MH - Final Exam - Module 10
c. Educate the teacher that this a common reaction in children of this age and it is best for the teacher to offer reassurance that he is safe.
A 10-year-old child returns to school after the death of his mother. The school nurse becomes aware that this child is frequently talking in the classroom about fears that he will die, too. The classroom teacher is asking for recommendations about how to handle this situation. Which of these actions by the nurse is most appropriate? a. Instruct the teacher to refer the child for psychological evaluation because this is a warning sign of depression and possible suicide. b. Encourage the teacher to redirect the child to activities that are focused on school performance. c. Educate the teacher that this a common reaction in children of this age and it is best for the teacher to offer reassurance that he is safe. d. Instruct the teacher to prohibit discussion of this topic in class because children in this age-group cannot understand the finality of death. Ch 36 Qs
a. Tending to the immediate care of her wounds
A battered woman presents to the emergency department with multiple cuts and abrasions. Her right eye is swollen shut. She says that her husband did this to her. What is the priority nursing intervention? a. Tending to the immediate care of her wounds b. Providing her with information about a safe place to stay c. Administering the prn tranquilizer ordered by the physician d. Explaining how she may go about bringing charges against her husband Ch 34 Qs
b. Physical abuse and neglect.
A child, age 5, is sent to the school nurse's office with an upset stomach. She has vomited and soiled her blouse. When the nurse removes her blouse, she notices that the child has numerous bruises on her arms and torso in various stages of healing. She also notices some small scars, and her abdomen protrudes on her small, thin frame. From the objective physical assessment, the nurse should screen further for: a. Physical and sexual abuse. b. Physical abuse and neglect. c. Emotional neglect. d. Sexual and emotional abuse. Ch 34 Qs
b. "It is not your fault. You did the right thing by coming here."
A client arrives at the emergency department and tells the nurse her husband inflicted the cuts to her face that required sutures. She says, "I didn't want to come. I'm really okay. He only does this when he has too much to drink. I just shouldn't have yelled at him." The best response by the nurse is: a. "How often does he drink too much?" b. "It is not your fault. You did the right thing by coming here." c. "How many times has he done this to you?" d. "He is not a good husband. You have to leave him before he kills you." Ch 34 Qs
B. "Tell me what you are thinking."
A client states, "Why do I feel relief now that my dad is gone?" Which of the following responses should the nurse make? A. "Do you feel guilty?" B. "Tell me what you are thinking." C. "You are in denial about your dad's death." D. "Your dad is not suffering anymore." Mod 10 Practice Qs
a. Assess the client for depression and suicide risk.
A client who lost his wife after 35 years of marriage presents at his primary care physician's office 10 months later. He has lost 20 pounds and tells the nurse, "I just don't want to eat or do anything else for that matter." Which of these actions by the nurse is a priority? a. Assess the client for depression and suicide risk. b. Ask the physician to order gastrointestinal studies. c. Encourage the client to talk about his relationship with his deceased wife. d. Instruct the client that the doctor will be in shortly, but right now the physical assessment must be completed. Ch 36 Qs
c. Phase II. The acute battering incident that was provoked by her threat to leave.
A client with multiple cuts and abrasions arrives at the emergency department with her three small children. She tells the nurse her husband inflicted the wounds. In the interview, she tells the nurse, "He's been getting more and more violent lately. He's been under a lot of stress at work the last few weeks, so he drinks a lot when he gets home. He always gets mean when he drinks. I was getting scared. So I just finally told him I was going to take the kids and leave. He got furious when I said that and began beating me with his fists." With knowledge about the cycle of battering, what does this situation represent? a. Phase I. Attempting to stay out of his way and keep everything calm. b. Phase I. A minor battering incident for which she assumes all the blame. c. Phase II. The acute battering incident that was provoked by her threat to leave. d. Phase III. The honeymoon phase where the husband believes that he has "taught her a lesson and she won't act up again." Ch 34 Qs
c. Bargaining
A client, who is dying of cancer, says to the nurse, "I just want to see my new grandbaby. If only God will let me live until she is born, then I'll be ready to go." This is an example of which of Kübler-Ross's stages of grief? a. Denial b. Anger c. Bargaining d. Acceptance Ch 36 Qs
b. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack."
