Chapter 9: Violence and Abuse PrepU

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 caring for a 16-year-old immigrant. The nurse wishes to asses if the client is a victim of human trafficking. Which questions should the nurse ask? Select all that apply.

"Can you leave your job or situation if you wish?" "Can you come and go as you please?" "Is there a lock on your door at home so you cannot get out?"

When implementing an intervention for a client experiencing intimate partner violence, what is the primary goal?

The client will regain a sense of control in life.

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.

Which type of elder mistreatment involves harm of self-worth?

emotional

Which statement is false regarding emergency contraception (EC)?

EC will disrupt an established pregnancy if taken within 72 hours.

A nurse is caring for a client who has presented to the emergency department seeking treatment after being raped. Which statement best demonstrates the nurse's attempt to fulfill the initial nursing responsibility to this client?

"You didn't deserve this assault; I'm here to help you in any way I can."

The victim of rape ask about emergency contraception. The nurse would educate the client that the drug should be taken within which time frame to ensure maximum effectiveness?

12 hours after the rape

The nursing student is studying violence and mistreatment against the older woman. While researching it, the student learns that laws require health care professionals to report elder or vulnerable person mistreatment. How many states currently have these laws?

50

A nurse is caring for a pregnant woman who has multiple bruises in varying stages across her body. Which is the priority nursing action?

Ask if anyone at home has hit or hurt her.

A nurse is caring for a client who admits to living in an abusive relationship. Which action would be the priority to meet the client's safety needs?

Help the client develop an emergency plan to leave.

A pregnant woman comes to the clinic with a head injury. She tells the nurse that her partner came home drunk and she made him angry by not having dinner ready. He lashed out, she got in the way, and her head hit the corner on the table. What action should the nurse take in this situation?

Provide the client with contact information for a 24-hour shelter and social worker on discharge.

While assessing a client, the nurse notes the partner answering questions for the client and clumps of hair missing from the client's head. What action will the nurse perform?

Take the client to the lab for a blood draw.

A nurse is using the SAVE model to assess a client for possible violence. When validating the client, which action would the nurse most likely perform?

Tell the client that the nurse believes the story.

A 16-year-old girl is seen in an emergency department following a rape. The management of a rape victim should be directed primarily toward:

decreasing guilt and increasing self-esteem.

While providing care to a pregnant woman at the clinic, the nurse suspects that the client may be a victim of intimate partner violence. Which findings would lead the nurse to suspect this? Select all that apply.

irregular adherence to scheduled prenatal visits up and down weight gain not keeping up with scheduled treatments

A group of nursing students are preparing a talk on violence against women and how to prevent it. They want to list characteristics of perpetrators of intimate partner violence and should include which characteristics? Select all that apply.

substance and/or alcohol use disorder negative affect (hostility and depression) history of childhood abuse current unemployment history of antisocial behavior

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 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

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

Building trust

A nurse is providing continuing care to a client that was raped. The nurse anticipates that the client will progress through the phases of recovery. Place the behaviors below in the order in which the nurse would expect to assess them as the client moves toward recovery. Use all options.

Client exhibits shock and disbelief. Client returns to work, denying the need for counseling. Client attempts to make adjustments in her life to cope. Client verbalizes beginning feelings of safety.

A client who is a victim of intimate partner violence fails to report the violence primarily because of which reason?

The client feels responsible for causing the incident.

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 feel safe at home?"

A victim of rape is prescribed emergency contraception. After teaching the client about this therapy, the nurse determines that the teaching was effective based on which client statement?

"It contains high doses of a typical birth control pill"

A client has just confided in the nurse about being slapped and kicked by the partner that morning. What is the best response by the nurse?

"It's very brave of you to tell me all this. Help is available if you choose it."

The nurse is educating women on characteristics of perpetrators of intimate partner violence. What characteristics of abusers will the nurse include in the teaching? Select all that apply.

