OB - Chapter 9 Violence and Abuse

A nurse is interviewing a client who is a survivor of abuse. The client is telling the nurse about how the violence occurred. Which statement would the nurse interpret as reflecting phase 3 of the cycle of violence? a) "He calls me stupid and incompetent, asking himself why he ever married me." b) "He threw me against the wall and started punching my face." c) "He tells me that he is sorry and that he will never hit me again." d) "He yells at me for not having dinner waiting for him when he came home."

"He tells me that he is sorry and that he will never hit me again."

A client comes to a local community health care facility for a routine check-up. While talking to the nurse, the client happens to mention that every time she has a serious fight with her husband, he forces her to have intercourse with him. The client seems to be very disturbed when revealing this to the nurse. Which is an appropriate response by the nurse? a) "Your husband is just trying to reconcile using intimacy." b) "It's okay in cases of fights where you're really at fault." c) "This behavior is considered sexual abuse." d) "Such behavior is considered normal in a married couple."

"This behavior is considered sexual abuse."

Which of the following statements might empower abuse victims to take action? a. "You deserve better than this." b. "Your children deserve to grow up in a two-parent family." c. "Try to figure out what you do to trigger his abuse and stop it." d. "Give your partner more time to come to his senses about this."

"You deserve better than this."

The nursing student is studying violence and abuse against the older woman. While researching it, she learns that laws require health care professionals to report elder or vulnerable person abuse. How many states currently have these laws? a) 40 b) 52 c) 50 d) 32

50

Which of the following would be considered child abuse? Select all that apply. a) A caregiver intentionally is demeaning to a child. b) A caregiver neglects a child's physical needs. c) A caregiver lets a child participate in school activities and the child gets injured. d) A caregiver allows siblings to talk inappropriately to each other.

A caregiver intentionally is demeaning to a child. A caregiver neglects a child's physical needs.

The nursing instructor overhears students discussing their recent lecture topic of abuse and realizes that they need clarification when she hears a student say which of the following? a) Violence against lesbian relationships may go unreported for fear of harassment. b) Abuse occurs only in heterosexual relationships. c) Violence against gay relationships may go unreported for fear of harassment. d) Abuse occurs in both heterosexual and homosexual relationships.

Abuse occurs only in heterosexual relationships.

When teaching a group of students about the cycle of violence, which behavior would the nurse describe as eventually disappearing as the violence becomes accelerated over time? a) Denial of the seriousness of the injuries b) Apologies for the pain and abuse c) Loss of control d) Excessive hostility and friction

Apologies for the pain and abuse

A nurse suspects that a 6-year-old girl is being sexually maltreated by her father, based on some comments made by the girl. Which of the following methods would be most effective in confirming the nurse's suspicion? a) Assess the girl for unexplained fractured bones b) Check for any sexual perpetrators listed in the area under Megan's law c) Ask the girl's mother what she knows of the father's activities d) Ask the girl to draw a picture of what happened

Ask the girl to draw a picture of what happened

A pregnant client and her husband are at their first prenatal visit. While performing the admission history, the nurse notes several new and old bruises on the woman's neck and body. She is silent and withdrawn. The husband answers all the questions. Based on these observations, the nurse suspects intimate partner violence. Which of the following is the most appropriate nursing intervention at this time? a) Ask the woman if she would like her husband to wait outside in the lobby. b) Ask the husband to wait in the lobby while the client is being examined. c) Ask the couple if they would like to see a social worker. d) Ask the husband if he feels the client has been depressed throughout the pregnancy.

Ask the husband to wait in the lobby while the client is being examined.

A nurse is assigned to care for a hospitalized 14 year old with gastroenteritis. The teen tells the nurse that a brother ran away about 2 months ago and hasn't been heard from since, a sister has a substance abuse problem, and both parents are fighting. What type of situation is this family displaying? a) Child neglect b) Child abuse c) Dysfunctional dynamics d) Impaired parenting

Dysfunctional dynamics

Which of the following is FALSE regarding emergency contraception (EC)? a) EC will disrupt an established pregnancy if taken within 72 hours. b) EC simply contains the same hormones that are found in birth control pills. c) EC works by preventing fertilization, ovulation, or implantation. d) EC is most effective if it is taken within 12 hours of rape.

