Question 1

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 reply by the nursing supervisor is most appropriate?

A) "These clients don't know life any other way, and change is not an option until they have improved insight."
B) "These clients have limited skills and few vocational abilities to be able to make it on their own."
C) "These clients often have a lack of financial independence to support themselves and their children, and most have religious beliefs prohibiting divorce and separation."
D) "These clients are paralyzed into inaction by a combination of physical threats and a sense of powerlessness."

"These clients are paralyzed into inaction by a combination of physical threats and a sense of powerlessness."

Accepted Answer

1.This is incorrect. This is not an appropriate reply. It makes the client seem like they are comfortable staying with the abuser.
2.This is incorrect. This reply is not appropriate. There is nothing to indicate the victim is staying with the abuser because they have limited skills and cannot make it on their own.
3.This is incorrect. This reply is not appropriate. There is nothing in the question to indicate the client is staying for religious or financial reasons.
4.This is correct. Clients in severely abusive relationships may be paralyzed into inaction by a combination of physical threats and a sense of powerlessness. Victims have been known to stay with an abusive partner for some of the following reasons: fear of losing custody of children, financial dependence, fear of retaliation, lack of a support network, cultural or religious reasons, and/or dissociation related to post-traumatic stress disorder (PTSD).

Question 2

Which action by the parent leads the nurse to suspect they may be emotionally abusing their child?&#10;A) The child has bite marks on their arms.&#10;B) The child shows up for school without a lunch.&#10;C) The parent blames the child whenever something goes wrong.&#10;D) The child has no coat, and it is very cold outside.&#10;

Accepted Answer

1.This is incorrect. The child having bite marks on the arm is an example of physical abuse.
2.This is incorrect. The child having no lunch at school is an example of neglect.
3.This is correct. This situation describes an example of emotional abuse. The parent is constantly blaming their child when things go wrong.
4.This is incorrect. The child having no coat when it is cold outside is an example of neglect.

Question 3

As a domestic violence nurse specialist, you are asked to testify in a court case involving intimate partner abuse. The defense attorney asks, "When Mr. and Mrs. Smith came to the emergency room, several people were around, yet Mrs. Smith still did not say that Mr. Smith hit her." Which statement describes the rationale for Mrs. Smith not accusing her husband?

A) Abuse victims are not likely to accuse spouses without photographic evidence.
B) Abuse victims who are accompanied by the person who battered them are not likely to be truthful about the cause of the injuries.
C) Abuse victims are not always aware of the resources available to them.
D) Abuse victims often lie about their injuries because they are afraid they will be killed or their children will be harmed.

Abuse victims who are accompanied by the person who battered them are not likely to be truthful about the cause of the injuries.

Accepted Answer

1.This is incorrect. Photographs may be called in as evidence if charges are filed. The nurse, in collaboration with physician, should ensure that all physical wounds, fractures, and other evidence of injury are photographed with permission of the client. This, however, does not explain why Mrs. Smith did not accuse her spouse.
2.This is correct. Abuse victims are not likely to be truthful about the incidence as long as the victimizer is nearby.
3.This is incorrect. Knowledge of available resources can help decrease the victim's feeling of powerlessness; however, it does not explain why Mrs. Smith did not accuse her spouse.
4.This is incorrect. Some people will attempt to keep secret how their injuries occurred in an effort to protect their partner or because they are fearful that the partner will kill them if they tell. This could be the reason Mrs. Smith does not accuse her spouse; however, given the scenario, this is not the most likely reason.

Question 4

A student at a local college attended a party with a classmate. After a few alcoholic beverages, she reported he raped her, and she does not remember anything. Which type of rape does this describe?&#10;A) Date&#10;B) Marital&#10;C) Sexual Abuse&#10;D) Statutory&#10;

Accepted Answer

1.This is correct. Date rape is a term used if the encounter occurs during a social engagement agreed to by the victim or applied to situations in which the rapist is acquainted with the victim.
2.This is incorrect. Marital rape is a term used when the rapist is married to the victim.
3.This is incorrect. Sexual abuse is when an individual is being used for the sexual pleasure of another any other person.
4.This is incorrect. Statutory rape is intercourse between an individual who is over the age of consent and someone under the legal age of consent.

Question 5

Which individuals are at highest risk for exhibiting aggressive behavior? Select all that apply.&#10;A) A parent who has been struggling to find work&#10;B) A person who suffers from epilepsy&#10;C) A child who has been raised by their grandparents since birth&#10;D) An adult whose father would abuse his mother&#10;E) A teen who prefers to read instead of play video games or watch television&#10;

Accepted Answer

1.This is correct. Poverty and long-term unemployment can lead to aggressive behavior.
2.This is correct. Disorders of the brain, including epilepsy, can lead to personality changes, including aggressive behavior.
3.This is incorrect. A child raised by their grandparents is not at risk for aggressive behavior.
4.This is correct. An individual who witnessed abuse is likely to exhibit aggressive behavior or become an abuser.
5.This is incorrect. Individuals who play a lot of video games with violence or watch a lot of television with violence are likely to exhibit aggressive behaviors.

Question 6

A client and his spouse arrived for the client's follow-up appointment 10 minutes late. The client appeared to be very frustrated and aggravated. The spouse repeatedly asked the client to keep his voice down and apologized to the receptionist when checking in. "I sure hope you figure out what is causing this change in his behavior. He's starting to scare me," said the spouse. Which statements are true regarding possible causes of the change in the client's behavior? Select all that apply.

A) Decreased dopamine release
B) High plasma concentrations of 5-hydroxyindoleacetic acid (HIAA)
C) Adverse side effect of testosterone therapy
D) Amygdala dysfunction

Accepted Answer

1.This is incorrect. Studies have associated increased dopamine release with aggression.
2.This is correct. Evidence demonstrates that high plasma (and low cerebrospinal fluid) concentrations of 5-HIAA are associated with aggression.
3.This is correct. In general, testosterone replacement therapy is safe; however, an adverse side effect of this therapy includes increased aggression and mood swings.
4.This is correct. Research consistently demonstrates that lower amygdala volume plays a role in aggression.

Question 7

____________________ aggression is associated with impulsivity and is more common among people who have a history of being abused.&#10;A) Proactive&#10;B) Sexual&#10;C) Reactive&#10;D) Extreme&#10;

Accepted Answer

1.This is incorrect. Proactive aggression is initiated rather than provoked and is more common in psychopathy.
2.This is incorrect. Sexual aggression is related to power, dominance, and violence, usually resulting in a sexual assault.
3.This is correct. Reactive aggression is associated with impulsivity and is more common among people who have a history of being abused. Proactive aggression, which is initiated rather than provoked, is more common in psychopathy.
4.This is incorrect. Extreme aggression can be associated with other mental health issues.

Deck 18: Survivors of Abuse or Neglect