A college-age client is brought to the emergency department by her roommate after she confided that she was raped by her date who invited her to a frat party. The client says to the nurse, "It's all my fault. I shouldn't have gone to a party where I knew there was going to be alcohol." Which of these is the best response by the nurse? a. "Yes, you're right. You put yourself in a very vulnerable position when you allowed him to get you drunk." b. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack." c. "There's no sense looking back now. Just look forward, and make sure you don't put yourself in the same situation again." d. "You'll just have to see that he is arrested so he won't do this to anyone else." Ch 34 Qs
anticipatory grief The problems arise when others meet the process of anticipatory grief and detachment from the dying person occurs prematurely. This may cause the dying person to feel lonely and abandoned.
A future loss is being mourned in advance. Mod 10 Lesson Content
D. "I have heard that abusers think of themselves as important and have high self esteem."
A home health nurse is speaking to a group of acute care nurses about domestic violence. Which of the following statements by one of the acute care nurses indicates a need for clarification? A. "I have heard that abusers try to keep their partner isolated from others." B. "I know that abusers lack social supports and social skills." C. "I know that men who are abusers gain power through intimidation." D. "I have heard that abusers think of themselves as important and have high self esteem." Mod 10 Practice Qs
B. Denial
A nurse in a dialysis center is caring for a client who has a new diagnosis of end-stage kidney disease. When he arrives for his first dialysis treatment, he tells the nurse, "I decided to come today, but I am not sure if I will need to come back again this week. I am feeling much better since my discharge from the hospital and I think my kidneys are working again." The nurse should identify that this client is demonstrating which of the following Kübler-Ross stages of grieving? A. Bargaining B. Denial C. Depression D. Anger Mod 10 Practice Qs
C. Plan the client's schedule to allow time for rituals.
A nurse in a mental health facility is planning care for a client who has obsessive-compulsive disorder (OCD) and is newly admitted to the unit. Which of the following actions should the nurse plan to take regarding the client's compulsive behaviors? A. Isolate the client for a period of time. B. Confront the client about the senseless nature of the repetitive behaviors. C. Plan the client's schedule to allow time for rituals. D. Set strict limits on the behaviors so that the client can conform to the unit rules and schedules. Final Review Qs
A. A client who has been taking amitriptyline for 3 months for depression
A nurse in a psychiatric unit is caring for several clients. Which of the following clients should the nurse recommend for group therapy? A. A client who has been taking amitriptyline for 3 months for depression B. A client exhibiting psychotic behavior C. A client admitted 12 hr ago for acute mania D. A client who is experiencing alcohol intoxication Mod 10 Practice Qs
C. Ask the client to describe the situation.
A nurse in an emergency department is caring for an adolescent client who reports being sexually assaulted just prior to admission. Which of the following actions should the nurse take? A. Discuss self-defense techniques with the client. B. Inform the client photographs of injuries are required for a police report. C. Ask the client to describe the situation. D. Give the client a bed bath prior to physical examination. Mod 10 Practice Qs
D. Self-esteem disturbance
A nurse in the emergency department is assessing a client who has experienced intimate partner abuse. The nurse should monitor the client for which of the following behavioral findings? A. Personal identity disturbance B. Body image disturbance C. Altered role performance D. Self-esteem disturbance Mod 10 Practice Qs
A. Identify the client's nutritional status.
A nurse is admitting a client who has experienced a weight loss of 11 kg (25 lb) in the past 3 months. The client weighs 40 kg (88 lb) and believes she is fat. Which of the following aspects of care should the nurse consider the first priority for this client? A. Identify the client's nutritional status. B. Request a mental health consult. C. Plan a therapeutic diet for the client. D. Provide a structured environment for the client. Final Review Qs
D. Increasing feelings of anger.
A nurse is assessing a client who has posttraumatic stress disorder (PTSD) following a sexual assault. Which of the following is an expected finding? A. Sleeping 12 hr or more each day. B. Increasing sense of attachment to others. C. Constant need to talk about the event. D. Increasing feelings of anger. Final Review Qs
A. Leaves the child's room exactly as it was before the loss
A nurse is assessing a parent who lost a 12-year-old child in a car crash 2 years ago. Which of the following findings indicates the client is exhibiting manifestations of prolonged grieving? A. Leaves the child's room exactly as it was before the loss B. Volunteers at a local children's hospital C. Talks about the child in the past tense D. Visits the child's grave every week after worship services Mod 10 Practice Qs