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

A nurse is assessing a boy who was recently found to have been molested by a neighbor. Which of the following characteristics is most likely in a pedophile? a) Physically abusive b) Violent c) Emotional fixation at a childhood level d) Homosexual

Emotional fixation at a childhood level

The primary goal of intervention in working with abused women is to: a. Set up an appointment with a mental health counselor for the victim b. Convince them to set up a safety plan to use when they leave c. Help them to develop courage and financial support to leave the abuser d. Empower them and improve their self-esteem to regain control of their lives

Empower them and improve their self-esteem to regain control of their lives

A nursing student studying sexual violence makes the following statement in class, "A man who has sex with his wife even though she did not want it cannot be charged with sexual abuse." Is this statement true or false? a) False b) True

False

When implementing an intervention for a woman in an abusive situation, what is the primary goal? a) For the woman to be able to stand up to her abuser b) For the woman to be removed from her abusive relationship c) For the woman to regain a sense of control in her life d) For the woman to be able to care for herself

For the woman to regain a sense of control in her life

What is the leading cause of death in pregnant women? a) Amniotic fluid embolism b) Undiagnosed cardiac condition c) Pulmonary embolism d) Intimate partner violence

Intimate partner violence

The nursing instructor is discussing violence and abuse that is seen in women with a student. She realizes that the student needs further instruction when the student states which of the following? a) Nurses will come in contact with violence no matter what health care setting they work. b) Violence against women is on the rise in the United States. c) Nurses will come in contact with sexual abuse no matter what health care setting they work. d) Nurses only come in contact with violence in the ER.

Nurses only come in contact with violence in the ER.

In caring for a child who has been admitted after being sexually abused, which of the following interventions would be included in the child's plan of care? a) Encourage frequent family visits b) Weigh on the same scale each day c) Observe for signs of anxiety d) Test the urine for glucose upon admission

Observe for signs of anxiety

A nurse is performing a routine physical for a 7-year-old girl who is thin, unwashed, and dressed in rags. Although it is winter time, she has no coat with her. Her teenaged brother in the waiting room, however, is dressed in trendy clothes and looks healthy and well-fed. Which of the following should the nurse most strongly suspect regarding this girl? a) Physical neglect b) Sexual maltreatment c) Psychological maltreatment d) Physical maltreatment

Physical neglect

Women recovering from abusive relationships need to learn ways to improve their: a. Educational level by getting a college degree b. Earning power so they can move to a better neighborhood c. Self-esteem and communication skills to increase assertiveness d. Relationship skills so they will be better prepared to deal with their partners

Self-esteem and communication skills to increase assertiveness

A patient who is abused fails to report the abuse MAINLY because of which of the following reasons? a) She feels lucky to be alive. b) She feels responsible for causing the incident. c) She does not want anyone to know. d) She thinks it will not happen again.

She feels responsible for causing the incident.

A female client has been admitted to the inpatient psychiatric facility with a diagnosis of posttraumatic stress disorder after a history of violence by her boyfriend. During the initial assessment interview, which assessment would be the priority? a) Hydration status b) Suicide risk c) Sleep patterns d) Nutritional status

Suicide risk

The first phase of the abuse cycle is characterized by: a. The woman provoking the abuser to bring about battering b. Tension building and verbal or minor battery c. A honeymoon period that lulls the victim into forgetting d. An acute episode of physical battering

Tension building and verbal or minor battery

A young mother brings her 6-month-old in for an examination, appearing listless and inattentive of her child. She sets the child in the floor and reads and sends text messages on her phone. The child appears underweight and lethargic. Which finding would confirm the nurse's suspicion that this child is experiencing failure to thrive? a) The child rests her head on the nurse's shoulder and cuddles with her after the examination b) The child is below the fifth percentile for weight and height c) The child resists when the nurse takes her vital signs d) The child cries when the nurse picks her up

