Question 1

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 woman's statement suggests that she is in the honeymoon phase of the cycle of battering, where the abuser shows remorse and tries to make up for their actions with gifts or affection. This phase is commonly followed by a return to the tension-building phase, leading to another incident of abuse.

Question 2

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 symptoms mentioned in the scenario are indicative of post-traumatic stress disorder (PTSD), which can develop after experiencing or witnessing a traumatic event. The client's statement about her father's recent return to town and her history of living alone suggest a possible history of childhood incest, which can be a traumatic experience that leads to PTSD. It is important for the nurse to assess for this possibility and provide appropriate referrals for therapy or support groups.

Question 3

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

Victims of severe abuse often feel trapped due to physical threats and a profound sense of powerlessness, making it difficult for them to leave the abusive situation.

Question 4

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 client's crying, pacing, and cursing are all part of an expressed response pattern, which is a typical immediate reaction to rape. The client is openly expressing her emotions and feelings, rather than suppressing them or being silent about them. The other options, controlled response pattern, compounded rape reaction, and silent rape reaction, do not accurately describe the client's current behavior.

Question 5

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

It is important for the nurse to consider that leaving an abusive situation can take time and multiple attempts, substance abuse can be a factor in abusive relationships, and women in abusive relationships often feel isolated and unsupported. It is not accurate to assume that children are not affected by parental discord and economic factors can also play a significant role in the decision to stay in an abusive relationship.

Question 6

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 7

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 8

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

Option C offers support and empowerment to the victim by discussing her options and providing resources for her safety. Option A is dismissive and unhelpful. Option B places blame on the victim and suggests she is responsible for her husband's actions. Option D may not be the best approach for every situation and could potentially put the victim in more danger.

Question 9

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

This statement shows that the client has been able to process the experience and understand that they are not to blame for what happened. It indicates a healthy attitude towards oneself and the situation. The other statements either blame oneself or others for the assault or suggest avoiding dating altogether, which may indicate unhealthy coping mechanisms.

Question 10

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

Accepted Answer

Choice A accurately reflects the central dynamic of domestic violence, which is the abuser's need for power and control over the victim. Poor communication, social isolation, erratic relationships, emotional injury, and learned helplessness may be present in a domestic violence situation, but they are not the primary cause or dynamic.

Question 11

Which of the following nursing diagnoses could be appropriate for an adult survivor of incest? (Select all that apply.)

Accepted Answer

The answer of Which of the following nursing diagnoses could...

Question 12

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

A weapon is often used to terrorize and subdue the victim, making it easier for the perpetrator to exert control over them. It can also serve as a way to psychologically dominate the victim and increase the perpetrator's sense of power and control. Using a weapon allows the perpetrator to reinforce their dominance and intimidate the victim.

Question 13

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

Accepted Answer

Having ready access to the number of a safe house for battered women is the best choice as it ensures the safety of the employee and provides them with a safe place to stay. It is important to prioritize safety and provide resources for the employee to seek help and support. Providing access to a gun or encouraging the employee to file charges may escalate the situation and put them in further danger. While researching lawyers may be helpful, it is not the immediate concern and should be addressed once the employee is in a safe place.

Question 14

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 15

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 16

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

Accepted Answer

It is important for the nurse to remain nonjudgmental and actively listen to the client's description of the event. This can help the client feel supported and validated. It is not appropriate to discourage the client from discussing the event or provide cues based on police information without the client's consent. While assisting with self-care may be important, it should be done in a sensitive and respectful manner with the client's consent.

Quiz 36: Victims of Abuse or Neglect