Question 1

A kindergarten student is frequently violent toward other children.A school nurse notices bruises and burns on the child's face and arms.What other symptom should indicate to the nurse that the child might have been physically abused?

Accepted Answer

The nurse should determine that a child who shrinks at the approach of adults in addition to having bruises and burns might be a victim of abuse.Whether or not the adult intended to harm the child,maltreatment should be considered.

Question 2

Which teaching should the nurse in an employee assistance program provide to an employee who exhibits symptoms of domestic physical abuse?

Accepted Answer

The nurse should provide information about safe houses for battered women when working with a client who has symptoms of domestic physical abuse.Many women feel powerless within the abusive relationship and may be staying in the abusive relationship out of fear for their lives.

Question 3

When questioned about bruises,a woman states,"It was an accident.My husband just had a bad day at work.He's being so gentle now and even brought me flowers.He's going to get a new job,so it won't happen again." This client is in which phase of the cycle of battering?

Accepted Answer

The client is in the honeymoon phase of the cycle of battering.In this phase,the batterer becomes extremely loving,kind,and contrite.Promises are often made that the abuse will not happen again.

Question 4

A client is brought to an emergency department after being violently raped.Which nursing action is appropriate?

Accepted Answer

The most appropriate nursing action is to remain nonjudgmental and actively listen to the client's description of the event.It is important to also communicate to the victim that he or she is safe and that it is not his or her fault.Nonjudgmental listening provides an avenue for client catharsis needed in order to begin the process of healing.

Question 5

A client who has been raped is crying,pacing,and cursing her attacker in an emergency department.Which behavioral defense should a nurse recognize?

Accepted Answer

The nurse should recognize that this client is exhibiting an expressed response pattern.In the expressed response pattern,feelings of fear,anger,and anxiety are expressed through crying,sobbing,smiling,restlessness,and tension.In the controlled response pattern,the client's feelings are masked or hidden,and a calm,composed,or subdued affect is seen.

Question 6

A client who is in a severely abusive relationship is admitted to a psychiatric inpatient unit.The client fears for her life.A staff nurse asks,"Why doesn't she just leave him?" Which is the nursing supervisor's most appropriate reply?

Accepted Answer

The nursing supervisor is accurate when stating that clients in severely abusive relationships are paralyzed into inaction by a combination of physical threats and a sense of powerlessness.Women often choose to stay with an abusive partner for some of the following reasons: for the children,financial reasons,fear of retaliation,lack of a support network,religious reasons,and/or hopelessness.

Question 7

Which of the following nursing diagnoses would be expected for an adult survivor of incest? Select all that apply.

Accepted Answer

An adult survivor of incest would most likely have low self-esteem and a sense of powerlessness.Adult survivors of incest are at risk for developing post-traumatic stress disorder,sexual dysfunction,somatization disorders,compulsive sexual behavior disorders,depression,anxiety,eating disorders,and substance abuse disorders.Disturbed personal identity refers to an inability to distinguish between self and nonself and is seen in disorders such as autistic disorders,borderline personality disorders,dissociative disorders,and gender identity disorders.

Question 8

A college student was sexually assaulted when out on a date.After several weeks of crisis intervention therapy,which client statement should indicate to a nurse that the student is handling this situation in a healthy manner?

Accepted Answer

The client who realizes that sexual assault was not her fault is handling the situation in a healthy manner.The nurse should provide nonjudgmental listening and communicate statements that instill trust and validate self-worth.

Question 9

In the emergency department,a raped client appears calm and exhibits a blunt affect.The client answers a nurse's questions in a monotone using single words.How should the nurse interpret this client's responses?

Accepted Answer

This client is most likely demonstrating a controlled response pattern.In a controlled response pattern,the client's feelings are masked or hidden,and a calm,composed,or subdued affect is seen.In the expressed response pattern,feelings of fear,anger,and anxiety are expressed through crying,sobbing,smiling,restlessness,and tension.

Question 10

A nursing student asks an emergency department nurse,"Why does a rapist use a weapon during the act of rape?" Which nursing reply is most accurate?

Accepted Answer

The nurse should explain that a rapist uses weapons to terrorize and subdue the victim.Rape is the expression of power and dominance by means of sexual violence.Rape can occur over a broad spectrum of experience,from violent attack to insistence on sexual intercourse by an acquaintance or spouse.

Question 11

Which assessment data should a school nurse recognize as signs of physical neglect?

Accepted Answer

The nurse should recognize that a child who is often absent from school and seems apathetic and tired might be a victim of neglect.Other indicators of neglect are stealing food or money,lacking medical or dental care,being consistently dirty,lacking sufficient clothing,or stating that there is no one home to provide care.

Question 12

Which statement made by an emergency department nurse indicates accurate knowledge of domestic violence?

Accepted Answer

The nurse accurately states that power and control are central to the dynamic of domestic violence.Battering is defined as a pattern of coercive control founded on physical and/or sexual violence or threat of violence.The typical abuser is very possessive and perceives the victim as a possession.

Question 13

An anorexic client states to a nurse,"My father has recently moved back to town." Since that time the client has experienced insomnia,nightmares,and panic attacks that occur nightly.She has never married or dated and lives alone.What should the nurse suspect?

Accepted Answer

The nurse should suspect that this client might have a history of childhood incest.Adult survivors of incest are at risk for developing posttraumatic stress disorder,sexual dysfunction,somatization disorders,compulsive sexual behavior disorders,depression,anxiety,eating disorders,and substance abuse disorders.

Question 14

When planning care for women in abusive relationships,which of the following information is important for the nurse to consider? Select all that apply.

Accepted Answer

When planning care for women who have been victims of domestic abuse,the nurse should be aware that it often takes several attempts before a woman leaves an abusive situation,that substance abuse is a common factor in abusive relationships,and that women in abusive relationships usually feel isolated and unsupported.Children can be affected by domestic violence from infancy,and economic factors often play a role in the victim's decision to stay.

Question 15

A woman describes a history of physical and emotional abuse in intimate relationships.Which additional factor should a nurse suspect?

Accepted Answer

The nurse should suspect that this client might be a victim of incest.Women in abusive relationships often grew up in abusive homes.

Question 16

A woman comes to an emergency department with a broken nose and multiple bruises after being beaten by her husband.She states,"The beatings have been getting worse,and I'm afraid that next time he might kill me." Which is the appropriate nursing reply?

Accepted Answer

The most appropriate reply by the nurse is to talk with the client about options so that the client does not have to return to the abusive environment.It is essential that clients make decisions independently without the nurse being the "rescuer." Imposing judgments and giving advice is nontherapeutic.

Quiz 35: Survivors of Abuse or Neglect