The child is below the fifth percentile for weight and height

Walter is an 11-year-old boy who was raised in a home where his father beat his mother on a regular basis. Which of the following statements is true regarding children being raised in a home where they have witnessed intimate partner violence? a) They have higher rates of schizophrenia b) They are at increase risk for being abused c) It has little impact on child functioning d) Female children are more likely to experience depression

They are at increase risk for being abused

Homicide from intimate partner violence is the number-one cause of death in pregnant women. a) False b) True

True

A nurse is caring for a client who was raped at gunpoint. The client does not want any photos taken of her 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? a) Document only descriptions of medical interventions taken b) Use direct quotes and specific language c) Respect the client's opinion and avoid informing the police d) Obtain photos to substantiate the client's case in a court of law

Use direct quotes and specific language

A 16-year-old girl is seen in an emergency room following a rape. The management of a rape victim should be directed primarily toward a) teaching the child how to prevent further attacks. b) decreasing guilt and increasing self-esteem. c) assessing for sources of infection resulting from the rape. d) relieving physical discomfort and pain.

decreasing guilt and increasing self-esteem.

The nurse has learned that the number one factor that will motivate a woman to escape an abusive relationship is which of the following? a) fear of harm to herself b) fear of death c) fear of harm to other family members d) fear of harm to her unborn child

fear of harm to her unborn child

When a pregnant patient is abused during her pregnancy what complication is likely to occur after delivery due to the abuse? a) post-partum depression b) schizophrenia c) low birth weight d) edema

post-partum depression

The nurse who counsels women who suffer from abuse understands that abuse can come in different forms that include which of the following? (Check all that apply.) a) sexual abuse b) spiritual abuse c) physical abuse d) financial abuse e) emotional abuse

sexual abuse physical abuse financial abuse emotional abuse

A 5-year-old girl is being admitted with a possible diagnosis of child abuse. The child has bruises in various places on her body that the caregiver attributes to the child recently beginning to play soccer. Bruises associated with child abuse would likely be found in which of the following areas of the body? a) elbows b) forehead c) knees d) thighs

thighs

Which of the following are forms of emotional abuse? Select all that apply. a) Humiliating b) Incest c) Destroying another's property d) Insulting e) Rape

• Insulting • Humiliating • Destroying another's property

The nurse who works in a woman's health clinic correctly identifies two key objectives for 2020 National Health Goals that addresses violence against women as which of the following? (Check two.) a) reduce the annual rate of rape or attempted rape b) increase the rate of women's depression c) reduce the rate of physical assault by current or former intimate partners d) increase the rate of women's consumed calories

• reduce the rate of physical assault by current or former intimate partners • reduce the annual rate of rape or attempted rape

Which of the following are biologic indicators of posttraumatic stress disorder (PTSD)? a) Auditory hallucinations b) A feeling of unreality about oneself c) Memory difficulties d) Flashbacks

Flashbacks

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? a) They have parents who are divorced. b) They are usually physically imposing. c) They exhibit antisocial behaviors. d) They belong to the low-income group.

They exhibit antisocial behaviors.

The generation-to-generation continuum of violence refers to the fact that a) Children who grow up in abusive homes almost always become abusers themselves unless they have professional intervention b) Children who grow up in an abusive home are less likely to be abusers themselves because they see first hand the devastation that violence can cause c) Violence is an innate behavior, and children become abusers because of external factors in their environment more often than in their family d) Violence is a learned behavior, and children who witness abuse are more likely to become abusers themselves

Violence is a learned behavior, and children who witness abuse are more likely to become abusers themselves

Which of the following is FALSE regarding screening for intimate partner violence in women? a) Screening should be routinely done at every visit. b) Although women who are abused may exhibit certain behavior patterns, all women should be screened for intimate partner violence. c) Women tend to fit a profile of abuse, and victims tend to share similar physical characteristics. d) An elderly female may be a victim of intimate partner violence.

