Deck 33: Survivors of Violence and Trauma

Question 1

Which intervention would be most therapeutic as a nurse provides initial care for a client who was abused by their partner?

A) Validate the truthfulness of the victim's comments.
B) Avoid pressuring the victim or disparaging the abuser.
C) Acknowledge the victim's inability to change the situation.
D) Allow the partner to stay with the victim during an interview.

Answer 1

Avoid pressuring the victim or disparaging the abuser.

Question 2

A patient comes to the clinic for the fifth time in a month with vague complaints of not feeling well.The nurse notices fresh bruises on the patient's upper body.Which assessment question should take priority?

A) "How much do you drink each day?"
B) "Are you annoying to anyone?"
C) "Did anyone hurt you?"
D) "Have you fallen?"

Answer 2

"Did anyone hurt you?"

Question 3

A survivor of childhood abuse is hospitalized following an episode of wrist cutting.The patient has a history of binge/purge eating disorder as well as difficulty trusting and relating to others.What is the nurse's priority intervention?

A) Set limits on self-harmful behavior.
B) Foster belief in and valuing of family unity.
C) Confront abnormal eating patterns and self-mutilation.
D) Encourage discussion of personal responsibilities associated with abuse.

Answer 3

Set limits on self-harmful behavior.

Question 4

For a victim of spousal abuse, a deterrent to leaving the abusive situation are the events that occur in which stage?

A) Tension building
B) Honeymoon
C) Processing
D) Battering

Question 5

Which comment by the nurse would best support relationship building with a client who has experienced partner abuse?

A) "It's normal to feel violated, because you thought you could trust your partner."
B) "I'm here for you.I want you to tell me about the bad things that happened to you."
C) "I'm very worried about you.I know you were living in a potentially violent situation."
D) "Abusers often target people who are passive.I will refer you to an assertiveness class."

Question 6

A patient, who reported being raped 2 hours ago, provides a medical history and assessment coherently, quietly, and calmly in a monotone voice.How should the nurse assess this behavior?

A) A delayed reaction to the trauma
B) Indicative of ego integrity
C) Evidence she is denying the rape occurred
D) Employment of the defense mechanism of sublimation

Question 7

A mother and her two children are in the emergency department for treatment of trauma experienced when the woman's husband physically abused her and the children.What is the nurse's priority intervention?

A) Conduct a detail medical history on both mother and children.
B) Focus on physical safety and emotional security of mother and children.
C) Discuss the mother's legal rights in this situation.
D) Discuss the legal obligation to notify the Child Protection Services.

Question 8

What statement made by a client accused of sexual abuse is characteristic of the primary motivation for most rapes?

A) "I was so nervous I just couldn't stop myself."
B) "I know a lot of men who act the same way."
C) "She wanted the sex, she just didn't want to say so."
D) "She is such a tease; I needed to teach her a lesson."

Question 9

The nurse cares for a client who experienced a violent assault and battery attack.When considering the need to communicate with the client, what is the most therapeutic intervention?

A) Discourage expression of feelings until the victim enters the recoil stage.
B) Demonstrate empathetic communication techniques.
C) Educate the victim about strategies to avoid attacks in the future.
D) Maintain a matter-of-fact manner, and remain objective.

Question 10

A woman accompanied by her domestic partner is being assessed for reports of neck pain.When the nurse notes a bald spot on the client's scalp, the woman explains that she caught her hair in a door, which pulled it out and caused her neck injury.What is the nurse's best action to facilitate the assessment?

A) Ask the client if she prefers her partner to stay during the examination.
B) Require the partner to stay in the waiting room when the woman is examined.
C) Call hospital security to have them stand by to prevent violence.
D) Report the situation to local law enforcement authorities.

Question 11

The nurse is establishing treatment goals for a person who was a victim of mind control and physical abuse.What is the initially focus goal for this individual?

A) Making independent personal decisions
B) Repressing emotions experienced during the abuse
C) Re-establishing relationships with support persons
D) Using desensitization strategies to restore equilibrium

Question 12

Which assessment findings would prompt a nurse to suspect that a 15-year-old patient may be a victim of serial ritual abuse?