A history of oxycodone and diazepam use disorder 10 different employers in the past 18 months Arrested twice in the last year Dominates the control in personal and social situations

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

The nurse is helping the family of a client who has experienced a rape provide appropriate support. Which information should the nurse provide if the client is in the disorganizational phase of recovery?

Feelings of guilt and shame are characteristic.

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?

Gain the client's trust.

The nurse is caring for a client in an abusive situation. In developing a plan of care, which factors does the nurse consider? Select all that apply.

It often takes several attempts before a woman leaves an abusive situation. Women in abusive relationships usually feel isolated and unsupported. Substance use is a common factor in abusive relationships

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

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

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

A victim of rape is exhibiting symptoms of posttraumatic stress disorder (PTSD) which the nurse interprets as indicative of intrusion. Which symptoms would the client be exhibiting? Select all that apply.

nightmares recurrent thoughts flashbacks

Place the three phases of intimate partner violence in the order in which they occur. Use all options.

tension-building phase acute violence phase honeymoon phase

The nurse is assessing a woman who underwent a female circumcision for cultural reasons when she was 9 years old. The nurse observes that the prepuce and a portion of the clitoris have been removed. The nurse identifies this as which type of female genital cutting procedure?

type I

During a prenatal examination the nurse observes bruises on a woman's arms and a black eye. When asked about the bruises, the client states, "It was an accident. My husband just had a bad day at work, and I was late getting his dinner. But he is being so kind now; he brought me flowers yesterday. He is looking for a new job, so it won't happen again." This client is in which phase of the cycle of violence?

The honeymoon phase

The nurse is caring for a victim of intimate partner violence who needs emotional support. What nursing actions are appropriate for this client? Select all that apply.

Allow the client to make as many decisions as possible. Encourage the client to attend support groups. Teach strategies for problem-solving and stress management.

A nurse is conducting an awareness session on sexual abuse, and she is explaining the psychological profile of an average abuser. Which trait is often displayed by abusers?

They exhibit antisocial behaviors.

The nurse is conducting a class on rape prevention for a group of young adults and is describing the various types of date rape drugs. Which drug would the nurse describe as causing a separation in perception and sensation?

ketamine

Which initial interview technique would be least effective in gathering information from a suspected abuse victim?

Ask the client to strip down and show you where she has been hurt.

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? Select all that apply.

Female Age 16 Speaks minimal English

A community health nurse is speaking at a local Chamber of Commerce luncheon on women's issues related to intimate partner violence. What are some of the myths about violence that need to address? Select all that apply.

Violence against women occurs only in lower socioeconomic classes. Substance use disorder causes the violence. Violence occurs to only a small percentage of women. Women provoke their partners to abuse them.

A nurse is conducting a presentation on violence and abuse for a community health program. When describing this concept, which information would the nurse include? Select all that apply.

Violence against women often goes unrecognized and unreported. In some countries, violence against women is considered acceptable behavior.

A nurse is caring for a client who has been admitted with an ear infection. While discussing the partner with the nurse, the client says that the lover's behavior is "threatening" and "intimidating" at times, even though the partner has not physically harmed the client. The client wants to know what emotional abuse is. Which statement best describes an example of emotional abuse?

destroying valued possessions or attacking pets

A nurse is working in a local community health care facility where many clients are victims of intimate partner violence. For which signs should the nurse assess to determine if a client is a victim? Select all that apply.

mental health problems such as depression, anxiety, or substance use disorder injuries on the face, head, and neck reported history of the injury inconsistent with the presenting problem

When caring for victim of intimate partner violence, the nurse uses the ABCDES framework to provide interventions. Which components are part of this framework? Select all that apply.

reassurance that the victim is not alone in this situation maintenance of confidentiality of the information reported education about the cycle of violence and its escalation plan of action and resources for safety for when the victim decides to leave

A nurse has experienced success by utilizing the SAVE model to evaluate clients for possible intimate partner violence. Which action would be least appropriate for the nurse to address?

validating that the client is the cause

Which behaviors are forms of emotional abuse? Select all that apply.

insulting humiliating destroying another's property

Which statement made by a new nurse demonstrates an understanding of the prevalence of sexual assault and related violence among the population?

