Chapter 12 Abuse and Violence

Chapter 12: Abuse and Violence The nurse learns that a client has been receiving unwanted gifts and visits from someone in the neighborhood. For which unwelcomed behavior should the nurse plan interventions for this client? A. B. C. D. Hazing Stalking Bullying Ostracizing A nurse is giving a talk about child abuse to a local community group. When discussing risk factors for child abusers, which would the nurse identify as the most likely profile of the perpetrator of fatal child abuse? A. B. C. D. Middle-aged woman with a college degree Unemployed young woman who dropped out of high school Middle-aged, wealthy businessman Young college graduate who recently gave birth to her first child The school health nurse is asked to see a child who has been coming to school with no lunch for the past week. The child tells the nurse, "I don't get a lunch this week, I have been wetting the bed." The nurse identifies that this child is experiencing which type of abuse? A. B. C. D. Physical Sexual Neglect Psychological What are some types of behavior that the nurse would recognize as qualifying as psychological abuse? Select all that apply. A. B. C. D. E. Criticizing Ridiculing Threatening a victim’s dog Asking for time alone when frustrated Using assertive language A nurse is gathering information about a health history of a person who has experienced violence. Which are important caring behaviors a nurse should implement during the interview? Select all that apply. A. B. C. D. E. stablish trustworthiness. Maintain a nonjudgmental attitude. Ask questions regarding religious background and preference. Secure open communication. Discuss the nurse's personal feelings on victims of violence. A middle-aged client with young children has been the victim of intimate partner violence (IPV). When providing initial care to this family, the nurse should: A. B. C. D. carefully assess the children for signs of trauma. determine what initially caused the violence to begin. teach the client life skills for moving on from the relationship. reassure the client that this will never happen again. An adolescent client has recently ended a physically and emotionaly abusive initimate relationship. What nursing assessment question(s) will help identify a commonly associated comorbid mental health problem? Select all that apply. A. B. C. D. E. "How much alcohol do you drink in an average week?" “Do you ever have thoughts of hurting or killing yourself?" “Are your teachers satisfied with the grades you earn in school?" “How would you alter your eating habits in order to lose weight?" “Has anyone every told you that you had a problem with your temper?" A nurse is assessing a client in a community clinic who reports feeling anxious lately because she is considering leaving her marriage. The client describes a long history of partner abuse associated with this relationship. How should the nurse respond to this client? A. B. C. D. "You have the right to be safe and respected." "Relationship counseling can be very helpful." "I am here to help you through every step of this process." "I wonder if your perceptions of the relationship are accurate." A nurse manager is working with the nursing staff of a busy community-based walk-in clinic that provides care to a large number of survivors of domestic violence. When helping the staff provide care, which information would be most important for the nurse manager to convey to the staff? A. B. C. D. Expectation that survivors will accept change right away Importance of measuring the clients' progress in small steps Encouragement for staff discussion about specific clients to gain support Identification of consequences from changes made by survivors as minimal An 8-month-old infant has been brought to the emergency department by the infant's teenage parent. The infant is unresponsive, and after initial assessment, the care team suspects shaken baby syndrome. When providing care for this infant, the nurse should prioritize which assessment? A. B. C. D. Respiratory assessment Neurological assessment Cardiac assessment Genitourinary assessment A nursing instructor teaching about sexual assault identifies a need for further instruction when one of the students makes which statement? A. B. C. D. Sexual assault involves nonconsenting sexual activity." "Fondling can be a type of sexual assault." "It is not considered rape if it occurs with same-sex couples." "Sexual assault occurs about once every 2 minutes in the United States." Which are forms of psychological abuse? Select all that apply. A. B. C. D. E. Insulting Humiliating Isolating a person from family Rape Incest Which is a pattern of repeated unwanted contact, attention, and harassment that often increases in frequency? A. Stalking B. Rape C. Incest D. Physical abuse A client comes to the clinic for a prenatal visit. While the client is in the examining room, her estranged husband appears and insists on seeing the client. The client tells the nurse that they are in the process of getting a divorce and she does not want to be around him. "He's been following me to work and at my home everyday." What should the nurse suspect? A. B. C. D. Intimate partner violence Stalking Sexual assault Neglect A nurse is aware of the high