Maternal-Newborn Ch 30 Vulnerable populations

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 Provides the opportunity for the client to validate feelings Assures the nurse will be available to meet the client's needs Helps guarantee proper attention to the preservation of evidence

Promotes the client's sense of safety

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? excessive hostility and friction loss of control denial of the seriousness of the injuries apologies for the pain and abuse

apologies for the pain and abuse

A nurse is conducting a program for a community group about violence and abuse. As part of the program, the nurse describes the characteristics of the typical abuser. Which characteristics would the nurse include? Select all that apply. feelings of insecurity aggression to express inadequacies withdrawal behavior violence as a means of control antisocial behaviors

feelings of insecurity aggression to express inadequacies violence as a means of control antisocial behaviors

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 always tells me that the abuse never happened." "My partner tells me who I can and cannot see." "My partner tells me that I will be turned into child services for being a bad mother." "My partner acts like the master of the castle and I'm the servant."

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

The nurse suspects a client is a victim of intimate partner violence. When the nurse asks the client if a partner abuses her, the client responds, "Oh no, he doesn't hit me." How will the nurse respond? "There are many types of abuse beyond physical abuse." "I do not believe you. You can trust that I will help you." "Great. I will continue with your assessment." "I think you need to talk to a psychologist since you won't talk to me."

"There are many types of abuse beyond physical abuse."

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 men by women is being significantly addressed. Violence against women often goes unrecognized and unreported. It ranks low on the scale as a cause for morbidity. Violence during pregnancy is rare occurrence. In some countries, violence against women is considered acceptable behavior.

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

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? gamma hydroxybutyrate liquid ecstasy ketamine rohypnol

rohypnol

A physically abused pregnant woman reports to the nurse that her spouse has stopped hitting her and promises never to hurt her again. Which response by the nurse would be most appropriate? "That's great. I wish you both the best." "Remember, the cycle of violence often repeats itself." "He probably didn't mean to hurt you." "You need to consider leaving him.

"Remember, the cycle of violence often repeats itself."

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 3 1 in 5 2 in 15 3 in 20

1 in 5

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?" "Are you enrolled in school?" "What do your parents and siblings do?" "Is there a lock on your door at home so you cannot get out?"

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

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." "Sports like football and soccer are my life." "My mother was the disciplinarian in our family." "It was just mom and me after dad died."

"My classmates always called me a bully."

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." "Violence is a learned behavior that can be changed." "Violence against women and children is a crime in every state." "Intimate partner violence reflects a pattern of behavior that is repeated over time."

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

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? 2 4 6 8

8

A nurse is caring for a pregnant woman who has multiple bruises in varying stages across her body. Which is the priority nursing action? Report this as intimate partner violence. Ask if anyone at home has hit or hurt her. Tell her about resources for abuse victims. Refer her to counseling with her partner.

Ask if anyone at home has hit or hurt her.

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? Notify the health care provider of the findings Ask the client how she acquired the bruises Document the findings in the client's chart Provide brochures on shelters for female victims of intimate partner violence

Ask the client how she acquired the bruises

Which initial interview technique would be least effective in gathering information from a suspected abuse victim? Ask open-ended, non-judgmental questions of the client. Avoid questions that appear accusatory such as "Why don't you just leave him?" Ask the client to strip down and show you where she has been hurt. Convey to the client that the abuse is not her fault, such as "No one deserves to be treated like this."

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

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? Notify the authorities. Gain the client's trust. Test for pregnancy. Assess for bruising.

Gain the client's trust.

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 Fear related to repeated episodes of maltreatment Disabled family coping related to recent rape of family member Risk for other-directed violence related to admitted poor self-control

Anxiety related to recent rape

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? Refer the client to social services for assistance. Help the client develop an emergency plan to leave. Give the client a list of shelters in the area. Encourage the client to take a self-defense class.

Help the client develop an emergency plan to leave.

Which of the following is TRUE regarding intimate partner violence? Women who are in an abusive relationship experience less abuse while they are pregnant. Abusers often have outward signs that they are abusers or have a mental illness. Even though women seldom blame themselves for the abuse, they often cannot leave the relationship. One in four women will be a victim of violence.

One in four women will be a victim of violence.

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. The client does not want anyone to know. The client thinks it will not happen again. The client feels lucky to be alive.

The client feels responsible for causing the incident.

You are assisting the RN in assessing a patient who is suspected of being the victim of IPV. What could you say that would be helpful in eliciting information from this patient? "Are you being abused by someone?" "Who is abusing you?" "I am concerned about these bruises. Do you want to talk about it?" "You know, there is a shelter in town for abused women. Would you like to go there?"

"I am concerned about these bruises. Do you want to talk about it?"

Which statement made by a new nurse demonstrates an understanding of the prevalence of sexual assault and related violence among the population? "The vast majority of victims of sexual assault and related violence are seen in the emergency room when they seek treatment." "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." "It seems obvious that the greatest number of clients experiencing sexual abuse and related violence are the young and middle-aged adults." "The greatest need for thorough assessment regarding sexual assault and related violence is among those who are dependent and rely on the care of others."

