ob exam 3 Ch 9.
A victim of rape is prescribed emergency contraception. After teaching the client about this therapy, the nurse determines that the teaching was effective based on which client statement?
"It contains high doses of a typical birth control pill"
A nurse has just finished a presentation about intimate partner violence at a local group meeting. The nurse determines that more teaching is needed based on which group statement?
"It's only women that get hurt. Men are the ones doing all the hurting."
The nurse has just finished a presentation about intimate partner violence at a local group meeting and realizes more teaching is needed when one person comments
"That was interesting, but it will never happen here. It only happens in the poor side of town."
rohypnol
(also known as "roofies," "forget pills," "mind erasers," and the "drop drug"). This drug is 10 times as strong as diazepam. The effects can be felt within 30 minutes and produces memory loss for up to 8 hours
(known as "Special K," "vitamin K," or "super acid"), and acts on the central nervous system very quickly to separate perception and sensation.
, ketamine
During integration and recovery
, the woman begins to feel safe and starts to trust others. She also may become an advocate for other rape victims
A nurse is developing a plan of care for a woman who is a victim of abuse. Which action would be most appropriate for the nurse to include in the plan?
Allow the woman to participate in her care
also known as "club drugs" because they are often used at dance clubs, fraternity parties, and all-night raves
Date rape drugs
To properly assist a victim of abuse, which action would be most appropriate for the nurse to do?
Document the details
most effective if is taken within 12 hours of the rape; it becomes less effective with every 12 hours of delay thereafter
Emergency contraception
"liquid ecstasy" or "easy lay") produces euphoria, an out-of-body high, sleepiness, increased sex drive, and memory loss. takes effects in about 15 minutes and can last three to four hours. It may cause unconsciousness, depression, and coma
Gamma hydroxybutyrate (GHB)
A client comes to the clinic reporting neck and back pain. Her partner appears anxious and overprotective. The nurse suspects possible abuse. How might the nurse handle this examination?
Isolate the client to ensure privacy before questioning about possible abuse
providing care to a victim
It is very important that the nurse listen carefully and nonjudgmentally. Judging or criticizing the victim for her decisions might lead to the impression that the victim deserves the abuse or that she is to blame. The nurse should build trust and a sense of rapport with the woman and help build her own confidence so she can take the necessary steps to leave the situation.
The SAVE model includes
Screen all clients for violence by asking simple questions; Ask direct questions in a nonjudgmental way; Validate the client by ensuring belief of the story and not blaming the client for what happened; Evaluate and educate the client as to the available resources.
The nurse is assessing a women 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 woman is inadequate in some way.
leaving realtionship
When leaving an abusive relationship, a victim should take with her a driver's license or photo ID, the deed to the house or apartment lease, and a change of clothes for herself and her children. She should develop a game plan for leaving and then rehearse it. The woman should not use phone cards because they can leave a trail the abuser can follow.
teaching about rape
Women can be forced and overpowered by most men. The majority of women who are raped never tell anyone about it, and almost two thirds of victims never report it to the police. No victim invites sexual assault, and what she wears is irrelevant. It can take several years for a woman to recover from rape. Medications can help initially, but counseling is necessary.
The nurse is working with a perpetrator of abuse. The nurse educates the perpetrator that the behavior can be changed with intervention based on the understanding that it is:
a learned behavior.
Some women believe that the abuse is caused by
a personality flaw or inadequacy in her.
A nurse is preparing a presentation fora local community group about intimate partner violence. Which statement would be most appropriate for the nurse to include in the presentation
abuse in homosexual relationships may go unreported for fear of harassment
A nurse is reviewing the medical record of a client. Which information would the nurse identify as indicating emotional abuse? Select all that apply.
calling the victim names threatening to hit the victim forcing the victim to perform a degrading act
Pregnancy is a time of unique vulnerability to intimate partner violence (IPV) victimization because
changes in women's physical, social, emotional, and economic needs during pregnancy
. Children who witness one parent abusing another are more likely to become
delinquents or batterers themselves
Calling the victim names; promising, swearing, or threatening to hit the victim; and forcing the victim to perform degrading or humiliating acts are examples of
emotional abuse
ndividual factors include young age, heavy drinking, personality disorders, depression, low academic achievement, witnessing and experiencing violence as a child, and low income
factors for ipv
Controlling the finances and spending is an example of
finacial abuse
Interfering with a victim's access to health care for injuries is an example of
physical abuse
Throwing things at the victim is an example of
physical abuse
A client who is a rape survivor has appeared to cope very well. However, at a routine visit several months later, she is describing nightmares and flashbacks. The nurse would suspect which condition?
posttraumatic stress disorder
A significant proportion of women who are raped also experience symptoms of
ptsd
A nurse working with abused women recognizes that one of the best interventions is to:
strengthen the woman's sense of control over her life.
A type IV procedure includes the following:
the clitoris or labia is pricked, pierced, or incised, the clitoris and/or labia are stretched, the clitoris and surrounding tissues are cauterized, the vaginal orifice is scraped or cut, corrosive substances are introduced into the vagina, and herbs are inserted to narrow it
. During denial
the woman appears outwardly composed and returns to work or school but refuses to discuss the assault and denies the need for counseling
During the reorganization phase
the woman attempts to make life adjustments by moving or changing jobs and uses emotional distancing to cope.