incidence of intimate partner violence (IPV) and actively seeks opportunities to screen women for IPV. Which female client represents the best opportunity for assessing for IPV? A. A client who is in the third trimester of pregnancy and who is having biweekly prenatal appointments at a clinic B. A client who has brought her young son to the emergency department because he fell at the playground and may have an arm fracture C. A client who is currently exploring long-term care options for her elderly father D. A client who expressed interest in joining a grief support group following the death of her husband The nurse asks the parent of a school-age child about intimate partner violence in the home. Which assessment finding caused the nurse to complete this assessment? A. B. C. D. child exhibiting reluctance to play with other children child crying and appearing sad parent encouraging the child to help with household chores parent limiting the amount of time the child watches television A nurse is caring for a child who had experienced sexual abuse. Which are expected behaviors of a child who has experienced sexual abuse? Select all that apply. A. B. C. D. E. Avoidance of sexually related content Secretiveness of behaviors Open and honest discussion about history High self-esteem Distorted view of sex The psychiatric nurse recognizes that a male rape victim is less likely to report the crime due to which reason? A. The belief that his masculinity will be in question B. The social ramifications of possibly contracting AIDS C. Fear of being accused of engaging in socially inappropriate or illegal activities leading to the rape D. The impact it will have on his family A 27-year-old has been brought to the emergency department by emergency medical services following a violent sexual assault that took place in the parking garage of the client's building. Which task would fall most clearly within the scope of practice of a forensic nurse? A. Providing reassurance to the client that the care team and the police will prioritize the client's care B. Collecting specimens from the client for use as evidence C. Assisting with diagnostic tests to determine the extent of the client's injuries D. Asking the client to describe the perpetrator in detail and documenting the client's statement The nurse provides care to individuals who have been sexually assaulted during their childhood. Which characteristic is most commonly noted by the nurse during an assessment of such clients? A. B. C. D. Overly self-confident Unusually aggressive Overly social Too trustful Which characteristics are found in violent families? Select all that apply. A. Adequate support systems B. Abuse of power and control C. Alcohol use disorder D. Social isolation A mental health nurse presenting an educational program on rape for high school students responds to the statement, "Women cry rape often times just to get even with the guy," by offering which answer? A. B. C. D. "I'm not sure where you heard that but statistically it isn't true." "I don't believe that's true but even if it were it doesn't excuse the real rapes that occur." "Actually, fewer than 2% of all reported rapes are found to be false." "If a man is falsely accused, the woman is prosecuted by the law." Which would not increase the likelihood that an older adult will incur physical abuse? A. B. C. D. The older adult has difficulty with mobility and can become confused. The older adult is independent with activities of daily living. The older adult lives with a son who receives financial aid. An older adult reports frequent multiple bruises that are related to falls. In clients who do not completely recover from the trauma of rape, which mental illness is most likely to develop? A. B. C. D. Post-traumatic stress syndrome Anxiety disorders Borderline personality disorder Delirium A nurse is caring for a young adult in the mental health clinic. The client tells the nurse that the client was physically neglected as a child. The nurse should assess the client for symptoms of what? A. B. C. D. Schizophrenia Major depression Narcissistic personality disorder Panic disorder A client is brought to the Emergency Department by a family member that reports being sexually assaulted while leaving work. What action by the nurse would best promote placing control back to the client? A. B. C. D. Inform the client that charges will have to be pressed against the perpetrator Allow the client to make decisions regarding care whenever possible Educate the client about attending a support group as soon as possible Inform the client that the assessment must be completed as soon as possible A nurse is working in the emergency department. Which situation would lead the nurse to suspect possible abuse of a client? Select all that apply. A. B. C. D. E. A 6-year-old is being seen for the 5th time for a urinary tract infection A baby with contrecoup injuries to the brain A 3-month-old with a fractured femur A 15-month-old with shortness of breath after peanut ingestion A 3-year-old with a deep finger laceration Which is an inaccurate picture of the cycle of abuse that occurs over time? A. B. C. D. Violent episodes are less frequent Violent episodes are more frequent The period of remorse disappears Severity of the