"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 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? "The medication will cause me to have an abortion." "I need to take 3 doses over the next several days." "It contains high doses of a typical birth control pill" "I can wait until tomorrow morning to start taking it."

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

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 Reinforcing the fact that violence is never deserved Educating the client about the symptoms of post traumatic stress disorder Teaching the client stress management strategies

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

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 Giving assurances of help Establishing a plan to protect the client Having the client be honest about the injuries

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 Protecting privacy Supporting autonomy Remaining nonjudgmental

Building trust

To properly assist a victim of intimate partner violence, which action would be most appropriate for the nurse to do? Document the details. Summarize the details of the incident. Discuss the details with the victim. Confront the abuser about the details.

Document the details.

A client comes to the clinic with a partner. The client has multiple bruises on the arm and neck. The nurse suspects that the client is a victim of intimate partner violence. Which action would the nurse do first? Move the client to an area away from the partner. Ask the client directly if she is being abused. Have the client acknowledge what has happened. Notify law enforcement.

Move the client to an area away from the partner.

A nurse is driving to visit a home care patient when she notices a car following and several youths lingering on the corner. The nurse feels uneasy. Which is the best option for the nurse to take in this situation? Proceed to the nearest police station for an escort. Park close to the patient's home,and quickly go in. The patient is the primary concern. Talk to the youths to determine their intentions. Drive around the corner and see if the car is still following.

Proceed to the nearest police station for an escort.

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 pregnant client looks at the examiner when asked questions. 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 client asks questions of the nurse about her pregnancy.

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 16-year-old girl is brought to the clinic by her mother because she has not had a menstrual period for the past 8 months. Which findings might alert the nurse to the possibility that anorexia nervosa may be contributing to the client's amenorrhea? Select all that apply. hyperthermia bradycardia hypotension reduced subcutaneous fat evidence of secondary sex characteristics

bradycardia hypotension reduced subcutaneous fat

A nurse is providing care to a older adult victim of intimate partner violence. When approaching this client, the nurse must ensure to avoid which type of behavior? critical nonjudgmental accepting consultative

critical

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: relieving physical discomfort and pain. decreasing guilt and increasing self-esteem. assessing for sources of infection resulting from the rape. teaching the client how to prevent further attacks.

decreasing guilt and increasing self-esteem.

After teaching a group of young adults about sexual violence, the nurse determines that the teaching was successful when the group identifies which acts as a type of sexual violence? Select all that apply. female genital mutilation bondage infanticide human trafficking prostitution

female genital mutilation bondage infanticide human trafficking

An adolescent who is 8 weeks' pregnant is at her first perinatal visit. During the health history interview, the nurse asks the client, "Are you afraid of anyone?" What is the nurse assessing with this question? mood mental status intimate partner violence social history

intimate partner violence

A nurse is assessing a rape survivor for posttraumatic 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? physical symptoms intrusive thoughts avoidance hyperarousal

intrusive thoughts

A client who is a rape survivor has appeared to cope very well. However, at a routine visit several months later, the client describes nightmares and flashbacks. The nurse would suspect which condition? posttraumatic stress disorder overwhelming guilt crisis avoidance continued recovery

posttraumatic stress disorder

A group of nurses are preparing a program about rape and sexual assault for a community health center. Which information would the nurses include as being most accurate? Select all that apply. Most victims of rape tell someone about it. Few people falsely cry "rape." Women have rape fantasies desiring to be raped. A rape victim feels vulnerable and betrayed afterwards. Medication and counseling can help a rape victim cope.

A rape victim feels vulnerable and betrayed afterwards. Medication and counseling can help a rape victim cope. Few people falsely cry "rape."

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 reassuring the client he or she is not alone documenting the violence educating about the cycle of violence

providing for the client's safety

While performing an assessment on a female client, the nurse notes signs of sexual assault. When questioned, the client states, "I am married, so I have not been raped or abused." What statement by the nurse is most appropriate? "Can you tell me how long you have been married?" "The lines of assault are very blurred when you are married." "I apologize, I did not realize that you are married." "If you do not consent, it is still assault when you are married."

"If you do not consent, it is still assault when you are married."

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 primarily affects young, unmarried women. Until the 1990s, society tended to legitimize a man's control over a woman. Intimate partner violence in LBGTI relationships may go unreported for fear of harassment. Children who witness intimate partner violence against a parent are less likely to become abusers.

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

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. Tell the client how your friend dealt with intimate partner violence. Explain how alcohol can cause intimate partner violence. Teach strategies for problem-solving and stress management.

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 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? Ensure the client understands the behaviors inherent in the cycle of intimate partner violence. Explain to the client how to develop a safety plan for leaving the relationship. Assist the client in finding a new apartment and a new job. Suggest that the client legally change his or her name and move out of state.

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

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. The situation will never get better. The client can leave at any time. The client recognizes being a victim.

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. Obtain photos to substantiate the client's case in a court of law. Document only descriptions of medical interventions taken. Respect the client's opinion and avoid informing the police.

Use direct quotes and specific language.

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. Women stay in the abusive relationship because they feel they have no options. Violence occurs to only a small percentage of women. Women provoke their partners to abuse them.

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.