Deck 23: Violence: Anger, Abuse, and Aggression

Question 1

A child was admitted to the children's unit,having been sexually abused by an acquaintance of her family.The child refuses to talk and participate in unit activities,choosing to stay in her room with her stuffed animals.Which therapeutic intervention will best help the child release pent-up feelings about the abuse?

A) Family therapy
B) Play therapy
C) Individual communication with the nurse
D) Role-play with other children on the unit

Answer 1

Play therapy

Question 2

The nurse is considering making a child abuse or neglect report to protective services.To make the report,the nurse needs to:

A) Have strong evidence that the abuse/neglect has occurred.
B) Obtain the supervisor's permission to make the report.
C) Notify the parents of the intent to file the report.
D) Have suspicions that the abuse has occurred.

Answer 2

Have suspicions that the abuse has occurred.

Question 3

A community health nurse is working with a family in which an elderly woman was neglected by her son and his wife but insists on remaining with the young couple despite the threat of future neglect.Which intervention should be given highest priority?

A) Identifying community resources to decrease the caregivers' stress
B) Establishing patient rights and consequences of abuse and monitoring
C) Providing stress management techniques for both of the caregivers
D) Educating the caregivers on the aging process and how to cope with it

Answer 3

Establishing patient rights and consequences of abuse and monitoring

Question 4

A patient admits to having been battered by her live-in boyfriend several times over the past 2 years.She states to the nurse,"We plan to get married next June,and I think things will be better then.He is always so sorry afterward,that I think I can trust him to change." Which intervention should be included in the patient's teaching plan?

A) Discourage her hope that the battering will end after they are married.
B) Assist her in enrolling in a class to learn techniques of self-defense.
C) Assist her in developing an emergency plan, because the pattern of violence is likely to continue.
D) Emphasize that the battering pattern usually remains the same in frequency and severity over time.

Question 5

Which symptom reported by an adult patient,who was sexually abused as a child,reflects the diagnosis of posttraumatic stress disorder (PTSD)?

A) A history of substance abuse
B) Refusing to go to public places from which escape may be difficult
C) Seeking advice and guidance prior to making any significant decision
D) Ruminating easily concerning the abuse with friends and acquaintances

Question 6

Which nursing intervention will assist a patient being treated in the Emergency Department for extensive soft tissue injuries to disclose an experience of domestic violence?

A) Allowing the patient to initiate the topic of violence
B) Speaking with the patient in the absence of her husband
C) Providing a safe, nonintimidating, and supportive environment
D) Interviewing her in the presence of another healthcare professional

Question 7

While planning care for a preschool child who has been physically and sexually abused,the nurse includes play therapy because it assists the child to:

A) Learn adaptive behaviors through acting.
B) Express feelings that cannot easily be verbalized.
C) Act out aggression in a sociably acceptable manner.
D) Interact with other children in the appropriate age group.

Question 8

When an elderly patient is brought into the Emergency Department by family members who reported a fall the nurse became suspicious that the patient had suffered physical abuse.The patient denied that she had been abused.Her denial is most likely based on her:

A) Feeling that she deserved the physical abuse
B) Strong belief that nothing could be done to help her
C) Lack of trust that the situation could ever be changed
D) Fear of the possibility of being removed from her family

Question 9

A patient has been chronically battered by her husband since they were married.Until now she had avoided dealing with her situation,but she now expresses a desire to deal with the problem since the attacks are occurring more frequently.Which outcome is realistic for the patient?

A) Setting a goal date for divorcing her husband
B) Verbalizing an awareness of her increasingly dangerous situation
C) Citing possible ways she may have contributed to the abusive episodes
D) Employing methods of retaliating in order to gain experience being assertive

Question 10

According to statistical research data,which of these children currently being followed by the pediatric nurse practitioner is at the greatest risk for fatal abuse?

A) A child who is 2 years old and has cerebral palsy
B) A child who is 5 years old and has chicken pox
C) A child who is 8 years old and has appendicitis
D) A child who is 11 years old and has a fractured humerus

Question 11

The nurse in the Emergency Department is taking a history from a family accompanying a child with suspicious traumatic injuries.The nurse should:

A) Be open, concerned, and honest.
B) Obtain information as covertly as possible.
C) Avoid responding to hints that abuse has occurred.
D) Separate the family from the child during the interview.