During the disorganization phase
the woman typically experiences shock, fear, disbelief, anger, shame, guilt, and feelings of uncleanliness.
While assessing a woman who underwent a female circumcision for cultural reasons when she was 9 years old, the nurse observes that the prepuce and a portion of the clitoris have been removed. The nurse identifies this as which type of female genital mutilation procedure?
type 1
the prepuce with or without a part or all of the clitoris is excised
type 1
a learned behavior that, without intervention, is selfperpetuating.
violence
The nurse is assisting a woman who is a victim of intimate partner violence in preparing a plan for leaving the relationship. Which instructions would the nurse include? Select all that apply.
"Be sure to have some type of identification, like a photo ID or driver's license." "Take the deed to the house or your apartment lease with you." "Set up a specific plan for leaving and then practice it
A concern for any rape victim is the chance of becoming pregnant. The nurse assisting a client who is a victim of rape would expect the client to receive emergency contraception within which time frame after the rape to ensure maximum effectiveness?
12 hour
A nurse is describing the cycle of violence to a group of women at a community clinic. The nurse determines that the women have understood the information when they identify which phase as usually lasting the longest?
A nurse is describing the cycle of violence to a group of women at a community clinic. The nurse determines that the women have understood the information when they identify which phase as usually lasting the longest?
As part of a local college awareness program, a nurse is interviewing several of the participants about their views on rape. Which statement would lead the nurse to determine that teaching about rape is necessary?
A woman can avoid being raped. If she doesn't want it to happen, then it won't.
cycle of violence
As the violence increases in frequency and severity over time, the honeymoon phase gradually shortens and eventually disappears altogether. The abuser no longer feels the need to apologize and indulge in a honeymoon phase as the woman becomes increasingly disempowered by the relationship.
what is the key of abuse?
Providing reassurance and support to the victim
consists of one dose taken within 72 to 120 hours of the unprotected intercourse.
The emergency regimen
When establishing a rapport with the client, it is important that a nurse remain nonjudgmental, be alert for subtle clues of abuse, and avoid classifying the client as
chronic complainer
A nurse is providing care to a victim of intimate partner violence. Which approaching this client, the nurse must ensure to avoid which type of behavior?
critical
Routine screening for IPV is the first way to
detect abuse
antianxiety agent that causes sedation, lethargy, mild drowsiness, confusion, and disorientation.
diazepam
A nurse is conducting a discussion group at a local women's health center about violence and women. The nurse would include that women are at a higher risk for violence at which time?
during pregnancy
While interviewing a client, the client tells the nurse, "Our budget is tight. My husband controls how all the money is spent. And he won't let me get a job either." The nurse suspects that the client may be experiencing which type of abuse?
financial
A young refugee has come to the clinic for medical care. On examination, the nurse discovers she underwent female genital cutting as a young girl. The nurse recognizes this practice is primarily based on:
her culture.
acute battering
in which there is the explosion of violence, and the honeymoon phase are not typically as long.
On a follow-up visit, a woman who was a victim of rape states that she has joined a rape survivor advocacy group. The nurse interprets this as indicating that the woman is in which phase of rape recovery?
integration and recovery
The nurse is conducting a class on rape prevention for a group of young adult women and is describing the various types of date rape drugs. Which drug would the nurse describe as causing a separation in perception and sensation?
ketamine
The nurse has educated a client about confidentiality. explaining that which mandate against confidentiality requires that some injuries, complaints, and/or situations must be reported?
laws
When caring for an abused woman, the nurse uses the ABCDES framework to provide interventions. Which components are part of this framework? Select all that apply.
reassurance that the woman is not alone in this situation maintenance of confidentiality of the information reported education about the cycle of violence and its escalation plan of action and resources for safety for when the woman decides to leave
Symptoms can include nightmares, flashbacks, increased emotional arousal, and irritability. These clients should be referred to counseling.
symptoms with ptsd
A nurse working in an inner city health clinic has experienced success by utilizing the SAVE model to evaluate clients for possible abuse. Which action would be least appropriate for the nurse to address?
validating what the client has said
Emergency contraception works b
y preventing ovulation, fertilization, or implantation. It does not disrupt an established pregnancy and should not be confused with mifepristone (RU-486)
With a type III procedure
all or part of the external genitalia is excised and the vagina is stitched or narrowed.
When teaching a group of young adult women about the cycle of violence, the nurse would describe which behavior as eventually disappearing as the violence becomes accelerated over time?
apologies for the pain and abuse
it can indicate different purposes, such as a rite of passage, to decrease a woman's sexual desires, or ensure her chastity.
female genital cutting
type II procedure
the clitoris and part or all of the labia minora are excised.
A nurse is assessing a victim of rape. The victim tells the nurse, "It felt like I was outside my body looking down and watching the whole thing." The nurse suspects that the client received which substance?
gamma hydroxybutyrate
Use of the ABCDES framework provides direction
reassuring the woman that she is not Alone; informing her of the Belief that violence is not acceptable in any situation; ensuring her that information reported is Confidential; Documenting information factually and accurately; Educating the woman about the cycle of violence and its escalation; and ensuring the woman's Safety by providing her with resources and a plan of action to carry out when she decides to leave
While discussing a client's injuries with her, the nurse recognizes several risk factors that could indicate intimate partner violence. Which factors might the nurse identify? Select all that apply
young age apparent poverty talk of heavy weekend drinking depression