"I've come to realize that I need to include questions related to sexual assault and related violence into the assessment of all my clients."

A nurse is working with a client who is anticipating the possibility of leaving a relationship with intimate partner violence. In helping the client make the decision to leave or to stay in the abusive situation, which action would be most important for the nurse to take?

Explain to the client how to develop a safety plan for leaving the relationship.

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? Select all that apply.

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

A female client shares that her partner often comes home in the evening after a couple of beers, and is jealous, tense and verbally abusive. He sometimes destroys things, such as breaking a vase of flowers. The client says this makes her feel embarrassed, but she tries to be submissive to her partner to calm him down. The nurse recognizes this interaction as which phase of a relationship with intimate partner violence?

Tension-building phase

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 nurse is working in a community hospital situated in an area with a history of grievous assaults on women, including rape. The nurse discovers that most rape victims come to the hospital but leave without seeking medical treatment. Which intervention should the nurse perform to ensure that rape victims get legal and medical aid?

Ensure that the appropriate law enforcement agencies are apprised of the incident.

A nurse is caring for a pregnant client and discovers signs of bruises near her neck. On questioning, the nurse learns that the bruises were caused by her spouse. The client tells the nurse that the spouse had stopped hitting her some time ago, and that this was the first time during the pregnancy that she was assaulted. The client blames herself because she admits to not paying enough attention to her spouse. Which facts about intimate partner violence during pregnancy should the nurse tell the client to convince her that the violence was not her fault? Select all that apply.

Intimate partner violence is a result of resentment toward the interference of the growing fetus and change in the woman's shape. Intimate partner violence is a result of the perception of the partner that the baby will be a competitor after he or she is born. Intimate partner violence is a result of insecurity and jealousy of the pregnancy and the responsibilities it brings.

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 is talking to a client who is a survivor of intimate partner violence. The client states that the client's spouse has the characteristics of antisocial personality disorder. The client also informs the nurse that the spouse has an extensive criminal record. The nurse interprets this information and suspects that the client's spouse would demonstrate which behavior?

moderate to severe violence with people both within and outside the family

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?"

In which age range are women most vulnerable for intimate partner violence?

16 to 24 years

The nurse is caring for a client suspected of being a victim of human trafficking. Which question, when given priority by the nurse during the admission interview, demonstrates a need for additional training?

"Are you working towards achieving American citizenship?"

A nurse is assessing a client for abuse. Which statement by a client would the nurse interpret as suggesting financial abuse?

"My spouse won't let me go out to find a job."

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."

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 nurse is preparing a presentation for a local community group about intimate partner violence. Which statement would be most appropriate for the nurse to include in the presentation?

Intimate partner violence in LBGTI relationships may go unreported for fear of harassment.

The nurse is caring for a pregnant client admitted for abdominal trauma following an assault. The nurse will monitor the client for which potential complications? Select all that apply.

Miscarriage Placental abruption Uterine rupture Preterm labor

The nurse is assessing the circumstances associated with a client's suspected acquaintance rape at a party. Which is the best question for the nurse to ask?

"Were alcohol and drugs available at the party?"

The nurse has just finished a presentation about intimate partner violence at a local group meeting and realizes more teaching is needed when one person comments:

"That was interesting, but it will never happen here. It only happens in the poor side of town."

A new nurse in the emergency department is caring for a pregnant woman who was beaten by her partner. Which statement by the new nurse would require intervention from the supervising nurse?

"That woman must be doing something to get beaten like that."

The nurse is teaching a group of nursing students about intimate partner violence. Which statement by the nurse is accurate?

"Power and control are central to the dynamic of intimate partner violence."

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? Select all that apply.

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

A nurse is assessing a victim of rape. Further assessment reveals that the client received rohypnol. The nurse understands that this drug can lead to memory loss for up to how many hours?

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