Women tend to fit a profile of abuse, and victims tend to share similar physical characteristics.

If the following data was collected on a group of children, which of the following would most likely be evaluated as possibly related to child abuse? Select all that apply. a) A child who has a spiral fracture in the femur. b) A child who has chronic nausea and diarrhea. c) A child whose blood work shows evidence of anemia. d) A child whose X-ray shows bone fractures in various stages of healing. e) A child whose CT scan shows a cerebral hemorrhage.

• A child who has a spiral fracture in the femur. • A child whose X-ray shows bone fractures in various stages of healing. • A child whose CT scan shows a cerebral hemorrhage.

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 husband. The client tells the nurse that her husband had stopped abusing her some time ago, but this was the first time during the pregnancy that she was assaulted. She blames herself because she admits to not paying enough attention to her husband. Which facts about abuse during pregnancy should the nurse tell the client to convince her that the abuse was not her fault? Select all that apply. a) Most men exhibit violent reactions during pregnancy as a way of coping with the stress. b) Abuse is a result of insecurity and jealousy of the pregnancy and the responsibilities it brings. c) Abuse is a result of the perception of the partner that the baby will be a competitor after he or she is born. d) Abuse is a result of concern for the unborn child when the mother doesn't fulfill her responsibilities toward the newborn. e) Abuse is a result of resentment toward the interference of the growing fetus and change in the woman's shape.

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

A nurse is working in a local community health care facility where she frequently encounters victims of abuse. For which signs should the nurse assess to find out if a client is a victim of abuse? Select all that apply. a) Reported history of the injury is inconsistent with the presenting problem b) Injuries on the face, head, and neck c) Partner of the suspected victim seems relaxed and not overly worried d) Affected by STIs frequently e) Mental health problems such as depression, anxiety, or substance abuse

• Injuries on the face, head, and neck • Mental health problems such as depression, anxiety, or substance abuse • Reported history of the injury is inconsistent with the presenting problem

When caring for an abused woman, the nurse uses the ABCDES framework to provide interventions. Which of the following are components of this framework? Select all that apply. a) Plan of action and resources for safety for when the woman decides to leave b) Clear documentation of the nurse's perception of the abuse c) Expression of the belief that there may be a reason for the violence d) Education about the cycle of violence and its escalation e) Maintenance of confidentiality of the information reported f) Reassurance that the woman is not alone in this situation

• Plan of action and resources for safety for when the woman decides to leave • Maintenance of confidentiality of the information reported • Reassurance that the woman is not alone in this situation • Education about the cycle of violence and its escalation

A group of nursing students is preparing a talk on violence against women and how to prevent it. They want to list characteristics of intimate partner violence and should include which of the following? (Check all that apply.) a) use and abuse of substances such as alcohol b) history of childhood abuse c) history of antisocial behavior d) negative affect (hostility and depression) e) current unemployment f) easy-going personality

• history of childhood abuse • use and abuse of substances such as alcohol • history of antisocial behavior • current unemployment • negative affect (hostility and depression)

The nurse working in the obstetrics clinic has been trained to pick up on warning signs of abuse during pregnancy. These include which of the following?(Select all that apply.) a) more weight gain than recommended b) unrealistic fears c) difficulty with physical exams d) weight fluctuations e) noncompliance with treatment f) poor attendance at prenatal visits

• poor attendance at prenatal visits • unrealistic fears • weight fluctuations • difficulty with physical exams • noncompliance with treatment

A woman has just confided in the nurse that her partner slapped and kicked her that morning. What is the best response by the nurse? a) "Oh my goodness, I cannot believe that happened to you. You poor thing, I feel terrible for you." b) "It's very brave of you to tell me all this. Help is available if you choose it." c) "Maybe he didn't mean to do it. Have you talked with him about it?" d) "Is this the first and only time he has done anything?"