B. The client's husband died seven months ago.
A nurse is caring for a 48-year-old client who is grieving following the death of her husband seven months ago. The client reports that she has lost 30 lb, and is having difficulty sleeping. Which of the following factors indicate the client is experiencing maladaptive grieving? A. The client is 48 years old. B. The client's husband died seven months ago. C. The client has lost 30 lb. D. The client is having difficulty sleeping Mod 10 Practice Qs
D. "It is not your fault that this happened."
A nurse is caring for a child who has been physically abused by a family member. Which of the following statements should the nurse to say to the child? A. "I promise I won't tell anyone about this." B. "Let's discuss what happened with your family." C. "Your family is bad for doing this to you." D. "It is not your fault that this happened." Mod 10 Practice Qs
B. Ask the client to agree to talk to a nurse whenever she feels the urge to exercise.
A nurse is caring for a client who has anorexia nervosa and overexercises to avoid gaining weight. Which of the following nursing actions should the nurse take? A. Praise the client for looking at herself in a mirror. B. Ask the client to agree to talk to a nurse whenever she feels the urge to exercise. C. Reprimand the client about the potential damage that has occurred due to overexercising her body. D. Restrict the client from being weighed. Mod 10 Practice Qs
B. "I don't like it when you address me with that tone of voice."
A nurse is caring for a client who has borderline personality disorder (BPD). As part of the client's plan of care, the nurse reviews the day's schedule with the client each morning. As the nurse begins to review the schedule with the client, the client says, "Why don't you shut up already? I can read it myself, you know!" Which of the following responses should the nurse give the client? A. "We do this every day. Why are you so angry with me this morning?" B. "I don't like it when you address me with that tone of voice." C. "I know you can, but are you going to read it or not?" D. "Fine. Here is the schedule, and I will expect you to be on time to your therapies." Final Review Qs
A. Discuss initiating hospice care with the client and family.
A nurse is caring for a client who has metastatic bone cancer. The client states, "I want to go home to die." The family is concerned about meeting the client's care needs at home. Which of the following actions should the nurse take? A. Discuss initiating hospice care with the client and family. B. Write a referral to place the client in a nursing home. C. Talk with the provider about extending the client's hospital stay. D. Inform the client's family that they are responsible for providing palliative care. Mod 10 Practice Qs
A. Difficulty relaxing C. Rule-conscious behavior E. Perfectionist behavior
A nurse is caring for a client who has obsessive-compulsive disorder (OCD). Which of the following characteristics are expected findings of OCD? (Select all that apply.) A. Difficulty relaxing B. Irrational fear of certain objects C. Rule-conscious behavior D. Unaware of compulsions E. Perfectionist behavior Mod 10 Practice Qs
A. "It sounds like you're having a difficult time."
A nurse is caring for a young adult client who says he is experiencing increased anxiety and an inability to concentrate. Which of the following responses should the nurse make? A. "It sounds like you're having a difficult time." B. "Have you talked to your parents about this yet?" C. "Why do you think you are so anxious?" D. "How long has this been going on?" Final Review Qs
D. Integrity vs. despair
A nurse is caring for several clients who are at various developmental stages. The nurse should explain that, according to Erikson, acceptance of death is a primary task of which of the following stages of psychosocial development? A. Autonomy vs. shame and doubt B. Generativity vs. stagnation C. Identity vs. role diffusion D. Integrity vs. despair Final Review Qs
C. The partner has lost 20 lb in the past 2 months.
A nurse is making a home visit to a client who has Alzheimer's disease and the client's partner. Which of the following observations indicates to the nurse that the partner is experiencing caregiver role strain? A. The partner has placed locks at the top of the doors leading to the outside. B. The partner has hired a house cleaner. C. The partner has lost 20 lb in the past 2 months. D. The partner redirects the client when the client is frustrated. Mod 10 Practice Qs
D. A child whose parents answer questions for the child
A nurse is providing care to children on a general pediatric unit. Which of the following children should the nurse identify as a potential victim of abuse? A. A child who has frequent visitors B. A child who has a BMI indicating obesity C. A child who uses the call light frequently D. A child whose parents answer questions for the child Mod 10 Practice Qs
A. Suicide risk C. Coping patterns D. Support systems E. Alcohol use
A nurse is teaching staff which factors to include in an abuse assessment of a client. Which of the following factors should the nurse include in the teaching? (Select all that apply.) A. Suicide risk B. Socioeconomic status C. Coping patterns D. Support systems E. Alcohol use Mod 10 Practice Qs
A. Avoid wearing necklaces during client care. B. Know the layout of the facility. E. Provide immediate verbal feedback for escalating behavior.