Question 12

A nurse planning a group to help batterers learn more effective ways to cope would teach participants that the key component in wife battering is:

A) Their need for the batterer to control
B) The role of alcohol in the pattern of abuse
C) History of psychotic or paranoid behavior
D) Failure of the woman involved to assert herself

Question 13

The nurse who sees a number of battered elderly females each year decides to put together a set of guidelines for nurses.An appropriate guideline to include would be to:

A) Make protective services aware of the abuse.
B) Take at least two photographs of each trauma area.
C) Begin the interview by asking the least sensitive questions.
D) Assess for the presence of sexually transmitted diseases.

Question 14

A nurse planning teaching for a parent group concerned with preventing family violence can discuss the fact that exposure to violence in the media:

A) Desensitizes people to the violence around them
B) Has no effect on the increase of violence in society
C) Broadens the viewer's knowledge about world happenings
D) Helps to distinguish appropriate behaviors from inappropriate behaviors

Question 15

A young child is being evaluated in the Emergency Department for injuries her mother reports resulted from a fall down the stairs.Which of these findings indicates that physical abuse may be a chronic problem for the child?

A) The mother's description of the child as being 'clumsy'
B) Several fractures revealed on x-ray in varying degrees of healing
C) Clinging to her mother as she attempted to leave the examining room
D) Struggling with the staff when attempts to obtain a blood specimen were made

Question 16

A new nurse asks the experienced nurse,"Why did you ask about culture when it was obvious you needed to focus on the battering?" The experienced nurse should respond:

A) "It's just a habit I got into awhile ago."
B) "It helps me focus on whether to do a complete physical assessment."
C) "Culture is a determinant of how women interpret and respond to violence."
D) "If I know more I can refer her to a shelter that caters to her cultural group."

Question 17

The nurse caring for a school-age child who has been sexually abused by a close family member demonstrates an understanding of communication barriers in this situation by:

A) Realizing that repeated questioning by others will occur
B) Assuring the child that the story they are telling is believed
C) Reinforcing that the child will not be in trouble with the police
D) Promising to tell only those who need to know about the incident

Question 18

To provide nursing care to abused children and their families,the nurse must first:

A) Recommend removal of the children from the family.
B) Complete a comprehensive physical and mental assessment.
C) Refer each case to the appropriate social worker for follow-up.
D) Examine personal feelings regarding the trauma of child abuse and neglect.

Question 19

A patient has been physically abused by her boyfriend frequently since moving in together.During her last discussion with the nurse,the patient stated,"I probably should not keep going back to him,because he continues to abuse me." The nurse is aware that the final decision to leave a batterer is:

A) Usually a gradual process that occurs over time
B) Likely to occur after the victim suffers a serious injury
C) More likely if the patient has approval from her family
D) Made when the batterer gives her permission to do so

Question 20

The nurse is leading a support group for women who have experienced interpersonal violence.When a patient asks about the characteristics of the perpetrators of interpersonal violence,the nurse accurately responds that they are:

A) Usually under the influence of alcohol
B) Most often someone the victim knows
C) A stranger to the victim in most cases
D) Often in a psychotic state during the act

Question 21

An experienced nurse correctly notes that an important factor in assessing survivors of childhood sexual abuse is to be aware that they often experience long-term symptoms most closely resembling DSM-IV-TR criteria for:

A) Adjustment disorders
B) Schizophreniform reaction
C) Posttraumatic stress disorder
D) Obsessive-compulsive personality disorder

Question 22

The nurse is interviewing a patient who presents with a dislocated shoulder and demonstrates signs of anxiety although relying on her partner for answers.Although the partner is out of the room,which question is most important to ask?

A) "Have you been with your partner long?"
B) "Are you being abused by your partner?"
C) "Shall I notify the police that you would like to press charges?"
D) "Have you ever been physically or emotionally hurt by someone?"

Question 23

A patient in her early teens who is being treated for irritable bowel syndrome has just disclosed that she has been the victim of child abuse for 8 years.For what other condition should the nurse assess this patient?

