Question 1

During assessment of a 9-year-old patient, the nurse notes purple-blue bruises to both knees.The mother and patient separately inform the nurse that the patient got the bruises playing soccer the day before.From the colour of the bruises the nurse:

A)Is convinced the child is being abused.
B)Recognizes that the objective data validates the subjective data.
C)Questions when the bruises actually occurred.
D)Is unable to identify the time frame for when the bruises were attained.

Accepted Answer

A new bruise is usually red and often turns purple or purple-blue 12 to 36 hours after blunt-force trauma.The colour of bruises (and ecchymoses) generally progresses from purple-blue to bluish green to greenish brown to brownish yellow before the bruise fades away.Bruises are noted more often to the front of children's bodies when they are walking and running.Recognizing that the progression of the bruises is the objective data validating the subjective data.

Question 2

The nurse is conducting a follow-up assessment of a 6-year-old patient 2 years after removal from his parents' home as a result of physical violence between the parents.The nurse will assess the patient for: (Select all that apply.)

A)Developmental progress.
B)Favourite foods.
C)Social interactions in school.
D)Musical talents.
E)Clothing trends.

Developmental progress.
Social interactions in school.

Accepted Answer

For children, being exposed to abuse (e.g., hearing abuse, directly witnessing abuse), seeing the effect of abuse on their mothers, and living under conditions of chronic stress can lead them to experience a wide range of problems (e.g., physical, behavioural, emotional and social problems).

Question 3

During admission assessment of a 72-year-old patient with dementia from a long-term care facility, the nurse notices multiple signs of old bruising to the patient's wrists and arms.The nurse should assess for:

A)Functional capabilities
B)Fall risk
C)Normal aging
D)Elder abuse

Elder abuse

Accepted Answer

With increasing numbers of older adults in Canada and the greater need for institutionalization of these older adults, recognition of abuse has become important and may include rough or violent handling during personal care, force feeding or withholding food, and neglect.

Question 4

The nurse is examining a 3-year-old child who was brought to the emergency department after a fall.Which finding would be of most concern?&#10;A)Bruise on the knee&#10;B)Bruise on the elbow&#10;C)Bruising on the abdomen&#10;D)Bruise on the shin

Accepted Answer

Studies have shown that children who are walking often have bruises over the bony prominences of the front of their bodies.Other studies have found that bruising in atypical places, such as the buttocks, hands, feet, and abdomen, were exceedingly rare and should arouse concern.

Question 5

During assessment of a 38-year-old patient with chronic headaches of no known cause, and diagnosed with depression, the nurse notes the despondent and flat affect.How should the nurse respond?&#10;A)&#34;You must be experiencing abuse.You need to leave your partner.&#34;&#10;B)&#34;Do you really have these headaches? Are you just wanting sympathy from your spouse?&#34;&#10;C)&#34;You seem to be getting worse.Do you need more medications for your depression?&#34;&#10;D)&#34;Depression and headaches can be related to violence in a relationship.For your safety, I need to ask you if this is the case.&#34;

Accepted Answer

When you identify social vulnerabilities, health issues commonly associated with abuse, or signs of possible abuse, a thorough assessment of interpersonal violence is needed.Inquire in safe and appropriate ways about their needs and concerns followed by appropriate and timely referral.Depending on the presentation, use questions that are direct and tailored to the person and situation.

Question 6

While working with a 27-year-old transgender patient, the nurse takes an approach to facilitate trust and safety for the patient to assess for abuse.What will the nurse do? (Select all that apply.)&#10;A)Reflect on personal views of IPV to not be judgemental.&#10;B)Inquire about patient history of abuse to initiate the conversation.&#10;C)Listen with interest and observe for cues of violence.&#10;D)Tell patient to leave the abuser.&#10;E)Recognize and commend patient on strengths.

Accepted Answer

The TVIC approach is needed for people of all gender identities, including those who identify as transgender or two-spirit.In line with the 2014 World Health Organization (WHO) guidelines, health care providers should respond to disclosure and assess using the WHO's LIVES approach: Listen, Inquire, Validate, Enhance safety, and Support.This approach can support assessment with or without the patient disclosing a history of IPV.A relational approach lets the patient take the lead in choosing to disclose, or not, the abuse.Inquiring their abuse history to initiate a conversation does not develop a safe and open environment for them to share and assumes abuse before disclosure.

Question 7

The nurse suspects abuse when a 10-year-old child is admitted to the urgent care centre for a leg injury.The best way to document the history and physical findings is to:&#10;A)Document what the child's caregiver tells the nurse.&#10;B)Use the words the child has said to describe how the injury occurred.&#10;C)Record what the nurse observes during the conversation.&#10;D)Rely on photographs of the injuries.

Accepted Answer

When documenting the history and physical findings of suspected child abuse and neglect, use the words the child has used to describe how his or her injury occurred.Remember, the abuser may be accompanying the child.

Question 8

Using the TVIC approach during patient assessment, the nurse focuses on:&#10;A)Assessing for violence in high-risk populations&#10;B)Obtaining evidence of abuse by a family member&#10;C)Gathering information of violence&#10;D)Creating a safe, nonjudgmental environment

Accepted Answer

The TVIC approach builds on the idea of trauma-informed practice, to take into account ongoing and historical violence and how structural violence (e.g., systemic racism, poverty, discriminatory policies) is related to interpersonal violence.TVIC focuses on creating a safe environment, not on getting a "disclosure."