A nurse manager is providing staff education about working with clients who have a history of anger and aggression. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. Avoid wearing necklaces during client care. B. Know the layout of the facility. C. Stand directly in front of the client when talking. D. Bring security with you for all client interactions. E. Provide immediate verbal feedback for escalating behavior. Mod 10 Practice Qs
A. Provide the client with small meals frequently. B. Monitor the client's weight daily. D. Stay with the client during meals and for 1 hr afterward. E. Offer specific privileges for sustained weight gain.
A nurse on an inpatient eating disorders unit is caring for a client who has anorexia nervosa and has a body mass index of 17.2. Which of the following actions should the nurse take? (Select all that apply.) A. Provide the client with small meals frequently. B. Monitor the client's weight daily. C. Allow the client to choose the meals she will eat. D. Stay with the client during meals and for 1 hr afterward. E. Offer specific privileges for sustained weight gain. Mod 10 Practice Qs
A. "As a nurse, I am required by law to report suspected child abuse."
A nurse reports an incident of suspected child abuse. One of the parents of the child becomes upset and demands to know the reason for the nurse's action. Which of the following responses by the nurse is appropriate? A. "As a nurse, I am required by law to report suspected child abuse." B. "I am unable to discuss this, but I can contact my supervisor to speak with you." C. "The provider will be coming to explain the situation." D. "I reported the incident to my supervisor who decided to contact the authorities." Mod 10 Practice Qs, Final Review Qs
B. Report the findings to a supervisor.
A public health nurse is assessing an older adult client who lives with a family member. The nurse identifies several bruises in various stages of healing. The client and family member explain that the bruises are a result of clumsiness. However, based on the distribution of the bruises, the nurse suspects abuse. Which of the following actions should the nurse take first? A. Document the bruises in the client's chart. B. Report the findings to a supervisor. C. Provide the client with a crisis hotline number. D. Discuss respite care with the client's family. Mod 10 Practice Qs
c. Task III: Adjusting to a world without the lost entity
A recent widow states, "I'm going to have to learn to pay all the bills. Hank always did that. I don't know if I can handle all of that." This is an example of which of the tasks described by Worden? a. Task I: Accepting the reality of the loss b. Task II: Processing the pain of grief c. Task III: Adjusting to a world without the lost entity d. Task IV: Finding an enduring connection with the lost entity in the midst of embarking on a new life Ch 36 Qs
d. Use a "family" of dolls to role-play the child's family with her.
A school nurse notices bruises and scars on a child's body, but the child refuses to say how she received them. Which of the following is an evidence-based approach for further assessment by the nurse? a. Have her evaluated by the school psychologist. b. Tell her she may select a "treat" from the treat box (e.g., sucker, balloon, junk jewelry) if she answers the nurse's questions. c. Explain to her that if she answers the questions, she may stay in the nurse's office and not have to go back to class. d. Use a "family" of dolls to role-play the child's family with her. Ch 34 Qs
a. As a health-care worker, report the suspicion to child protective services.
A school nurse notices bruises and scars on a child's body. The nurse suspects that the child is being physically abused. Which action by the nurse is a priority at this point? a. As a health-care worker, report the suspicion to child protective services. b. Check the child again in a week and see if there are any new bruises. c. Meet with the child's parents and ask them how she got the bruises. d. Initiate paperwork to have the child placed in foster care. Ch 34 Qs
acts of omission
Acts of neglect. This is when the physical, emotional or educational needs are not met. This also includes medical and dental need, or when the child is not protected from harm. Mod 10 Lesson Content
J. William Worden
Theorist for the "Tasks of Mourning" Mod 10 Lesson Content
▪ Be alert for hesitation in responding, inappropriate affect, inappropriate explanations, poor eye contact and increased anxiety. ▪ Make sure the victim is questioned in a private area, away from all others.
Therapeutic Communication for Abuse victims Mod 10 Lesson Content
art of presence
To be present with the client and family. There are two necessary skills, listening and observing. Mod 10 Lesson Content
Victims are at greatest risk when they *threaten or leave the relationship.* Violence also escalates when the partner makes a move towards independence.