A) Schizophrenia
B) Agoraphobia
C) Posttraumatic stress disorder
D) Obsessive-compulsive disorder

Question 24

After being raped,a woman was told by her aunt,"I'm not surprised that happened to you.You always dress to show off your figure." The victim states,"I can't believe that people can think that way." The rape crisis nurse correctly hypothesizes that the patient is:

A) Being revictimized by society
B) Overly sensitive to others' views
C) Overreacting to not resisting more strongly
D) Unaware of the normalcy of male sexual aggression

Question 25

The care plan for a battered woman will be most successful if the nurse:

A) Empowers the patient to make her own decisions
B) Develops the plan and presents it to the woman
C) Obtains photo evidence of the battery for use in court
D) Has a family conference and mediates among the parties

Question 26

A patient who has been battered by her partner sobs,"It was my own fault." Which of the following would be the priority response by the nurse?

A) "Why do you think he does it?"
B) "What did you do to deserve this?"
C) "No one has the right to abuse another."
D) "Tell me about when you were growing up."

Question 27

An elderly patient who lives with her daughter,son-in-law,and their three children reveals that her daughter sometimes slaps her when she does not move fast enough or spills things.The daughter states,"I have so much to do that I become frustrated when my mother can't move fast enough or causes me extra work." The nurse caring for the mother could appropriately suggest:

A) Moving the mother to an adult ambulatory care facility
B) Employing an aide to provide care and stimulation for the mother
C) Enrolling in a therapeutic group that addresses stress management
D) Reading the elder law of the state to learn the penalties for elder abuse

Question 28

The nurse is planning care for a battered woman who has mentioned,"Someday I'll have to leave him." Which outcome should the nurse include in the plan of care for this patient?

A) Patient will leave husband for a safe environment within 3 weeks.
B) Patient will verbalize awareness of the dangerousness of her situation.
C) Patient will state that she feels strong enough to return to the situation.
D) Patient will state that she feels more relaxed after consultation with nurse.

Question 29

A teenage boy has been periodically beaten by his father.The boy tells the nurse,"He'll pay for this one way or another." The nurse treating his contusions should assess for behaviors suggesting:

A) Aggression
B) Depression
C) Regression
D) Withdrawal

Question 30

Which statement regarding the various types of child offender is correct?

A) The physical offender lacks remorse, although the sexual offender usually shows guilt and shame.
B) The physical offender has diverse characteristics, although the sexual offender has lack of remorse.
C) The physical offender has a mature ego, although the sexual offender has a rigid, overdeveloped superego.
D) The physical offender has poor self-esteem and unrealistic expectations of children, although the sexual offender has diverse characteristics.

Question 31

The experienced nurse assessing a battered woman patient uses many open-ended questions during the interview.The rationale for this is that:

A) The woman will feel more in charge of the interview.
B) Patients can't refuse to answer when sensitive information is being probed.
C) The questions are direct and easily understood by the anxious individuals.
D) Such questions allow for simple "yes" or "no" answers when the patient is upset.

Question 32

A toddler was brought to the hospital with a broken humerus and upper arm bruising.The child's father states that he shook the child while disciplining him to teach him to be quiet.An appropriate family-related nursing diagnosis is:

A) Anxiety related to physical abuse
B) Powerlessness related to inability to keep child quiet
C) Impaired parenting related to unrealistic expectations for child
D) Risk for impaired parenting related to harsh disciplinary methods

Question 33

A woman whose husband physically abuses her mentions to the nurse,"Someday I'll have to leave him." Which of the following would be the nurse's best response?

A) "Yes, you should, before he harms you badly."
B) "Could we talk about developing a safety plan?"
C) "Are you afraid of what your family will say?"
D) "I don't know why you would stay with him."

Question 34

Which of the following would be an appropriate outcome for a patient diagnosed with rape-trauma syndrome?

A) Patient will sleep 8 hours without medication by week 6 of therapy.
B) Patient will develop better self-esteem by week 8 of therapy.
C) Patient will accept nurse's word that her reactions are normal.
D) Patient will verbalize that recovery may never happen totally.