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

A client is receiving treatment for injuries sustained during a fight with her partner. The nurse observes that the partner visits her daily in the hospital and appears very solicitous and contrite. When questioned, the client tries to convince the nurse that her partner always apologizes and brings gifts after a fight. Which information should the nurse provide this client? a) "Your partner seems to be genuinely contrite." b) "Although your partner seems sorry, often they will repeat this behavior in the future." c) "Sometimes people do things that cause them to be a victim of physical abuse." d) "You should try not to upset your partner in the future."

"Sometimes people do things that cause them to be a victim of physical abuse."

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

One in four women will be a victim of violence.

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? a) They belong to the low-income group. b) They are usually physically imposing. c) They have parents who are divorced. d) They exhibit antisocial behaviors.

They exhibit antisocial behaviors.

A nurse observes telltale signs of injuries from physical abuse on the face and neck of a female client. When questioned, the client tells the nurse that the injuries are the result of a physical attack by her partner and that she has developed palpitations thereafter. Which action should the nurse take to gain the trust of the client and enhance the nurse-client relationship? a) Tell the client to forget about the incident to avoid the trauma b) Inform the client that there is no connection between the violence and palpitations c) Offer referrals so the client can get help that will allow her to heal d) Confirm with the partner whether the client's story is true

Offer referrals so the client can get help that will allow her to heal

A patient who has been seen in the clinic multiple times for counseling recently admitted to being abused by her husband over a period of five years. Today she states, "He has been so sweet to me the last six days that I think this time he has really changed. He even brought me flowers yesterday and said he loves me." How should the nurse respond to this? a) Over a period of time the honeymoon phase ends and abuse becomes accelerated and thus more dangerous. b) That was a very sweet gesture. c) It seems as if he really loves you. d) I certainly would not be sucked into that.

Over a period of time the honeymoon phase ends and abuse becomes accelerated and thus more dangerous.

A woman comes to a local community health care facility with her partner. She has a broken arm and bruises on the face that she reports were caused by a fall. The nature of the injuries, however, causes the nurse to be convinced that this is a case of physical abuse. Which intervention should the nurse perform? a) Tell the partner to leave the room immediately b) Ask the partner directly if he was responsible c) Attempt to interview the woman in private d) Question the client about the injury in front of the partner

Attempt to interview the woman in private

Nurses at an urban emergency department seek to develop a plan to help women involved in abusive relationships. Which of the following components is critical to the success of the plan? a) A quality of life assessment tool b) An intimate partner violence (IPV) counselor c) Educational materials d) Avenues for referral

Avenues for referral

Which of the following would the nurse identify as indicating emotional abuse? Select all that apply. a) Calling the victim names b) Throwing things at a victim c) Not allowing the victim to seek care for an injury d) Threatening to hit the victim e) Controlling how the family's money is spent f) Forcing the victim to perform a degrading act

• Calling the victim names • Threatening to hit the victim • Forcing the victim to perform a degrading act

The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse in which of the following situations? a) A 6-year-old with a greenstick fracture of the wrist, which the caregiver reports was caused when the child fell while ice-skating b) A 7-year-old with a spiral fracture of the humerus, which the caregiver reports was caused when the child was hit with a bat swung by a Little League teammate c) A 10-year-old with a simple fracture of the femur, which the caregiver reports was caused when the child fell down a set of stairs d) A 9-year-old with a compound fracture of the tibia, which the caregiver reports was caused when the child attempted a flip on a skateboard

A 7-year-old with a spiral fracture of the humerus, which the caregiver reports was caused when the child was hit with a bat swung by a Little League teammate

The nurse is talking to a female client who is a survivor of intimate partner violence. The woman relates that her husband has been told that he has the characteristics of an antisocial personality disorder. The woman also informs the nurse that her husband has an extensive criminal record. The nurse interprets this information and suspects that the woman's husband would most likely demonstrate which behavior? a) A risk for moderate to severe violence with people both within and outside his family b) Symptoms of depression along with harboring feelings of inadequacy c) Purposefully remain socially isolated from people other than those in his family d) Intermittent remorse for the violence and abuse that he commits

A risk for moderate to severe violence with people both within and outside his family

When providing care to a victim of abuse, which of the following would the nurse do? a) Provide an overview of the procedures to be done. b) Make the decisions for the woman. c) Take the lead in providing the interventions quickly. d) Allow the woman to participate in her care.

