Exam 3: Chapter 12: Abuse and Violence

A nurse is preparing to gather a health history of a client. Which questions can elicit disclosure if a client has been abused? Select all that apply. "When there are arguments at home, have you ever been hurt or afraid?" "It looks like someone has hurt you. Tell me about it." "Some other women I have cared for have described problems like yours. If this is happening to you, can we talk about it." "I don't believe you. Why don't you tell me the truth?" "It appears that you are distracted. Let me know when you are ready to discuss the incident."

"When there are arguments at home, have you ever been hurt or afraid?" "It looks like someone has hurt you. Tell me about it." "Some other women I have cared for have described problems like yours. If this is happening to you, can we talk about it."

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

70% women and 30% men

A psychiatric-mental health nurse is conducting a program for a women's group. When describing psychological abuse, which information would the nurse address? Select all that apply. Criticism Insults Public ridicule Isolating a person from family Uncontrollable spending

Criticism Insults Public ridicule Isolating a person from family

The nurse's suspicion that a child has been sexually abused is supported by what assessment data? Select all that apply. The anal area is bruised The child reports "itching down there" The vulva appears edematous The urinalysis reports a bacterial infection There are frequent ear infections

The anal area is bruised The child reports "itching down there" The vulva appears edematous The urinalysis reports a bacterial infection

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.

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.

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."

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 nurse is planning a community education session on elder abuse awareness. Which points should the nurse be sure to include? (Select all that apply.) Withholding money for necessities is a form of abuse Not helping you get medical attention you need is a form of abuse It is abuse if you feel forced to have sex It is abuse if your caregiver holds your arm too tight If you are arguing constantly with a family member, it is a form of abuse

Withholding money for necessities is a form of abuse Not helping you get medical attention you need is a form of abuse It is abuse if you feel forced to have sex It is abuse if your caregiver holds your arm too tight

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

a client who is in the third trimester of pregnancy and who is having biweekly prenatal appointments at a clinic

Which assessment finding can help the nurse differentiate a child experiencing child neglect rather than child abuse? A young child is admitted to the hospital with hypothermia because the child is inadequately dressed. A child is brought to a clinic by a parent who is unable to adequately explain how the child broke an arm. A child tells a social worker that the child does not like it when the child's mother's boyfriend touches the child "down there." A child exhibits multiple scars on the back and buttocks upon examination.

a young child is admitted to the hospital with hypothermia because the child is inadequately dressed

The nurse in the emergency room is assessing a client who was brought in by the police for evaluation after receiving a call from a neighbor. The client reports to the nurse that the person who has been cooking and helping around the house has not been home for days. Which type of abuse does the nurse suspect based on the client's statement? neglect physical emotional abandonment

abandonment

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

abandonment

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

abuse of power and control alcohol use disorder social isolation

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? Inform the client that charges will have to be pressed against the perpetrator Allow the client to make decisions regarding care whenever possible 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

allow the client to make decisions regarding care whenever possible

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? power assertive anger retaliation power reassurance anger excitement

anger retaliation NOTE: 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 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 Secretiveness of behaviors Open and honest discussion about history High self-esteem Distorted view of sex

avoidance of sexually related content secretiveness of behaviors distorted view of sex

When noted in an assessment of a child, the nurse should suspect child abuse if which common physical findings signaling abuse are present? Eye, head, and skeletal injuries; swollen glands; and breaks in skin Broken bones and finger joints, bruises, scars, and eye injuries Bruises, burns, lacerations, missing teeth, and skeletal injuries Missing teeth, scars on genitalia, loose bones, broken legs, and burn marks

bruises, burns, lacerations, missing teeth, and skeletal injuries NOTE: The most common indicators of physical abuse of a child are as follows: (1) bruises involving no breaks in skin integrity, (2) burns, usually due to immersion in hot water, contact with cigarettes, tying with a rope, or the application of a hot iron, (3) lacerations, abrasions, welts, and scars noted on the lips, eyes, face, and external genitalia, (4) missing or loosened teeth, and (5) skeletal injuries such as fractured bones, epiphyseal separation, or stiff, swollen, enlarged joints.