injuries worsen Which provides the most appropriate example of neglect according to the definition of the term? A. B. C. D. Criticizing a child frequently for being overweight and restricting the child's diet Rejecting a 3-year-old who cries and seek affection after falling Disciplining a 6-year-old child for "sassing" by putting tape on the child's mouth Correcting a child in front of the entire class for copying homework A nurse is preparing a presentation for an adolescent and young adult community group about stalking. Which group would the nurse identify as having the highest risk of being stalked? A. B. C. D. Boys and young men, ages 12 to 21 years Men, ages 24 to 28 years Girls and young women, ages 10 to 18 years Women, ages 18 to 24 years Which statement, made by a nurse who experienced sexual abuse as as a child, demonstrates being best prepared to work with sexual abuse and trauma survivors? A. "I've put the incident behind me and seldom think of it." B. "Working with survivors of sexual trauma is very fulfilling work." C. "I've been supported by health care professionals and now I want to support other survivors." D. "Survivors of sexual assault deserve the best care I can give them." After a series of admissions to the emergency department over the past several months, an 80year-old client's malnutrition, vague history, and pattern of physical injuries lead the nurse to suspect elder abuse. Which aspect of the client's situation may contribute to elder abuse? Select all that apply. A. The client is physically dependent on the client's son since losing mobility. B. C. D. E. The client has no income or savings of the client's own. The client's son describes the client as “needy, helpless, and pathetic.” The client and client's child are recent immigrants to the United States. The client self-describes and describes the client's child as “not well-off, but not terribly poor either.” Which is a priority nursing intervention when child abuse or neglect is suspected? A. B. C. D. Safety Physiologic needs Psychological needs Social support A client is brought to the Emergency Department by a family member that reports being sexually assaulted while leaving work. What action by the nurse would best promote placing control back to the client? A. B. C. D. Inform the client that charges will have to be pressed against the perpetrator Allow the client to make decisions regarding care whenever possible Educate the client about attending a support group as soon as possible Inform the client that the assessment must be completed as soon as possible When attempting to preserve evidence from a possible rape with no report of oral sex, the female victim should be instructed that which self-care activities are permitted? A. B. C. D. Douching Showering Drinking a glass of water Changing clothes When assessing a 6-year-old child believed to be a victim of emotional abuse, the possibility is supported when the child is ... A. B. C. D. showing signs of developmental delays. attending day care 5 days a week. observed to be anxious and rejecting adult attention parented by a single parent. In violent families, which environment may be the most dangerous place for victims? A. B. C. D. Home School Work Church Which statement made by a client raises the greatest concern that the client may be experiencing relationship violence? A. "He was so much nicer when we started dating." B. "His father physically abused his mother for years." C. "He doesn't like it when I go out with my girlfriends." D. "I don't know what else I can do to keep him from getting angry at me." A client comes to the clinic for an evaluation. The nurse assesses the client and suspects that the client is a victim of abuse. Which finding would support the nurse's suspicion? Select all that apply. A. The client is vague about the injuries on the body. B. The client came to the clinic right after the injuries occurred. C. The client minimizes the severity of the injuries. D. The client has a history of frequent visits to the emergency department for injuries. E. The client voices statements about having control over current status. A female client states that she has been receiving numerous text and phone messages from a coworker. Which type of harrassment should be documented in the nurse's notes? A. B. C. D. Jealousy Isolation Harassment Cyberstalking Which assessment question should the nurse ask of a client suspected of being ostracized by a school bully? A. B. C. D. "Do you feel like a part of a group in school?" "Do you smoke or use drugs?" "Can you go to the school principal with personal problems?" "Have you talked to your parents about your problems at school?" A nurse who provides care in a large, urban emergency department has worked with numerous victims of various forms of abuse as well as those who are abusers. The nurse recognizes that persons who commit abuse are most likely what? A. B. C. D. Of low socioeconomic means Past victims of abuse themselves Delusional and/or psychotic Over 50 years of age Which type of elder abuse involves leaving an older adult and no longer providing care for the individual? A. B. C. D. Abandonment Emotional Physical Neglect What percentage of women can expect to be a victim of an ongoing unwanted pursuit from