family is at work. In the evenings, members of the family provide care.

Alzheimers disease

8. An 11-year-old says, My parents dont like me. They call me stupid and say they wish I were never born. It doesnt matter what they think because I already know Im dumb. Which nursing diagnosis applies to this child?

Chronic low self-esteem related to negative feedback from parents

10. A young adult has recently had multiple absences from work. After each absence, this adult returned to work wearing dark glasses and long-sleeved shirts. During an interview with the occupational health nurse, this adult says, My partner beat me, but it was because I did not do the laundry. What is the nurses next action?

Document injuries with a body map.

2. An 11-year-old reluctantly tells the nurse, My parents dont like me. They said they wish I was never born.

Emotional

3. What feelings are most commonly experienced by nurses working with abusive families?

Helplessness regarding the victim and anger toward the abuser

11. A patient tells the nurse, My husband lost his job. Hes abusive only when he drinks too much. His family was like that when he was growing up. He always apologizes and regrets hurting me. What risk factor was most predictive for the husband to become abusive?

History of family violence

12. An adult tells the nurse, My partner abuses me when I make mistakes, but I always get an apology and a gift afterward. Ive considered leaving but havent been able to bring myself to actually do it. Which phase in the cycle of violence prevents this adult from leaving?

Honeymoon

15. An older adult with Lewy body dementia lives with family and attends a day care center. A nurse at the day care center noticed the adult had a disheveled appearance, strong odor of urine, and bruises on the limbs and back. What type of abuse might be occurring?

Physical

9. An adult has recently been absent from work for 3-day periods on several occasions. Each time, the individual returned wearing dark glasses. Facial and body bruises were apparent. What is occupational health nurses priority assessment?

Physical injuries

6. What is a nurses legal responsibility if child abuse or neglect is suspected?

Report the suspicion according to state regulations.

13. After treatment for a detached retina, a survivor of intimate partner abuse says, My partner only abuses me when I make mistakes. Ive considered leaving, but I was brought up to believe you stay together, no matter what happens. Which diagnosis should be the focus of the nurses initial actions?

Risk for injury related to physical abuse from partner

17. An older adult with Lewy body dementia lives with family. After observing multiple bruises, the home health nurse talked with the daughter, who became defensive and said, My mother often wanders at night. Last night she fell down the stairs. Which nursing diagnosis has priority?

Risk for injury related to poor judgment, cognitive impairments, and inadequate supervision

18. An older woman diagnosed with Alzheimers disease lives with family and attends day care. After observing poor hygiene, the nurse talked with the caregiver. This caregiver became defensive and said, It takes all my energy to care for my mother. Shes awake all night. I never get any sleep. Which nursing intervention has priority?

Secure additional resources for the mothers evening and night care.

4. Which rationale best explains why a nurse should be aware of personal feelings while working with a family experiencing family violence?

Strong negative feelings interfere with assessment and judgment.

2. A nurse assists a victim of intimate partner abuse to create a plan for escape if it becomes necessary. Which components should the plan include? Select all that apply.

a. Keep a cell phone fully charged. c. Have the phone number for the nearest shelter. e. Secure a supply of current medications for self and children. f. Assemble birth certificates, Social Security cards, and licenses. g. Determine a code word to signal children when it is time to leave.

1. A 10-year-old cares for siblings while the parents work because the family cannot afford a babysitter. This child says, My father doesnt like me. He calls me stupid all the time. The mother says the father is easily frustrated and has trouble disciplining the children. The community health nurse should consider which resources as priorities to stabilize the home situation? Select all that apply.

a. Parental sessions to teach childrearing practices b. Anger management counseling for the father c. Continuing home visits to give support

3. A community health nurse visits a family with four children. The father behaves angrily, finds fault with the oldest child, and asks twice, Why are you such a stupid kid? The wife says, I have difficulty disciplining the children. Its so frustrating. Which comments by the nurse will facilitate an interview with these parents? Select all that apply.

a. Tell me how you discipline your children. b. How do you stop your baby from crying? c. Caring for four small children must be difficult.

1. Which comment by the nurse would best support relationship building with a survivor of intimate partner abuse?

a. You are feeling violated because you thought you could trust your partner.

7. Several children are seen in the emergency department for treatment of various illnesses and injuries. Which assessment finding would create the most suspicion for child abuse? The child who has:

bruises on extremities.