Deck 35: Survivors of Abuse or Neglect

Question 1

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?

A)"These clients don't know life any other way,and change is not an option until they have improved insight."
B)"These clients have limited skills and few vocational abilities to be able to make it on their own."
C)"These clients often have a lack of financial independence to support themselves and their children,and most have religious beliefs prohibiting divorce and separation."
D)"These clients are paralyzed into inaction by a combination of physical threats and a sense of powerlessness."

Answer 1

"These clients are paralyzed into inaction by a combination of physical threats and a sense of powerlessness."

Question 2

A child is brought in to the emergency room with physical injuries being reported as an accident.The nurse should consider if the explanation is reasonable,if the injury is consistent with the explanation,and which of the following?

A)If it is consistent with the child's developmental capabilities
B)If previous hospital admissions have occurred for the same injuries
C)The time of the day or night when admission occurs
D)The level of concern exhibited by the parent or caregiver

Answer 2

If it is consistent with the child's developmental capabilities

Question 3

Roger has been newly diagnosed with a Comorbid Psychosis.With an understanding of the neurobiology of violence,which of the following classifications of medication will the physician likely prescribe to help control aggression and violence?

A)Selective serotonin reuptake inhibitors (SSRIs)
B)Mood stabilizers (Tegretol,Dilantin,Depakote,lithium)
C)Anti-adrenergic agents (propranolol)
D)Antipsychotics (typical and atypical)

Answer 3

Antipsychotics (typical and atypical)

Question 4

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

A)"I know that it was not my fault."
B)"My boyfriend has trouble controlling his sexual urges."
C)"If I don't put myself in a dating situation,I won't be at risk."
D)"Next time I will think twice about wearing a sexy dress."

Question 5

Which of the following medications could be used to reduce aggression by dampening excessive nonadrenergic activity?

A)Tegretol
B)Dilantin
C)Lithium
D)Propranolol

Question 6

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

A)Have ready access to a gun and learn how to use it
B)Research lawyers who can aid in divorce proceedings
C)File charges of assault and battery
D)Have ready access to the number of a shelter for battered women

Question 7

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

A)The child is often absent from school and seems apathetic and tired.
B)The child is very insecure and has poor self-esteem.
C)The child has multiple bruises on various body parts.
D)The child has sophisticated knowledge of sexual behaviors.

Question 8

When Beverly told her sister Liz about the repeated episodes of abuse she'd experienced,her sister replied,"If you leave him,how will you be able to pay your bills?" Liz's reply supports which notion?

A)Battered women may be encouraged by their social network to remain in the abusive relationship.
B)Women who are battered often take blame for their situations.
C)The sisters were victims of child abuse.
D)Family members rarely believe that intimate partner violence is occurring.

Question 9

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

A)Discourage the client from discussing the event,as this may lead to further emotional trauma.
B)Remain nonjudgmental and actively listen to the client's description of the event.
C)Meet the client's self-care needs by assisting with showering and perineal care.
D)Provide cues,based on police information,to encourage further description of the event.

Question 10

In the emergency department,a client who was raped appears calm and exhibits a blunt affect.The client answers the nurse's questions in a monotone using single words.Which indicates the nurse interpretation of this client's responses?

A)The client may be lying about the incident.
B)The client may be experiencing a silent rape reaction.
C)The client may be demonstrating a controlled response pattern.
D)The client may be having a compounded rape reaction.

Question 11

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?

A)"A weapon is used to increase the victimizer's security."
B)"A weapon is used to inflict physical harm."
C)"A weapon is used to terrorize and subdue the victim."
D)"A weapon is used to mirror learned family behavior patterns."

Question 12

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

A)Controlled response pattern
B)Compounded rape reaction
C)Expressed response pattern
D)Silent rape reaction

Question 13

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." The nurse recognizes this client is in which phase of the cycle of battering?

A)Phase I: The tension-building phase
B)Phase II: The acute battering incident phase
C)Phase III: The honeymoon phase
D)Phase IV: The resolution and reorganization phase

Question 14

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

A)The child shrinks at the approach of adults.
B)The child begs or steals food or money.
C)The child is frequently absent from school.
D)The child is delayed in physical and emotional development.

Question 15

An anorexic client states to the 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.Which should the nurse suspect?