stalking? A. B. C. D. 5-10% 12-32% 40-48% 50-60% A young adult client female is assessed after being raped. The client reports being tied up and beaten while the perpetrator forced sexual intercourse. She recalls the perpetrator saying, "I will make you pay." What most accurately describes this category of rapist? A. B. C. D. Power assertive Anger retaliation Power assurance Anger excitement The nurse is aware that fewer than half of rapes and sexual assaults are reported. Which are some of the reasons people do not report being sexually assaulted? Select all that apply. A. B. C. D. E. The client is embarrassed of the assault. They have a fear of being blamed for the incident The perpetrator may use coercion or threats to control the victim The victim is responsible for the attack The person is concerned about the financial issues associated with the hospitalization. Nurses at an urban emergency department seek to develop a plan to help women involved in abusive relationships. Which component is critical to the success of the plan? A. B. C. D. An intimate partner violence (IPV) counselor Access to community resources for referral A quality of life assessment tool Written educational materials The nurse is legally obligated to report suspected child abuse to local authorities. Which information is essential? A. B. C. D. Proof that the child has been recently abused Child's current school, grade, and teacher Therapist's name and client address Child's name, location, age, and suspected perpetrator Approximately what percentage of women rape victims are raped by someone they know? A. 35% B. 65% C. 45% D. 55% The nurse in the emergency room is assessing a client who was brought in by the police for evaluation after receiving a call from a neighbor. The client reports to the nurse that the person who has been cooking and helping around the house has not been home for days. Which type of abuse does the nurse suspect based on the client's statement? A. B. C. D. Neglect Physical Emotional Abandonment A nurse is working on developing a safety plan with a client who is a survivor of violence. Which would the nurse address first? A. B. C. D. Identifying a safe place to hide Recognizing the signs of danger Devising an escape route Identifying a signal to indicate it is safe to leave A frightened young woman calls the emergency department and tearfully tells the nurse, “I've been raped! Please help me!” Before telling the client what to do, the nurse would need to know if A. If the client was injured, was in a safe place, and had transportation available B. If the client knew her assailant, knew her location, and had notified the police C. If she has insurance, if she could get to the hospital by herself, and if pregnancy is a possibility D. If she had bathed, douched, or changed clothes A group of nursing students is reviewing information about intimate partner violence (IPV). The group demonstrates understanding of this topic when they identify which of the following? A. Men are more likely to be seriously injured even though more women are typically victims. B. Men may not consider behaviors such as slapping or shoving as abuse. C. IPV in same-sex couples occurs less frequently than in heterosexual relationships. D. The reactions to IPV are similar in male and female victims. A nurse is caring for clients who are psychologically abused. Which clients should the nurse screen for psychological abuse? Select all that apply. A. A partner of a client who has destroyed the front door of their home. B. A client whose friend makes a joke about the clothing the client is wearing. C. A client whose partner is monitoring the amount of money spent on food and clothing. D. A partner of client who does not want the client to spend any time with family or friends E. A parent of a client who is threatening to injure the family's pet. When the school nurse is assessing an adolescent who reports trouble sleeping, which characteristics of the client indicate there may be violence in the home? (Select all that apply.) A. B. C. D. E. the client's father monitors contact with friends feeling social pressure to use alcohol feeling left out of peer group has a family history of alcohol abuse must go straight home after school each day A nursing student learning about intimate partner violence (IPV) correctly identifies the percentage of deaths attributed to IPV to be what? A. B. C. D. 70% women and 30% men 70% men and 30% women 50% women and 50% men 90% women and 10% men In clients who do not completely recover from the trauma of rape, which mental illness is most likely to develop? A. B. C. D. Anxiety disorders Post-traumatic stress syndrome Borderline personality disorder Delirium The nursing student learning about intimate partner violence correctly identifies its prevalence in same-sex couples as what? A. B. C. D. Twice as often as in heterosexual couples Half as frequent as in heterosexual couples Three times more frequent as in heterosexual couples Same frequency as in heterosexual couples A group of nursing students is reviewing information about the types of abuse. The students demonstrate understanding of the information when they identify stalking as a crime of which of the following? A. B. C. D. Violence Jealousy Intimidation Fear