Chapter 12- Abuse and Violence (Prep U)
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." "I wonder if your perceptions of the relationship are accurate." "I am here to help you through every step of this process." "Relationship counseling can be very helpful."
"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, 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% 50-60% 12-32% 40-48%
12-32% Women are 12-32% and men 17% who can expect to be victims of ongoing unwanted pursuit.
A nurse is working in the emergency department. Which situation would lead the nurse to suspect possible abuse of a client? Select all that apply. A 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
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 in the third trimester of pregnancy and who is having biweekly prenatal appointments at a clinic A client who expressed interest in joining a grief support group following the death of her husband 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 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? Emotional Abandonment Neglect Physical
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).
Which are forms of psychological abuse? Select all that apply. Insulting Humiliating isolating a person from family Rape Incest
Humiliating isolating a person from family Insulting 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. Rape and incest are forms of sexual assault.
Which type of rapist derives erotic gratification from the victim's suffering? Power rapist Anger rapist Premeditated rapist Sadistic rapist
Sadistic rapist 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.
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? Cardiac assessment Respiratory assessment Genitourinary assessment Neurological assessment
Neurological assessment While there may be musculoskeletal damage as a result of shaken baby syndrome, the most serious damage is neurological.
Which assessment question should the nurse ask of a client suspected of being ostracized by a school bully? "Have you talked to your parents about your problems at school?" "Do you smoke or use drugs?" "Do you feel like a part of a group in school?" "Can you go to the school principal with personal problems?"
"Do you feel like a part of a group in school?" 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."
"He tells me that he is sorry and that he will never hit me again." 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.
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." 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." 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 acts like the master of the castle and I'm the servant." "My partner tells me who I can and cannot see." "My partner always tells me that the abuse never happened." "My partner tells me that he or she will tell child services I'm a bad parent."
"My partner tells me that he or she will tell child services I'm a bad parent." 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? "My partner would hunt me down and kill me for sure." "No one would believe me if I tell them how terrible life has been." "The kids love my partner and my partner has been a good parent to them." "I do not have a job or anyway to support myself and my kids."
"My partner would hunt me down and kill me for sure." Leaving an abusive relationship is a process that can be quite complex. Fear is one of the most important factors in deciding whether to leave or to stay in a violent relationship. Victims recognize the valid concern that leaving may not stop the violence. If victims attempt to leave or actually do leave the relationship, perpetrators often escalate their violence, stalk their partners, and may even kill them, which makes leaving the time of greatest risk in intimate partner violence. While all the options present reasons to stay, the most compelling is fear of future violence and possible death.
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? "Domestic violence seems to skip every other generation when it is traced in families." "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." "People who are violent are that way because of the various neurochemical imbalances in their brains." "People who grow up in violent home situations tend to be involved in domestic violence situations as an adult."
"People who grow up in violent home situations tend to be involved in domestic violence situations as an adult." Violent families create an atmosphere of tension, fear, intimidation, and tremendous confusion about intimate relationships. Children in violent homes often learn violent behavior as an approved and legitimate way to solve problems, especially within intimate relationships. The social learning or intergenerational transmission of violence theory posits that children who witness violence in their homes often perpetuate violent behavior in their own families as adults. Moreover, children who grow up in violent homes learn to accept violence and expect it in their own adult relationships. Neurochemical imbalances, genetics, or skipping generations are unrelated to this theory.
Which characteristics are found in violent families? Select all that apply. Adequate support systems Alcohol use disorder Abuse of power and control Social isolation
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.
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 Written educational materials 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? 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 Inform the client that charges will have to be pressed against the perpetrator Allow the client to make decisions regarding care whenever possible
Allow the client to make decisions regarding care whenever possible 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 Distorted view of sex High self-esteem Secretiveness of behaviors Open and honest discussion about history
Avoidance of sexually related content Secretiveness of behaviors Distorted view of sex 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. Give the same reason his sister would give were she asked to explain his injuries. Be reluctant to report abuse because of shame or fear of retaliation Carefully explain that his mother disciplines him because she loves him.
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.