Allow the woman to participate in her care.

A nurse is interviewing a rape victim who was assaulted 6 month ago. Which questions should the nurse ask the client to know the extent of physical symptoms of PTSD? Select all that apply. a) "Are you having trouble sleeping?" b) "Do you have heart palpitations or sweating?" c) "Do you ever feel as you are reliving the event?" d) "Do you feel numb emotionally?" e) "Have you felt irritable or experienced outbursts of anger?"

• "Are you having trouble sleeping?" • "Have you felt irritable or experienced outbursts of anger?" • "Do you have heart palpitations or sweating?" • "Do you ever feel as you are reliving the event?"

The nurse is talking to a female client who is a survivor of intimate partner violence. The woman relates that her husband has been told that he has the characteristics of an antisocial personality disorder. The woman also informs the nurse that her husband has an extensive criminal record. The nurse interprets this information and suspects that the woman's husband would most likely demonstrate which behavior? a) A risk for moderate to severe violence with people both within and outside his family b) Intermittent remorse for the violence and abuse that he commits c) Symptoms of depression along with harboring feelings of inadequacy d) Purposefully remain socially isolated from people other than those in his family

A risk for moderate to severe violence with people both within and outside his family

Question: Place the three phases of intimate partner violence in the order in which they occur. 1. Acute violence phase 2.Tension-building phase 3.Honeymoon phase

Tension-building phase, Acute violence phase, Honeymoon phase

Nurses sometimes have difficulty assessing women for violence. Which of the following refers to the screen protocol to use to be the most thorough? a) The RACE model b) The FACE model c) The SBAR model d) The SAVE model

The SAVE model

The nurse is assisting with a physical exam on a child who has been admitted with a diagnosis of possible child abuse. Which of the following findings might alert the nurse to this possibility that the child may have been abused? a) The child has a fractured bone. b) The child has a burn that has not been treated. c) The child has bruises on the knees and elbows. d) The child is hyperactive and angry.

The child has a burn that has not been treated.

A nurse is presenting a program to a church group about domestic violence. During the presentation, a member of the audience asks the nurse to explain what "intergenerational transmission of violence" means because he has seen that phrase used in the media. Which of the following responses by the nurse would be most appropriate? a) "Domestic violence seems to skip every other generation when it is traced in families." b) "People who grow up in violent home situations tend to be involved in domestic violence situations as an adult." c) "Recent research has identified a gene that is responsible for transmission of a risk for violent behavior that is passed on from generation to generation." d) "People who are violent are that way because of the various neurochemical imbalances in their brains."

"People who grow up in violent home situations tend to be involved in domestic violence situations as an adult."

A nurse is caring for a rape victim who was just brought to the local emergency care facility. Which interventions should the nurse perform to minimize risk of pregnancy in this client? a) Wait for first signs of pregnancy before taking action b) Administer prescribed double dose of emergency contraceptive pills c) Apply spermicidal cream or gel near the vaginal area upon arrival d) Administer prescribed regular oral contraceptive pills

Administer prescribed double dose of emergency contraceptive pills

A 13-year-old immigrant from Asia is admitted to the health care facility with vaginal bleeding. A genital examination reveals unhealed circumcision wounds. The client can understand limited English but cannot speak the language fluently. The service of an interpreter is employed. What are the points the nurse should keep in mind when interacting with this client? a) Allow the interpreter to question the client directly to assist with data gathering b) Use pictures and diagrams to supplement the questions and answers of the client's understanding c) Condemn the cultural practice and explain why it is wrong to the client d) She is still a child so convey important information in precise medical terms to ease understanding

Use pictures and diagrams to supplement the questions and answers of the client's understanding