A)Possible major depressive disorder
B)Possible history of childhood incest
C)Possible histrionic personality disorder
D)Possible history of childhood bulimia

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 most appropriate nursing reply?

A)"Leopards don't change their spots,and neither will he."
B)"There are things you can do to prevent him from losing control."
C)"Let's talk about your options so that you don't have to go home."
D)"Why don't we call the police so that they can confront your husband with his behavior?"

Question 17

As a domestic violence nurse specialist,you are asked to testify in a court case involving intimate partner abuse.The defense attorney asks,"When Mr.and Mrs.Smith came to the emergency room several people were around,yet Mrs.Smith still did not say that Mr.Smith hit her.With all those people around,why didn't Mrs.Smith accuse her husband then?" What is the most likely and most appropriate rationale?

A)Abuse victims are not likely to accuse spouses without photographic evidence.
B)Abuse victims who are accompanied by the person who battered them are not likely to be truthful about the cause of the injuries.
C)Abuse victims are not always aware of resources available to them.
D)Abuse victims often lie about their injuries because they are afraid they will be killed or their children will be harmed.

Question 18

What is the main goal of crisis intervention for sexual assault?

A)Help survivors return to their previous lifestyle as quickly as possible.
B)Determine the appropriate long-term assistance needed.
C)Treat any physical symptoms that exist resulting from the assault.
D)Focus on the rape incident alone.

Question 19

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

A)"Power and control are central to the dynamic of domestic violence."
B)"Poor communication and social isolation are central to the dynamic of domestic violence."
C)"Erratic relationships and vulnerability are central to the dynamic of domestic violence."
D)"Emotional injury and learned helplessness are central to the dynamic of domestic violence."

Question 20

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

A)The woman may be exhibiting a controlled response pattern.
B)The woman may have a history of childhood neglect.
C)The woman may be exhibiting codependent characteristics.
D)The woman might be a victim of incest.

Question 21

__________________________ is defined by federal law as "a commercial sex act is induced by force,fraud,or coercion,or in which the person induced to perform such act has not attained 18 years of age."

Question 22

After found in an alley,Theresa was taken to a nearby emergency room.Upon arrival,police notified the nurse that Theresa was a suspected rape victim,which Theresa confirmed.The doctor orders a rape kit to retrieve any DNA that may still be present on or in the victim.What is the most appropriate nursing intervention?

A)Try to have as few people as possible collecting immediate evidence.
B)Offer to call the victim's pastor or spiritual advisor.
C)Provide a variety of support resources for survivors of sexual assault.
D)Clean the victim's wounds and administer sedative medications as ordered.

Question 23

________________ guidance is needed to deal with the crises commonly associated with stages of development in children.

Question 24

______________ comes only when a victim of intimate partner violence chooses to use support resources for her own benefit.

Question 25

___________________ refers to a chronic failure by the parent or caretaker to provide the child with the hope,love,and support necessary for the development of a sound,healthy personality.

Question 26

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

A)Low self-esteem
B)Powerlessness
C)Disturbed personal identity
D)Knowledge deficit
E)Noncompliance

Question 27

Behavioral indicators of emotional maltreatment may include which? Select all that apply.

A)Extreme aggression
B)Suicide attempts
C)Inappropriately adult behavior
D)Begging or stealing for food or money

Question 28

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

A)It often takes several attempts before a woman leaves an abusive situation.
B)Substance abuse is a common factor in abusive relationships.
C)Until children reach school age,they are usually not affected by parental discord.
D)Women in abusive relationships usually feel isolated and unsupported.
E)Economic factors rarely play a role in the decision to stay in abusive relationships.

Question 29

______________ aggression is associated with impulsivity and is more common among people who have a history of being abused.

Question 30

Joe and his wife Mary arrived for one of Joe's follow-up appointment 10 minutes late.Joe appeared to be very frustrated and aggravated.Mary repeatedly asked Joe to keep his voice down and apologized to the receptionist when checking in."I sure hope you figure out what is causing this change in Joe's behavior.He's starting to scare me," said Mary.What are the possible causes of the change in Joe's behavior? Select all that apply.

A)Decreased dopamine release
B)High plasma concentrations of 5-HIAA serotonin
C)Adverse side effect of testosterone therapy
D)Amygdala dysfunction