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? Showering Brushing her teeth Changing clothes Douching
Brushing her teeth 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 Assisting with diagnostic tests to determine the extent of the client's injuries Collecting specimens from the client for use as evidence Asking the client to describe the perpetrator in detail and documenting the client's statement
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.
What are some types of behavior that the nurse would recognize as qualifying as psychological abuse? Select all that apply. Asking for time alone when frustrated Criticizing Using assertive language Ridiculing Threatening a victim's dog
Criticizing Ridiculing Threatening a victim's dog 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? Requires assistance with food preparation Diagnosed with mild dementia Widowed, female Lives with adult daughter
Diagnosed with mild dementia 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. Ask questions regarding religious background and preference. Discuss the nurse's personal feelings on victims of violence. Secure open communication. Establish trustworthiness. Maintain a nonjudgmental attitude.
Establish trustworthiness. Maintain a nonjudgmental attitude. Secure open communication. 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 to 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 preparing a presentation for a senior center about elder abuse. When describing individuals associated with abusing older adults, which group would the nurse most likely identify? Select all that apply. Family member Children Friends Spouses Adults
Family member Adults Children Spouses Family members, adults, children, or spouses are implicated in 90% of the cases of elder abuse.
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 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 knew her assailant, knew her location, and had notified the police
If the client was injured, was in a safe place, and had transportation available 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.
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? Identification of consequences from changes made by survivors as minimal Importance of measuring the clients' progress in small steps Encouragement for staff discussion about specific clients to gain support Expectation that survivors will accept change right away
Importance of measuring the clients' progress in small steps 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.
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? Narcissistic personality disorder Panic disorder Major depression Schizophrenia
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.
The nurse should consider which as a possible indicator of child neglect? Malnourishment unrelated to illness Angry outbursts Helplessness Hesitance to talk openly
Malnourishment unrelated to illness Malnourishment is a possible indicator of neglect. Helplessness, hesitance to talk openly, and anger could be psychological or emotional indicators of abuse.
Which statement requires additional education regarding the truth about rape? No person deserves to be raped. Rape can occur between married individuals. Rape is a crime of passion. No person wants to be raped.
Rape is a crime of passion. 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.
A nurse is working on developing a safety plan with a client who is a survivor of violence. Which would the nurse address first? Identifying a safe place to hide Devising an escape route Identifying a signal to indicate it is safe to leave Recognizing the signs of danger
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.
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.
In a toddler, which injury is most likely the result of child abuse? A 1-inch forehead laceration A hematoma on the occipital region of the head A small, isolated bruise on the right lower extremity Several small, circular burns on the child's back
Several small, circular burns on the child's back Small circular burns on a child's back are no accident and may be from cigarettes. Toddlers are injury prone because of their developmental stage, and falls are frequent because of their unsteady gait; head injuries are not uncommon. A small area of ecchymosis is not suspicious in this age group.
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 Sexual assault Stalking Neglect
Stalking 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.
Which is a pattern of repeated unwanted contact, attention, and harassment that often increases in frequency? Stalking Incest Rape Physical abuse
Stalking Stalking is a pattern of repeated unwanted contact, attention, and harassment that often increases in frequency. Stalking is a crime of intimidation. Rape is the penetration of any bodily orifice by the penis, fingers, or an object. Incest involves sexual contact between family members. Physical abuse involves bodily harm.
Which feature would most likely predispose an adult to engage in family violence? The adult is used to being in control The adult was physically abused as a child The adult experiences chronic mild depression The adult has been experiencing financial problems
The adult was physically abused as a child The tendency for adults to raise their children in the same way that they were raised perpetuates the cycle of family violence. Adults who were victims of abuse as children frequently abuse their own children.
The psychiatric nurse recognizes that a male rape victim is less likely to report the crime due to which reason? The belief that his masculinity will be in question The impact it will have on his family The social ramifications of possibly contracting AIDS Fear of being accused of engaging in socially inappropriate or illegal activities leading to the rape
The belief that his masculinity will be in question It is a common misconception that males cannot be sexually abused, that only "sissies and weaklings allow abuse," leading to the possibility that his masculinity is at stake if he is identified as a 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 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." The client is physically dependent on the client's son since losing mobility. The client's son describes the client as "needy, helpless, and pathetic." 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 has no income or savings of the client's own. The client's son describes the client as "needy, helpless, and pathetic." Physical and financial dependence and personality conflicts with caregivers and children are known to contribute to elder abuse. Low socioeconomic status and recent immigration are not identified as causative factors.
