Deck 9: Violence Against Women

Question 1

The nurse is presenting a session on intimate partner violence. Which statement indicates a need for further education?

A) "My daughter is not to blame for the violence in her marriage."
B) "Everyone experiences anger and hitting in a relationship."
C) "Abusers can be either husbands or boyfriends or girlfriends."
D) "The 'honeymoon period' follows an episode of violence."

Answer 1

"Everyone experiences anger and hitting in a relationship."

Question 2

The nurse at a shelter is counseling a group of battered women. The nurse will emphasize that:

A) Battering will not stop or decrease if they become pregnant.
B) About 1 of every 5 women will experience abuse in her lifetime.
C) When these women go back to the situation after the abuser has cooled down, it will be better.
D) The battered woman can readily leave the situation.

Answer 2

Battering will not stop or decrease if they become pregnant.

Question 3

A woman is seen in the prenatal clinic. The nurse notices that the woman has a swollen eye and a bruise on her cheek. Which statement is most appropriate for the nurse to make?

A) "You must leave your partner before you are injured again."
B) "It is important that you refrain from doing things that anger your partner."
C) "Women who are abused often have injuries like yours."
D) "I am required by law to notify the police department of your injuries."

Answer 3

"Women who are abused often have injuries like yours."

Question 4

The nurse working in the emergency department knows that many batterers have feelings of ambivalence. In what way might this be evident?

A) The abuser alternates episodes of unmerciful beatings with periods of remorse and loving attention.
B) The abuser has alternating periods of sadness and happiness.
C) The abuser has alternating periods of maturity and immaturity.
D) The abuser alternates letting the person he abuses be independent and then dependent.

Question 5

The nurse is teaching an in-service educational presentation about working with battered women. The nurse should explain that it is often frustrating for nurses to work with battered women because:

A) There is little the nurse can really do to help.
B) Healthcare policies and practices are not supportive of abused women.
C) Both husband and wife must agree to therapy.
D) These women might return to the abusive situation.
E) Women often accept that they are the cause of the violence.

Question 6

A woman has come to the emergency department with multiple bruises over her body and a small laceration over her upper lip. She says she fell down the stairs while doing her housework. Which observation would most likely cause the nurse to suspect that she has been a victim of battering? The patient:

A) Is hesitant to provide details about how the injuries occurred.
B) Was accompanied to the emergency department by her mother instead of her partner.
C) Has sought care quickly after the incident.
D) Does not seem to be in pain.

Question 7

The nurse working in the emergency department of a hospital is caring for a woman whom the nurse suspects is the victim of domestic violence. The nurse knows that contributing factors to domestic violence are:

A) Experiencing or witnessing abuse as a child.
B) Strong patriarchal family traditions.
C) Linking masculinity to male honor.
D) Low levels of marital conflict.
E) Alcohol and drug abuse cause the violence.

Question 8

The nurse working in the emergency department is admitting a woman who has been battered for a second time, and recognizes that the woman is again in the cycle of violence. The nurse knows that the characteristics of the phases of the cycle of violence include:

A) Batterer demonstrates power and control.
B) Active battering from some event.
C) A loving, contrite period.
D) Defeat and admission of guilt by the victim.
E) Blame and punishment for inferiority.

Question 9

The nurse is interviewing a patient who has admitted to being a victim of spousal abuse. The most typical description of how the spousal violence developed in a relationship is:

A) "He changed overnight. Everything was fine, and all of a sudden he flipped out and beat me up; he nearly killed me."
B) "It was severe from the beginning. As soon as we got married, he began hitting me and threatening to kill me."
C) "We've both always dated other people. I thought that was understood. He was as emotionally abusive in the beginning as he is now."
D) "I don't know when it started, really. It was gradual. First, just yelling, blaming, and shoving. Then the beatings started; and now they're more frequent."

Question 10

A nurse in the emergency department recognizes in the husband of a patient one of the common characteristics of batterers, which are:

A) Emotionally immature.
B) A low tolerance for frustration.
C) Feelings of insecurity and inferiority.
D) A lack of respect in the community.
E) Limited jealousy or possessiveness.

Question 11

A home health nurse is making a home visit to a new mother who is diabetic and requires some follow-up to make sure her baby is doing well and that her diabetes is in control while she is breastfeeding. The patient meets her at the door, crying, with bruises on her face and legs. The nurse knows the patient has been in a questionable relationship. What is the first responsibility of the nurse for this patient at this time?

A) Assist in getting the patient and her baby to a safe situation.
B) Check her blood sugar and make sure it is within normal limits.
C) Ask her how she is doing with the breastfeeding.
D) Check the baby's heart rate and other vital signs.

Question 12

A woman who has been abused for a number of years asks the nurse for assistance in leaving the relationship. What response by the nurse is most appropriate?

A) Comment that she should have left long ago.
B) Remind the patient that that fault was not likely all attributable to her abuser.
C) Encourage her to be sure with her decision, as her abuser will be difficult to deal with.
D) Assist the patient to develop a safety plan.