When are victims at the greatest risk for abuse? Mod 10 Lesson Content
Task II
Name this Bereavement Process task: ▪ Processing the grief Mod 10 Lesson Content
Delayed (inhibited) grief
Name this maladaptive response to loss: ▪ Absence of evidence of grief at the time of the loss. The grief response may be triggered years later. Mod 10 Lesson Content
Distorted (exaggerated) grief
Name this maladaptive response to loss: ▪ Often, the grieving individual is fixed in the anger stage. Often the individual feels helpless and becomes depressed. Mod 10 Lesson Content
Chronic (prolonged) grief
Name this maladaptive response to loss: ▪ The process is prolonged (>6 mo.), and the individual is unable to let go of grieving behavior. Mod 10 Lesson Content
Stage II: Anger
Name this stage of grief: ▪ reality sets in and the feelings associated with this stage are sadness, guilt, helplessness and hopelessness. Mod 10 Lesson Content
Stage V: Acceptance
Name this stage of grief: ▪ the individual accepts or is resigned to the loss. Methods for coping have been established. Mod 10 Lesson Content
Stage I: Denial
Name this stage of grief: ▪ the individual has difficulty believing the loss has occurred. This stage may provide protection from the pain of reality. Mod 10 Lesson Content
Stage III: Bargaining
Name this stage of grief: ▪ the individual may attempt to bargain with God for a second chance or more time. Mod 10 Lesson Content
Stage IV: Depression
Name this stage of grief: ▪ the individual mourns for that which has or will be lost. Mod 10 Lesson Content
psychological abuse
Name this type of abuse: ▪ Symptoms associated with depression, withdrawal, increased agitation, insomnia and anxiety Mod 10 Lesson Content
physical abuse
Name this type of abuse: ▪ bruises, welts, lacerations, burns, evidence of hair pulling, skeletal dislocation and fractures Mod 10 Lesson Content
financial abuse
Name this type of abuse: ▪ disparity between assets and living conditions, and lack of funds for living expenses ▪ failure to provide for the needs of a vulnerable person when adequate funds are available Mod 10 Lesson Content ATI Ch 32
neglect
Name this type of abuse: ▪ hunger, poor hygiene, inappropriate dress, unattended physical or medical needs, sedation, and abandonment Mod 10 Lesson Content
sexual abuse
Name this type of abuse: ▪ pain or itching in the genital area, bruising or bleeding in external genitalia or vaginal area and unexplained sexually transmitted diseases. Mod 10 Lesson Content
They may become withdrawn or attempt to continue activities in an effort to avoid the pain of the loss. Some become aggressive or defiant.
Perceptions of Death: *Adolescents* Mod 10 Lesson Content
The adult's concept is influenced by experimental, cultural and religious beliefs.
Perceptions of Death: *Adults* Mod 10 Lesson Content
*They are able to understand the finality of death.* Feelings of anger, guilt and depression are common. Peer relationships and school performance may be affected.
Perceptions of Death: *Age 10-12* Mod 10 Lesson Content
They have difficulty distinguishing between fantasy and reality. They believe *death is reversible.* They often feel they may have caused the person to become ill and die. They also feel there may be a threat to themselves or their family.
Perceptions of Death: *Age 3-5* Mod 10 Lesson Content
They are beginning to understand the finality of death. Normal grief reactions include: regressive and aggressive behavior, they may withdraw from others, experience somatic symptoms and clinging behavior.
Perceptions of Death: *Age 6-9* Mod 10 Lesson Content
They are unable to understand death. Often react to the emotions of adults (more irritable & crying).
Perceptions of Death: *Birth to Age 2* Mod 10 Lesson Content
At this time it may be difficult for the individual to complete the grief process in response from one loss before another occurs. This may create bereavement overload.
Perceptions of Death: *Older Adults* Mod 10 Lesson Content
a. Death of a pet dog b. Being told by her doctor that she has begun menopause c. Failing an exam d. Losing a spouse through divorce
Which of the following is most likely to initiate a grief response in an individual? (Select all that apply.) a. Death of a pet dog b. Being told by her doctor that she has begun menopause c. Failing an exam d. Losing a spouse through divorce Ch 36 Qs
a. The ability to grieve in anticipation of the loss
Which of the following is thought to facilitate the grief process? a. The ability to grieve in anticipation of the loss b. The ability to grieve alone without interference from others c. Having recently grieved for another loss d. Taking personal responsibility for the loss Ch 36 Qs
▪ They may fear retaliation, be embarrassed about the abuse in the family, feel protective of the family member or unwilling to institute legal action. ▪ They may also be isolated or feel totally dependent on the abuser. ▪ They may also be afraid of being placed in another, even worse environment.