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. 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.
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 nurse must allow the older adult mother to decide whether she wants to leave the situation. The main focus of the nurse's actions should be on improving the elderly mother's self-esteem. 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 has difficulty with mobility and can become confused. The older adult is independent with activities of daily living. 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 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.
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 Overly self-confident Too trustful Overly social
Unusually aggressive 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.
Which is an inaccurate picture of the cycle of abuse that occurs over time? Severity of the injuries worsen Violent episodes are less frequent Violent episodes are more frequent The period of remorse disappears
Violent episodes are less frequent 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 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 Girls and young women, ages 10 to 18 years Men, ages 24 to 28 years Boys and young men, ages 12 to 21 years
Women, ages 18 to 24 years
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 excitement anger retaliation power assertive power reassurance
anger retaliation In this case, the most accurate description of this rapist is anger retaliation. In this category, the perpetrator wants to punish the victim and often causes substantial injury. The power assertive rapist desires to dominate and control the victim and may repeat with the same victim. The power reassurance rapist commits rape when the opportunity presents itself, such as when another crime is being committed. An anger excitement rapist acts out fantasies and can be strategic in carrying out the crime, for example, carries a rape kit.
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: teach the client life skills for moving on from the relationship. reassure the client that this will never happen again. carefully assess the children for signs of trauma. determine what initially caused the violence to begin.
carefully assess the children for signs of trauma. 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.
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? call for an ambulance for transport to the hospital contact the police assess the client for injuries call a family member to pick up the children
contact the police The client was in a lethal situation and escaped for help. Since children are in the home with an adult who is impaired with a firearm, the police should be immediately notified. There is no evidence to suggest the client is injured. The client should not return to a potentially lethal situation however the children need to be removed. The police should remove the children and not another family member since this could place them all in harm's way.
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? sexual neglect psychological physical
neglect 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 ... attending day care 5 days a week. showing signs of developmental delays. observed to be anxious and rejecting adult attention. 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 caring for a client who is a victim of intimate violence. The client has pressed charges and the perpetrator is involuntarily remanded to a treatment center for 5 years. The client asks the nurse about the requirements of the treatment center that will help prevent ongoing substance abuse. Which of the following required actions does the nurse include in the correct response? attend group therapy sessions submit to random drug testing attend Alcoholics Anonymous meetings spend time in solitary confinement
submit to random drug testing Intervention programs may require abusers to undergo substance abuse treatment concurrently, so clients are required to remain sober and to submit to random drug testing. Treatment centers will use a variety of approaches however none are specifically identified such as group therapy, solitary confinement, or attending Alcoholics Anonymous meetings.
While talking with a client who is suspected of being a victim of intimate partner violence, the nurse observes that the client receives repeated text messages. The client states that the messages from the spouse, who is demanding to know where the client is, with whom, and when the client plans to return home. Which phase within the cycle of violence does the nurse assess that the client is experiencing? violence erupts tension building damage occurs remorse ensues
tension building In the tension building phase of the cycle of violence, the victim's activities are monitored. In the violence erupts stage, injury occurs. In the remorse ensure stage the perpetrator becomes kind, contrite, loving, begging for forgiveness and promises to never inflict the abuse again. Damage occurs is not a phase of the cycle of violence.
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 instruct in relaxation techniques use "I feel" statements suggest reenacting the abuse
use "I feel" statements Anger and rage are part of the healing process for survivors and should be expected. Anger management techniques include appropriately recognizing and labeling anger and expressing it assertively. Assertive ways of expressing anger include owning the feeling by using "I feel" statements. Reenacting the abuse, relaxation techniques, and reading stories about survivors are appropriate techniques to help a child who is a victim of abuse.