Chapter 30: Vulnerable Populations

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A nurse is screening a client for intimate partner violence using indirect questions. Which question would the nurse most likely ask?

"Clients with your injuries are often abused. Is anything like this happening now?"

The nurse is caring for a client who is a victim of sexual violence. How can the nurse best support the necessary grieving process?

Actively listening to the client as he or she talks about the experience

A client at 36 weeks' gestation presents in the emergency department with a broken arm. The client states, "I fell while cooking dinner." During the assessment, the nurse notes no prenatal care for this pregnancy, as well as bruises in multiple stages of healing on the client's abdomen, arms, and chest. What action will the nurse perform next?

Ask the client how she acquired the bruises

A nurse is performing a physical examination of a pregnant woman. During examination, the nurse notices a bruise on the client's abdomen. Which action should the nurse take?

Ask the client to account for the bruise.

When initiating care for a client suspected of being a victim of human trafficking, what is the nurse's primary responsibility?

Building trust

Which of the following is TRUE regarding intimate partner violence?

One in four women will be a victim of violence.

A woman arrives at the prenatal clinic and is accompanied by her partner. Which behaviors would be suggestive of intimate partner violence (IPV)?

The partner answers questions for the pregnant client. The partner is overly protective of the pregnant client. Poor weight gain during the pregnancy and low birth weight infant

The nurse in the emergency department is documenting the appearance and care provided to a victim of rape. Which statement should the nurse include when documenting this care?

Victim has blood stains on both inner thighs.

A nurse is a guest speaker for a local college campus group discussing violence and rape. After discussing rape with the group, the nurse determines that additional discussion is needed when the group states which information?

"Most rape victims tell someone about the rape."

Which statement made by a male client who has a history of perpetrating intimate partner violence reflects a known factor that is characteristic of this behavior?

"My classmates always called me a bully."

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 tells me that I will be turned into child services for being a bad mother."

The nursing instructor is discussing violence and abuse that is seen in clients with a student. The instructor realizes that the student needs further instruction when the student makes which statement?

"Nurses only come in contact with violence in the emergency department."

After teaching a class about intimate partner violence to a group of young adults, the nurse determines that additional teaching is needed based on which statement by the group?

"People who are battered typically come from lower socioeconomic groups."

A client tells the nurse "My partner is going to stop drinking, so I know I won't be hit again." What is the nurse's best response?

"Violence is a learned behavior, not caused by alcohol."

A nurse is presenting a discussion on sexual violence at a local community college. When describing the incidence of sexual violence, the nurse would identify that a woman has which chance of experiencing a sexual assault in her lifetime?

1 in 5

A client has been seen and treated in the emergency room several times for injuries that are deemed suspicious. The client is reluctant to participate in a screening process. How best can the nurse provide reassurance to this client?

Being nonjudgmental

To properly assist a victim of intimate partner violence, which action would be most appropriate for the nurse to do?

Document the details.

The nurse has completed an assessment and interview on a client being treated for lacerations and abrasions. What acquired data support the nurse's suspicion that the client may be a victim of human trafficking?

Female Age 16 Speaks minimal English

The nurse is assessing a client who is a victim of intimate partner violence and recognizes a belief that is common among victims of abuse. Which belief would the nurse most likely identify?

The client is inadequate in some way.

A nurse is caring for a client who was raped at gunpoint. The client does not want any photos taken of the injuries. The client also does not want the police to be informed about the incident even though state laws require reporting life-threatening injuries. Which intervention should the nurse perform to document and report the findings of the case?

Use direct quotes and specific language.

When teaching a group of young adults about the cycle of violence, the nurse would describe which behavior as eventually disappearing as the violence becomes accelerated over time?

apologies for the pain and abuse

A nurse is developing a plan of care for a victim of intimate partner violence. Which intervention would be least appropriate for the nurse to include?

assisting the client to project anger

Nurses at an emergency department seek to develop a plan to help clients who are victims of intimate partner violence. Which component is critical to the success of the plan?

avenues for referral

The nurse who counsels clients who suffer from intimate partner violence understands that abuse can come in which different forms?

emotional abuse physical abuse financial abuse sexual abuse

Which occurrence is a biologic indicator of post-traumatic stress disorder (PTSD)?

flashbacks

A nurse is assessing a victim of rape. The victim tells the nurse, "It felt like I was outside my body looking down and watching the whole thing." The nurse suspects that the client received which substance?

gamma hydroxybutyrate

A nurse is assessing a rape survivor for post-traumatic stress disorder. The nurse asks the survivor, "Do you feel as though you are reliving the trauma?" The nurse is assessing for which effect of the trauma?

intrusive thoughts

A nurse is working with a victim of intimate partner violence. Which intervention would be most important for this client?

providing for the client's safety

After teaching a class at a local college campus on date rape, the nurse determines that the teaching was successful when the class identifies which substance as the most common date rape drug?

rohypnol

A nurse is working with a victim of intimate partner violence. The client has decided that she is going to leave the relationship. Which instructions by the nurse would be most appropriate?

"I can offer you choices, but you are the one who has to choose." "Let's work on a safety plan so that it is ready for when you leave." "Remember, it might take you several tries before you succeed."

The nurse is caring for a client who is seeking care after being raped. What is the primary reason the nurse does not leave the client alone during the emergency room stay?

Promotes the client's sense of safety

When beginning care for a victim of rape, the nurse asks the patient to "talk about what happened" to her. For which nursing diagnosis is the nurse using this approach?

Anxiety related to recent rape


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