Question 13

The nurse in the emergency department is caring for a pregnant Middle Eastern woman in the emergency department who presents with a broken wrist and multiple bruises. When asked how this happened, she states she fell down the stairs. The husband stays very close to his wife and does most of the talking. The nurse is aware that:

A) The patient likely did fall down the stairs.
B) The husband is being attentive and trying to help her feel better.
C) The husband could have battered her and possibly caused her to fall down the stairs.
D) This patient is safe to return home after her wrist is fixed.

Question 14

The nurse suspects that a pregnant patient might be experiencing abuse when the patient:

A) Denies that any injuries occurred, even though bruising is visible.
B) Gives an implausible explanation for any injuries.
C) Makes eye contact with the nurse while answering questions.
D) Allows her partner to answer the nurse's questions.
E) Frequently calls to change appointment times.

Question 15

The patient has been a victim of a violent, sadistic rape. She is crying, and asks the nurse "Why would someone do something like that?" The nurse should explain that the primary purpose of sadistic rape is to:

A) Take pleasure from the victim's struggle and pain.
B) Express feelings of rage.
C) Feel a sense of power or mastery.
D) Relieve intolerable anxiety.

Question 16

The nurse is addressing a college class on the topic of domestic violence. Which information would the nurse be sure to convey to her students?

A) The ANA advocates education for all nurses in identifying and preventing violence against women.
B) The ANA has concluded that there is little nurses can do to eliminate violence.
C) The nurse who suspects abuse should ask the doctor to deal with it, per ANA guidelines.
D) The nurse who suspects abuse should ask the hospital's social work department to deal with it, per ANA guidelines.

Question 17

A woman with multiple bruises on her face and arms is seen in the emergency department. Her significant other is with her. When asked about her injuries, the woman states, "I ran into a door." Which action by the nurse is of highest priority?

A) Take the woman's vital signs.
B) Document the location of the bruises.
C) Assess for additional bruising.
D) Interview the woman in private.

Question 18

The nurse is planning a community education presentation on battering. Which statement about battering should the nurse include?

A) Battering occurs in a small percentage of the population.
B) Battering is mainly a lower-class, blue collar problem.
C) Battered women are at greatest risk for severe violence when they leave the batterer.
D) If the batterer stops drinking, the violence usually stops.

Question 19

The patient with limited English language skills has a black eye, and bruises across her face and arms. The patient's husband has been acting as an interpreter for her, and answers all of the questions the nurse asks, often without talking to his wife first. The nurse suspects the patient has been a victim of domestic abuse. What should the nurse do next?

A) Ask the husband whether he has beaten his wife.
B) Ask the husband to have a female friend come in with his wife.
C) Provide written materials in English for the patient to read at home.
D) Ask the husband to step out of the room, and obtain a professional interpreter.

Question 20

A 35-year-old patient in the women's health clinic has just told the nurse about being abused by her husband for the past 10 years. The nurse's most appropriate intervention, initially, is to:

A) Offer to call the police and help her to file charges.
B) Ask her to tell you the details surrounding the abuse.
C) Reassure her that many women experience the same problem.
D) Listen to her account of the situation and offer support.

Question 21

The nurse has been talking to a woman about the reorganization phase following a rape. Which response would indicate that the patient understands this phase?

A) "By using denial and suppression in this phase, I will eventually be able to accept what has happened to me."
B) "During this time, I won't talk much about the rape, because I am examining my inward feelings regarding the rape."
C) "During this time, I will repeatedly replay the role of the victim until I come to terms with the experience."
D) "My perception of a normal sexual relationship will be similar to my perception prior to the rape."

Question 22

A young woman was a victim of a sexual assault. After the rape exam is finished, the patient requests emergency contraception. Which information should the nurse teach the patient regarding the therapy?

A) Emergency contraception is illegal in all 50 states.
B) The most common side effect of emergency contraception is excessive vaginal bleeding.
C) The medicine that is used for emergency contraception is used to induce abortions.
D) Emergency contraception is best when used within 72 hours of contact.

Question 23

A woman comes into the emergency department and states that her husband has abused her physically. She has a number of bruises, and is obviously pregnant. She states she is 7 months pregnant. She states that her husband arrived home drunk and just started hitting her. She states that her main concern at this time is her three young children, who are still in the home with her husband. She had a neighbor bring her in to emergency department. What can the nurse do to assist with this situation?

A) The nurse can ask the neighbor to go and get the children.
B) The nurse can call the authorities to go with social service workers to get the children, with the patient's permission.
C) The nurse can call the husband at home to bring the children into the emergency department, with the patient's permission.
D) The nurse can call social services and have them go pick up the children, with the patient's permission.