Question 9

During a home visit, the nurse notices that an older adult woman is caring for her bedridden husband.The woman states that this is her duty, she does the best she can, and her children come to help when they are in town.Her husband is unable to care for himself, and she appears thin, weak, and exhausted.The nurse notices that several of his prescription medication bottles are empty.This situation is best described by the term:

A)Physical abuse
B)Financial neglect
C)Psychological abuse
D)Unintentional physical neglect

Accepted Answer

Unintentional physical neglect may occur despite good intentions and is the failure of a family member or caregiver to provide basic goods or services.Physical abuse is defined as violent acts that result or could result in injury, pain, impairment, or disease.Financial neglect is defined as the failure to use the assets of the older person to provide services needed by him or her.Psychological abuse is defined as behaviours that result in mental anguish.

Question 10

As a nurse working with many different populations, which of the following individuals can be at increased risk for abuse? (Select all that apply.)&#10;A)The 70-year-old confined to a wheelchair&#10;B)The 45-year-old female bank manager&#10;C)The 21-year-old living with a boyfriend who uses harmful amounts of alcohol&#10;D)The 35-year-old stay-at-home mother with a controlling spouse&#10;E)The 21-year-old university student living at home

Accepted Answer

Although some populations may be more vulnerable to abuse, everyone the nurse encounters can be experiencing abuse.All patients should be observed for potential signs of abuse.Some patients are more vulnerable to abuse: those who are isolated, economically dependent on others (e.g., immigrants sponsored as spouses, children, and adolescents), or dependent on others for care (e.g., people with disabilities).Actively consider IPV when a person is vulnerable in other ways.

Question 11

The nurse is using the Danger Assessment (DA) tool to evaluate the risk for violence.Which of these statements best describes its use?&#10;A)The DA tool is to be administered by law enforcement personnel.&#10;B)The DA tool should be used in every assessment of suspected abuse.&#10;C)The number of &#34;yes&#34; answers indicates the woman's understanding of her situation.&#10;D)The higher the number of &#34;yes&#34; answers, the more serious is the danger of the woman's situation.

Accepted Answer

The answer of The nurse is using the Danger Assessment...

Question 12

The 25-year-old female Indigenous patient in for her first prenatal checkup appears despondent and unhappy.The nurse finds numerous old bruises on the patient during the physical examination.With use of a relational approach and further questioning, the patient admits that her husband has been hitting her when he is frustrated with work.The best response by the nurse is:

A)"What do you do that makes him angry? Maybe avoiding saying things to frustrate him will stop the hitting."
B)"You need to leave him.Don't be weak."
C)"I am really concerned for you and your baby, and I really want to help you.Can you tell me how I can best support you?"
D)"Are you sure you are not imagining this? Is it just your normal fighting?"

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Accepted Answer

The answer of The 25-year-old female Indigenous patient in for...

Question 13

The nurse is aware that screening for intimate partner violence (IPV) using the trauma- and violence-informed care (TVIC) approach should occur with which type of situation?&#10;A)When IPV is suspected&#10;B)When a woman has an unexplained injury&#10;C)As a routine part of each health care encounter&#10;D)When a history of abuse in the family is known

Accepted Answer

The answer of The nurse is aware that screening for...

Question 14

During a home visit with an 80-year-old patient cared for by family, the nurse notices that the patient is in severe pain.The nurse knows that the patient was prescribed medication for the pain and family administered all medications.When asked, the patient states not receiving any medications for the past week.The nurse recognizes this situation as:

A)Caregiver burden
B)Criminal neglect
C)Malnourishment
D)Unintentional neglect

Accepted Answer

The answer of During a home visit with an 80-year-old...

Question 15

A patient has come to the clinic with persistent abdominal pains.During the interview, the patient tells the nurse that her husband controls the finances, gives her a minimal allowance, and makes her account for what she spends to the penny.The patient constantly looks down and will not make eye contact with the nurse.What will the nurse assess for?

A)Situational violence
B)Chronic ulcerative colitis
C)Stomach flu
D)Intimate partner terrorism

Accepted Answer

The answer of A patient has come to the clinic...

Question 16

The nurse is interviewing the parents of a 5-year-old patient who seriously physically hurt another child.The parents inform the nurse that they adopted the patient when he was removed from his parents' custody at 8 months of age.What does the nurse ask?

A)"Is he the only child you have adopted?"
B)"Did he have issues with the child he hurt?"
C)"Can you tell me anything about his parents and the family situation?"
D)"Did he have siblings when you adopted him?"

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Accepted Answer

The answer of The nurse is interviewing the parents of...

Question 17

The nurse observes bruises of various stages on a 6-year-old child and suspects child abuse.What should the nurse do?&#10;A)Ask the parents what they did to their child&#10;B)Consult with a child protection social worker&#10;C)Report the parent for child abuse&#10;D)Document and photograph the abuse

Accepted Answer

The answer of The nurse observes bruises of various stages...

Deck 8: Interpersonal Violence Assessments