Deck 33: Survivors of Violence and Trauma

Question 1

The nurse cares for a victim of a violent assault and battery. What is the most therapeutic intervention?

A) Discourage expression of feelings until the victim enters the recoil stage.
B) Use accepting, nurturing, and 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.

Answer 1

Use accepting, nurturing, and empathetic communication techniques.

Question 2

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 2

Set limits on self-harmful behavior.

Question 3

A woman comes to the clinic with neck pain. There's a bald spot on her scalp. She explains that she caught her hair in a door, which pulled it out and caused her neck injury. The partner wants to stay with the injured woman. What is the nurse's best action?

A) Encourage the partner to remain with the woman to provide emotional support.
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.

Answer 3

Require the partner to stay in the waiting room when the woman is examined.

Question 4

What is the difference between incest and sexual abuse?

A) The two terms are interchangeable.
B) Incest is committed by relatives. Sexual abuse can apply to anyone.
C) Incest includes rape. Sexual abuse applies to voyeurism and molestation.
D) Incest occurs between a parent and child. Sexual abuse involves any other person.

Question 5

A nurse caring for victims of violence plans care based on an understanding that after the initial impact, most victims begin to react emotionally to effects of the trauma. This second stage of recovery is known as:

A) disorganization.
B) reorganization.
C) retribution.
D) recoil.

Question 6

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. Select the nurse's best action.

A) Assign a female nursing assistant to remain with the patient in a private cubicle.
B) Assign a male nursing assistant to help the patient undress in a private cubicle.
C) Direct hospital security personnel to monitor the patient in the waiting room.
D) Notify law enforcement authorities immediately.

Question 7

Select the best staff member for an emergency department triage nurse to assign to care for a female rape victim.

A) Ex-policeman 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 8

When working with rape victims, immediate care focuses first on:

A) collecting evidence.
B) notifying law enforcement.
C) helping the victim feel safe.
D) documenting the victim's comments.

Question 9

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 10

Which intervention would be most therapeutic as a nurse cares for a victim of partner abuse?

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) Encourage the partner to stay with the victim during an interview.

Question 11

In preparing a care plan for an abuse victim, it is most important to include a long-term outcome that addresses the need to:

A) move the individual from victim to survivor status.
B) provide support groups for long-term assistance.
C) use empathy to establish rapport and build trust.
D) shift blame for the incident from patient to perpetrator.

Question 12

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?"

Question 13

A mother and two children are in the emergency department. She has just escaped from a severe beating by her husband. What is the nurse's priority intervention?

A) Appeal to her maternal instincts regarding child care.
B) Focus on physical safety and emotional security.
C) Provide a support group referral.
D) Disclose victims' legal rights.

Question 14

Battered woman syndrome is an aspect of which medical diagnosis?

A) Sexual abuse
B) Major depression
C) Impaired adjustment
D) Post-traumatic stress disorder ( PTSD )

Question 15

What is the primary motivator for most rapists?

A) Anxiety
B) Need for humiliation
C) Overwhelming sexual desires
D) Desire to humiliate or control others

Question 16

Which comment by the nurse would best support relationship building with a victim of partner abuse?

A) "You are feeling 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 was very worried about you. I knew 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 17

A patient says, "I was raped 2 hours ago." The patient coherently, quietly, and calmly states the facts in a monotone voice. The nurse should assess this behavior as:

A) a delayed reaction to the trauma.
B) indicative of ego integrity.
C) evidence of denial.
D) sublimation.

Question 18

A woman who has been repeatedly abused by her partner comes to the emergency department with severe contusions. She tells the nurse, "He almost killed me this time. I guess I should 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 19

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 20

Choose the initial desired outcome for a person who was a victim of mind control and torture. The person will:

A) make independent decisions for herself.
B) repress emotions experienced during event.
C) reestablish relationships with support persons.
D) use desensitization strategies to restore equilibrium.

Question 21

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 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

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.

Question 24

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:

A) are victims of childhood sexual abuse.
B) have antisocial personality disorder.
C) are experiencing schizophrenia.
D) have been ritually abused.