Why do elders deny abuse? Mod 10 Lesson Content
▪ The most frequent response is that they fear for their life and the lives of their children ▪ It is what they know-learned behavior ▪ They lack support or assistance ▪ Religious beliefs ▪ Lack of financial independence.
Why do victims of intimate partner abuse remain in their situations? Mod 10 Lesson Content
▪ Added stress ▪ Doubts about paternity ▪ See baby as competition ▪ Financial burden
Why does pregnancy trigger or increase intimate partner violence? Mod 10 Lesson Content
d. "I hope you have made the right decision. Call this number if you need help."
A woman who has a long history of being battered by her husband is staying at the woman's shelter. She has received emotional support from staff and peers and has been made aware of the alternatives open to her. Nevertheless, she decides to return to her home and marriage. The best response by the nurse to the woman's decision is: a. "I just can't believe you have decided to go back to that horrible man." b. "I'm just afraid he will kill you or the children when you go back." c. "What makes you think things have changed with him?" d. "I hope you have made the right decision. Call this number if you need help." Ch 34 Qs
b. Provide physical and emotional support during evidence collection.
A young man who has just undergone a sexual assault is brought into the emergency department by a friend. What is the priority nursing intervention? a. Help him to bathe and clean himself up. b. Provide physical and emotional support during evidence collection. c. Provide him with a written list of community resources for survivors of rape. d. Discuss the importance of a follow-up visit to evaluate for sexually transmitted diseases. Ch 34 Qs
b. Assess vital signs and obtain an ECG.
An 80-year-old client arrives at the emergency department accompanied by her daughter. The daughter tells the nurse that her mom lost her husband 2 months ago and since then her mom has complained of feeling depressed and anxious. Earlier today, she began complaining of chest pain. Which of these actions by the nurse is a priority? a. Instruct the daughter not to worry; these are common grief responses in the elderly. b. Assess vital signs and obtain an ECG. c. Refer the client to grief support groups in the area. d. Educate the client in relaxation and deep breathing exercises and evaluate whether this helps resolve the chest pain. Ch 36 Qs
▪ Submissive/ passive ▪ Low self-esteem ▪ Fearful/ feel guilt ▪ No system ▪ Dependent
Characteristics of a *Victim* Mod 10 Lesson Content ATI Ch 32 p. 186
d. When the bereaved person can discuss both positive and negative aspects about the lost entity
Engel identifies which of the following as successful resolution of the grief process? a. When the bereaved person can talk about the loss without crying b. When the bereaved person no longer talks about the lost entity c. When the bereaved person puts all remembrances of the loss out of sight d. When the bereaved person can discuss both positive and negative aspects about the lost entity Ch 36 Qs
Task I
Name this Bereavement Process task: ▪ Accepting the reality of the loss Mod 10 Lesson Content
Task III
Name this Bereavement Process task: ▪ Adjusting to a world without the lost entity Mod 10 Lesson Content
▪ Low self esteem ▪ Feel inadequate ▪ Insecure ▪ Immature ▪ Manipulative ▪ Poor frustration tolerance ▪ Poor impulse control
Characteristics of a *Perpetrator* Mod 10 Lesson Content ATI Ch 32 p. 186
acts of commission
Deliberate and intentional acts. They include physical, sexual and emotional abuse. Mod 10 Lesson Content
Task IV
Name this Bereavement Process task: ▪ Finding an enduring connection with the lost entity in the midst of embarking on a new life. ▪ The lost entity becomes "relocated." The memories are intact, and the bereaved continues to love and miss the individual but moves forward in life. Mod 10 Lesson Content
▪ This is the fastest growing segment of population. ▪ They are often physically dependent on others. ▪ They are also financially dependent. ▪ Stress of the caregiver is a factor in most elder abuse cases. ▪ There may be unresolved family conflicts or retaliation for previous maltreatment. ▪ Substance abuse may play a part in the abuse. ▪ There may be economic stress on the family.
Factors that contribute to *Elder Abuse* Mod 10 Lesson Content
1. Identify culturally specific death rituals and expectations. 2. Understand mourning practices 3. Know specific burial practices - Identify cultural responses to death and grief - Accept the client's cultural and religious beliefs of death, dying and afterlife.