Question 24

A patient comes to the reproductive health clinic and reports that she woke up in a strange room this morning, that her perineal area is sore, and she can't clearly remember what happened the previous evening. The patient says that she is afraid that she was a victim of a drug-facilitated sexual assault. Which statement should the nurse include when discussing this possibility with the patient?

A) "Drinking alcohol can lead to uninhibited sexual behavior, which is not the same as rape."
B) "Some men use drugs mixed into a drink to subdue a potential victim prior to a rape."
C) "It is rare that a woman doesn't remember what happened if she is actually raped."
D) "We need to check for forensic evidence of rape before we can be sure what happened."

Question 25

The most important aspect of care for the nurse to remember when screening a woman for partner abuse is:

A) Ensuring privacy and confidentiality.
B) Conveying warmth and empathy.
C) Asking specific, direct questions about abuse.
D) Clarifying her myths about battering

Question 26

When evaluating the care given a battered woman, the nurse analyzes care plan components to see whether:

A) Compassionate, respectful care was delivered.
B) The woman has the necessary information to make decisions.
C) Medical records are deliberately vague.
D) Psychological care was given in the hospital.
E) The woman identifies culturally appropriate resources.

Question 27

A patient arrives at the emergency department stating that she was raped, but she felt so "dirty" that she went home and showered. She states that she has on clean clothes but has her other clothes in a bag. What will the nurse tell the patient?

A) "I understand why you felt dirty, but you know you should not have taken a shower."
B) "We will probably never find out who raped you, since you destroyed evidence."
C) "Do you want an emergency contraceptive pill?"
D) "I understand that was important to you. We will see what we can get from your clothes, and give them to the authorities."

Question 28

Vicarious trauma is a phenomenon nurses might experience. Signs the nurse should be aware of indicating this problem are:

A) Reduced sense of accomplishment.
B) A positive effect on commitment to one's work.
C) Questioning of personal belief systems.
D) Balance of time for family, self, friends, and work.
E) Frustration with the judicial system.

Question 29

The nurse suspects that a patient has been physically abused, but the woman refuses to report the abuse to the police. Which statement by the patient suggests to the nurse that the relationship might be in the "honeymoon stage"?

A) "My boyfriend says he will never hurt me again."
B) "My boyfriend only drinks alcohol on the weekends."
C) "My boyfriend yells less than he used to."
D) "My boyfriend has frequent bouts of insomnia."

Question 30

In educating a group of women at a community center, the nurse talks about the myths surrounding sexual assault. Topics included are:

A) Older women are less likely to be sexually assaulted.
B) Rape is universal, and all societies have rape.
C) Women who party and do drugs set themselves up for sexual assault.
D) If the woman just relaxes, it will be over, and she might even like it.
E) Women lie about rape as an act of revenge.

Question 31

When a woman who has been raped is admitted to the emergency department, the nurse caring for the woman knows that the priority nursing intervention is:

A) Explaining exactly what will need to be done to preserve legal evidence.
B) Assuring the woman that everything will be all right.
C) Creating a safe, secure atmosphere for her.
D) Contacting family members.

Question 32

The nurse is counseling a rape victim on her choices in pursuing legal action. The nurse will explain to the patient that:

A) Prosecution proceedures are described as a second rape.
B) The prosecution will victimize her in court during testimony.
C) Publicity can intensify her feelings of humiliation.
D) Prosecution of the assailant is a community responsibility.
E) The patient's sexual history will be publicized.

Question 33

The emergency department nurse is admitting a patient who has been sexually assaulted. The nurse is explaining how the physical evidence will be collected. Which statement made by the patient indicates that teaching has been effective?

A) "All the evidence will be kept in a locked cupboard until the police arrive."
B) "You have to collect evidence to prove I wasn't sexually active."
C) "The evidence you collect might be able to identify the rapist."
D) "I will find out whether the rapist has HIV from the evidence."

Question 34

The nurse is caring for an abused mother in the postpartum department. The patient is afraid to go home, but has no money to do anything else. What can the nurse do to assist this individual and her baby?

A) Work with social services to have the patient and her baby go to a safe place, complete paperwork to obtain financial assistance, and obtain some temporary assistance.
B) Explain that she will have to go home at this time, but provide her with paperwork to complete to obtain assistance.
C) Offer to have her partner come in and attend a counseling session with her.
D) Suggest that once she gets home, she should pursue getting a restraining order against her abuser.

Question 35

The nurse is caring for a battered woman in the emergency department. Nursing interventions used in the care include:

A) Letting the woman tell her story at her own pace.
B) Anticipating ambivalence toward the batterer.
C) Acknowledging the woman's feelings as reasonable.
D) Letting the woman figure out how to identify specific problems on her own.
E) Allowing the family to stay with the woman during the interview.

Question 36

The nurse is conducting a rape exam on a patient in the emergency department after a sexual assault. What specimens will the nurse collect?

A) Swabs of body stains and secretions
B) Samples of pubic hair
C) Toenail scrapings
D) Samples of head hair
E) Sputum, for disease analysis