A client states to the nurse, "My husband hits me. I want to leave him, but I have to be sure that I can leave and won't have to go back." Which question does the nurse ask during the psychosocial interview to assess the client's social network? "Does your husband criticize and belittle you?" "Does your husband blame you for his abusive behavior?" "Do you have any friends who can provide emotional support?" "Did you experience any form of abuse when you were a child?"

do you have any friends who can provide emotional support

Which question does the nurse include when assessing a client for physical violence associated with intimate partner abuse (IPV)? "Does your partner criticize or insult you?" "Does your partner destroy your property?" "Does your partner ever strike or kick you?" "Does your partner humiliate you in public settings?"

does your partner ever strike you or kick you

The nurse provides care to a 4-month-old infant who presents to the emergency department (ED) with the parents at the advice of the pediatrician due to poor feeding and potential dehydration. Which finding noted by the nurse during the physical examination indicates the need to assess for child abuse? mild diaper rash sunken fontanelle ecchymosis to the arms dry mucous membranes

ecchymosis to the arms NOTE: Infants do not begin to move or ambulate on their own prior to the age of 6 months, when they begin to crawl; therefore, any bruises on an infant before the age of 6 months is cause for suspicion. Based on this information, the finding that indicates a need to assess for child abuse is ecchymosis to the arms

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. Establish trustworthiness. Maintain a nonjudgmental attitude. Ask questions regarding religious background and preference. Secure open communication. Discuss the nurse's personal feelings on victims of violence.

establish trustworthiness maintain a nonjudgemental attitude secure open communication

Nurses working with rape trauma victims need to be aware of their own attitudes about rape and sexual assault. Which rationale best explains why? Nurses can learn from the experiences of clients and thus help prevent becoming victims of assault themselves. The attitudes of individual nurses reflect on the overall profession. Nurses need to be able to sympathize with their clients. Giving back the survivor as much control as possible is important.

giving back the survivor as much control as possible is important

Which characteristic would a nurse least likely see in an abused individual? Guilt High self-esteem Isolation Entrapment

high self-esteem

In violent families, which environment may be the most dangerous place for victims? Home School Work Church

home

The nurse provides care to a client who is experiencing intimate partner violence (IPV). The client lives in a rural area and asks the nurse how they can receive support. Which response by the nurse is appropriate? "You should discuss this issue with your practitioner." "I can provide you with a list of virtual support groups." "I think it is best if you just make a plan to leave and stick to it." "You should find a support group that that meets during your lunch hour."

i can provide you with a list of virtual support groups

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 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

if the client was injured, was in a safe place, and had transportation available

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

insulting humiliating isolating a person from family

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."

it can take at least a year or more to get back to where you were before

A group of nursing students is reviewing information about intimate partner violence (IPV). The group demonstrates understanding of this topic when they identify which of the following? Men are more likely to be seriously injured even though more women are typically victims. Men may consider it is a right of a patriarchal society. IPV in same-sex couples occurs less frequently than in heterosexual relationships. The reactions to IPV are similar in male and female victims.

men may consider it is a right of patriarchal society NOTE: Within a patriarchal society, men often hold traditional gender role beliefs. For example, whereas men are heads of households and provide for their families, women are homemakers and mothers. Nearly one in four women and one in nine men are victims of IPV at some point in their lives. Women are much more likely than men to be seriously injured as a result of IPV and to require medical treatment.