A) Lying in a fetal position; echolalia; body rocking
B) Multiple scars and burns; missing teeth; fear of being examined
C) Scarred index finger; tooth enamel erosion; sores around mouth
D) Acting-out behaviors; verbal aggression; arrested for grand larceny

Question 13

A nurse plans care for a client who in the recoil phase of trauma recovery.What assessment question addresses a common focus of this phase?

A) "Are you having nightmares about the trauma you experienced?"
B) "Does it feel like the abuse happen to someone else?"
C) "Is there anyone you blame for putting you in that situation?"
D) "What are your fantasies about getting revenge on your abuser?"

Question 14

What assessment data supports the possibility that the sexual abuse is incestual in nature?

A) The abuse began when the client was 10 years old.
B) The abuser was the client's uncle.
C) The client's parents were aware that the abuse occurred.
D) The abuse involved only fondling.

Question 15

A woman demonstrating characteristics of "battered woman syndrome" should be asked which assessment question to identify a comorbid psychological condition?

A) "Have you ever been sexually abused?"
B) "Have you ever been diagnosed with major depression?"
C) "Would you say you experience anxiety on a regular basis?"
D) "Are you aware of the condition known as posttraumatic stress disorder (PTSD)?"

Question 16

The emergency department triage nurse should assign to initially care for a female client who has been raped?

A) Social worker with good communication skills
B) Male nursing assistant who is tall and caring
C) Nurse who is efficient and attentive to detail
D) Soft-spoken and empathetic nurse

Question 17

A woman who has been repeatedly abused by her partner comes to the emergency department with severe contusions.She tells the nurse, "I was almost killed me this time.I need to do something." What is the nurse's priority intervention?

A) Document the woman's injuries.
B) Help the patient devise a safety or escape plan.
C) Encourage the patient to take independent action.
D) Provide referrals contingent on the patient leaving the abuser.

Question 18

A male victim of gang rape comes to the emergency department.The victim is severely anxious, but the nurse will not be able to care for the patient for at least 20 minutes based on the current patient load.How can the nurse best meet the client's needs?

A) Assigning a female nursing assistant to remain with the patient in a private cubicle
B) Assigning a male nursing assistant to help the patient undress in a private cubicle
C) Directing hospital security personnel to monitor the patient in the waiting room
D) Notifying law enforcement authorities of the situation immediately

Question 19

The nurse is preparing a care plan for a client who experienced abuse by a domestic partner.It is most important to include a long-term outcome that addresses what client need?

A) Moving from the individual from victim to survivor status
B) Providing a support groups for emotional assistance
C) Using empathy to establish rapport and build trust
D) Shifting blame for the incident from patient to perpetrator

Question 20

When working with clients who have experienced rape, what should immediate care focus upon?

A) Collecting evidence for legal purposes
B) Notifying law enforcement to initiate a search for the rapist
C) Helping the client feel both physically and emotional safe
D) Documenting the victim's comments for future reference in care planning

Question 21

A 15-year-old patient is seen for evaluation by court order.The parents seek to have this teen declared incorrigible because of excessive drinking, habitually running away, and prostitution.The nurse interviewing the patient should recognize that these behaviors often occur in adolescents who have what experience?

A) Childhood sexual abuse
B) Antisocial personality disorder
C) Early onset schizophrenia
D) Ritual physical abused

Question 22

Which interventions should a nurse include in the plan of care for a woman who has been physically abused by a partner for 10 years? (Select all that apply.)

A) Be objective and nonthreatening.
B) Help the victim to assess strengths.
C) Make referrals contingent on leaving the abuser.
D) Inform the woman that marital counseling is rarely effective.
E) Help the victim recognize that the perpetrator's behavior is abusive.

Question 23

An adult in the emergency department has wrist slashes, suggesting self-mutilation.The patient's history reveals alcohol and drug abuse, binge eating, and unstable interpersonal relationships.Which history should the nurse suspect?

A) Rape trauma
B) Partner abuse
C) Serial ritual abuse
D) Childhood sexual abuse

Question 24

During the impact stage of response to a violent crime, which nursing interventions would be appropriate for a victim? (Select all that apply.)

A) Provide physical safety.
B) Use empathetic responses.
C) Distract the patient with humor.
D) Provide clear, simple directions.
E) Support expression of feelings.