Guidelines for Assessing Culturally Specific Death Rituals Mod 10 Lesson Content
honey moon or contrition phase
In the _________ phase the abuser demonstrates kindness and loving behavior, makes promises to change and tells the victim he/she is loved and needed. Unfortunately, the cycle will repeat itself and the period of fear and anger are more intense. This pattern erodes the victim's self-esteem. Often the victim believes the violence was deserved and accepts blame for the abuser's behavior. Mod 10 Lesson Content
▪ the child is under 4 years of age ▪ the perpetrator perceives the child as being different (the child is the result of an unwanted pregnancy, is physically disabled, or has some other trait that makes them particularly vulnerable) ▪ Disabilities may increase caregiver burden ▪ Social isolation of families ▪ Parent's history of domestic abuse ▪ Poverty or socioeconomic disadvantages ▪ Lack of family cohesion ▪ Substance abuse in the family ▪ Young, single non-biological parent(s) ▪ Parental stress, depression or another mental health condition ▪ Parents with poor coping skills ▪ Parents with history of abuse, neglect or emotional depression as a child
Risk factors for *Child Abuse* Mod 10 Lesson Content ATI Ch 32
▪ Change in self-confidence ▪ Headaches/stomach aches with no medical cause ▪ Abnormal fear
Signs of *Emotional Abuse* Mod 10 Lesson Content
▪ Failure to gain weight ▪ Desperately affectionate behavior ▪ Voracious appetite/stealing food ▪ Caretaker not available
Signs of *Emotional Neglect* Mod 10 Lesson Content
▪ Any injury (bruise, burn, fracture, abdominal or head injury) that cannot be explained ▪ Scalding burns with clear demarcation ▪ Marks (cords, belt, ropes) ▪ Multiple fractures in various stages of healing ▪ Sedation from overmedication
Signs of *Physical Abuse* Mod 10 Lesson Content
▪ Abdominal pain ▪ Bedwetting ▪ Urinary tract infection ▪ Genital pain or bleeding ▪ Fearful behavior (nightmares, depression, attempts to run away) ▪ Sexually transmitted disease ▪ Extreme sexual behavior (inappropriate for child's age)
Signs of *Sexual Abuse* Mod 10 Lesson Content
TRUE.
T/F: Elder victims often minimize the abuse or deny the abuse occurred if the perpetrator is a family member. Mod 10 Lesson Content
TRUE.
T/F: Over 90% of child abuse perpetrators are the child's parents. Mod 10 Lesson Content
FALSE. It may not follow in the exact order. The stages may fluctuate, and the client may not reach the stage of acceptance.
T/F: The grief process follows in the exact same order Mod 10 Lesson Content
tension building phase
The ________ phase begins with minor incidents such as pushing, shoving and verbal abuse. During this time, the abuser may rationale that the behavior is acceptable. The victim may try to *reduce the tension* by minimizing the importance of the incident. Mod 10 Lesson Content ATI Ch 32
acute battering phase
The ________ phase occurs when the tension peaks. It is usually triggered by an external event. In some case, the victim provokes an incident and endures the battering stage in order to move to the honeymoon stage. *this stage is the most violent and shortest* Mod 10 Lesson Content
d. Rape is an expression of power and dominance by means of sexual aggression and violence.
The nurse is providing education to a support group for survivors of rape. Which of the following items is evidence-based information to include in this teaching? a. Rapists typically drink alcohol and are not in control of their actions. b. Rape is usually an event that occurs between two people who are sexually frustrated. c. Men who are born into poverty are predisposed to becoming rapists after puberty. d. Rape is an expression of power and dominance by means of sexual aggression and violence. Ch 34 Qs
intimate partner violence
physical violence, rape and/or stalking and aggression by a current or former intimate partner. Mod 10 Lesson Content
Elizabeth Kubler-Ross
psychologist who created the 5 stages of grief: denial, anger, bargaining, depression, acceptance Mod 10 Lesson Content
grief
the deep mental and emotional anguish that is a response to the experience of loss of something of personal importance. *the inner emotional response to loss* Mod 10 Lesson Content ATI Ch 27
loss
the experience of separation from something of personal importance. Mod 10 Lesson Content
mourning
the psychological process through which the individual passes in order to successfully adapt to the loss of something of personal importance. *the outward display of loss* Mod 10 Lesson Content ATI Ch 27