A nurse is working with a child whose parents have subjected him to neglect and emotional maltreatment, which primarily took the form of unavailability and general disinterest in his welfare. The nurse should expect that a child subjected to this type of maltreatment would experience problems in which of the following? Emotional and intellectual functioning Behavioral and physical functioning Behavioral and emotional functioning Multiple intellectual, physical, behavioral, and emotional arenas

multiple intellectual, physical, behavioral, and emotional arenas

The nurse provides care to a client who presents for an initial prenatal appointment. When reviewing the client's medical record, intimate partner violence (IPV) is documented. Which client statement made during the health history interview indicates phase 1 of the cycle of violence? "My husband begged me not to leave him after the last incident." "My husband is happy about this pregnancy and even bought me flowers." "My husband monitors my cell phone calls every month when the bill arrives." "My husband has not hit me since he promised to stop drinking several months ago."

my husband monitors my cell phone calls every month when the bill arrives

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? physical sexual neglect psychological

neglect

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.

observed to be anxious and rejecting adult attention

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.

rape is a crime of passion NOTE: this is a myth

Which provides the most appropriate example of neglect according to the definition of the term? Rejecting a 3-year-old who cries and seek affection after falling Criticizing a child frequently for being overweight and restricting the child's diet Disciplining a 6-year-old child for "sassing" by putting tape on the child's mouth Correcting a child in front of the entire class for copying homework

rejecting a 3 year old who cried and seek attention after falling

In a toddler, which injury is most likely the result of child abuse? Several small, circular burns on the child's back A hematoma on the occipital region of the head A 1-inch forehead laceration A small, isolated bruise on the right lower extremity

several small, circular burns on the child's back NOTE: 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.

The majority of perpetrators of elder abuse include which population? Spouses Adult children Siblings Grandchildren

spouses

Which type of abuse does the nurse assess for when providing care to a client who experiences intimate partner violence (IPV)? Select all that apply. stalking child abuse sexual violence physical violence psychological aggression

stalking sexual violence physical violence psychological aggression

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 social ramifications of possibly contracting AIDS Fear of being accused of engaging in socially inappropriate or illegal activities leading to the rape The impact it will have on his family

the belief that is masculinity will be question NOTE: 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.

Which is not a risk factor for child sexual abuse? The child is aged 10 years or younger. The child suffers from developmental delays. The child lives in a home where substance abuse occurs. The child has primary caretaker who is mentally ill.

the child is aged 10 years or younger NOTE: Children at high risk for sexual abuse include those who• Are aged 3 years or younger• Suffer from a developmental delay• Live in a home where substance abuse occurs• Have adolescent parents or a single parent• Are in foster care• Have primary caretakers who were sexually abused themselves• Have primary caretakers who are mentally ill or have a developmental delay

The nurse conducts a wellness visit for a pediatric client. Which findings could indicate an increased risk for child abuse and the potential need for an additional assessment? Select all that apply. The child is diagnosed with a developmental delay. The child is average height and weight for chronological age. The parent states, "We use time-out as a form of punishment." The parent states, "Our child was conceived using in vitro fertilization (IVF)." The child has bruises in various degrees of healing on the buttock and upper legs.

the child is diagnosed with a developmental delay the child has bruised in various degrees of healing on the buttock

When the school nurse is assessing an adolescent who reports trouble sleeping, which characteristics of the client indicate there may be violence in the home? (Select all that apply.) the client's father monitors contact with friends feeling social pressure to use alcohol feeling left out of peer group has a family history of alcohol abuse must go straight home after school each day

the client's father monitors contact with friends has family history of alcohol abuse must go straight home after school each day

Which statement is true regarding children being raised in a home where they have witnessed intimate partner violence? They are at increased risk for being abused. They have higher rates of schizophrenia. It has little impact on child functioning. Female children are more likely to experience depression.

they are at increased risk for being abused

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

unusually aggressive

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? use "I feel" statements suggest reenacting the abuse instruct in relaxation techniques provide stories about survivors of abuse

use "I feel" statements NOTE: 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.

Which is an inaccurate picture of the cycle of abuse that occurs over time? Violent episodes are less frequent Violent episodes are more frequent The period of remorse disappears Severity of the injuries worsen

violent episodes are less frequent