Deck 36: Child Abuse and Neglect

Question 1

Which of the following statements best defines the term child maltreatment?

A) intentional injury of a child
B) not giving a child what he or she wants
C) failure to provide what a child needs
D) accidental harm to a child by someone

Answer 1

intentional injury of a child

Question 2

Which of the following statements best defines the term physical abuse?

A) bodily injury to a person that seems to have been inflicted by other than accidental means
B) purposefully beating a child so that there are highly visible marks on the child's body
C) use of the hands applied to a child in an excessively forceful manner
D) any damage to a child that involves the use of muscle-applied force

Answer 2

bodily injury to a person that seems to have been inflicted by other than accidental means

Question 3

The school nurse observes parents interacting with a school-aged child and notices that they do not show any affection toward the child and there is no evidence of emotional support or supervision. Later the nurse learns from the child that he must take care of all his own hygiene tasks, has to find something to eat on his own, and his parents never say anything nice about him. The nurse at this point believes that the parents are engaging in:

A) physical abuse
B) psychological abuse
C) poor parenting
D) withholding of love

Answer 3

psychological abuse

Question 4

The majority of perpetrators of abuse to children reported to state Child Protective Service agencies as suspected victims of abuse and neglect are:

A) neighbors within one block
B) strangers
C) parents
D) relatives other than parents

Question 5

The majority of child abuse victims fall into which of the following age ranges?

A) over 10 years
B) 8 to 10 years
C) 6 to 8 years
D) under 6 years

Question 6

In the sociological model of family violence, family violence is viewed as:

A) a pattern of behavior that is passed from generation to generation
B) a pattern of harm within the nuclear family with no outside persons involved
C) any harmful action(s) between related persons no matter how distant the relationship is
D) harmful activities within a group designated as family no matter what the relationship

Question 7

When family violence is passed from generation to generation, this type of abuse has which of the following characteristics?

A) It continues without changing to another type.
B) The form of abuse may change.
C) It usually gets more violent.
D) It is more detrimental to the child from generation to generation.

Question 8

Which of the following children is in a high-risk family for less nurturing and more hurtful behavior?

A) a child being raised by grandparents
B) a child who is forbidden from playing with other children
C) a child being raised by two men
D) a child in a nuclear family there both parents have full-time jobs

Question 9

The social-interactional systemic perspective of child abuse and neglect says that the legitimization of violence in the family is due to which of the following factors?

A) family pathology of a genetic nature
B) increased availability of pornography
C) emphasis on hiding sexuality and not being open
D) society's attitudes, beliefs, and values

Question 10

According to the social-interactional systemic perspective of child abuse and neglect, four factors place the family members at risk for abuse. These risk factors are the family itself, the caregiver, the child, and:

A) chronic poverty
B) genetics
C) the presence of a family crisis
D) the national emphasis on sex

Question 11

When caregivers lack knowledge about parenting, lack parenting skills, and are emotionally immature, the child often assumes which of the following roles?

A) victim
B) caregiver role toward the caregiver
C) regressed child of regressed caregivers
D) scapegoat

Question 12

Which of the following examples best defines the term role reversal?

A) The child assumes a caregiver role toward the caregiver.
B) The good child takes on a bad child role.
C) A person who has been a good provider quits his or her job.
D) A lazy person becomes very productive in the family.

Question 13

When there is a depressed parent in the family, it is most likely that the depression will have which of the following effects?

A) will not affect the person's ability or performance in parenting
B) will cause the parent who is depressed to try harder to be a good parent
C) places the parent at risk for physically or emotionally abusing the children
D) will be seen in the child during the growing-up years

Question 14

The nurse working in the pediatric clinic notices that a newborn seems particularly fussy. The mother verifies that this is a very "fussy baby and that it is impossible to soothe the baby." In thinking through what to further assess and what to teach the mother, the nurse will keep in mind that fussy babies are:

A) often in some kind of pain
B) somewhat neurologically unstable
C) often victims of the mother's drug use
D) at greater risk for abuse

Question 15

Which of the following children are at greatest risk of abuse or neglect by the parents?

A) postmaturity babies
B) 13-year-old children
C) children with high intelligent quotient (IQ)
D) premature infants

Question 16

An infant is separated from his parents for a few minutes while the nurse weighs him. The infant seems distressed and looks around for the mother. The mother soothes the infant then the nurse is through weighing him. This type of attachment between mother and baby is most likely which of the following types of attachment?

A) avoidant
B) disorganized
C) secure
D) strange

Question 17

The nurse is caring for an infant who shows no distress then her parents leave, and then they return the infant ignores her parents. There was no evidence of distress while the parents were gone. This type of attachment between the infant and parents is most likely which of the following types of attachment?

A) secure
B) avoidant
C) ambivalent
D) detached

Question 18

Asian parents bring their child to the hospital with what appears to be burns or abrasions on the neck, spines, and ribs. The parents use the words cao gao. The nurse is aware that these physical findings and the term cao gao refers to:

A) an Asian practice of burning and inflicting pain on children who won't obey
B) parents rubbing a pumice stone over a child's body to sand off evil spirits
C) rubbing a coin or a spoon heated in oil on an ill child's neck, spine, and ribs
D) burning incense on a rice paper on a child's upper body to bring good luck

Question 19

A child of Russian parentage is brought to the hospital with what appears to be second-degree burns. The nurse is aware of a Russian practice of treating headaches and abdominal pain by creating a vacuum under a cup or glass then a small amount of burning material is placed on the skin. This practice is called:

A) tassos
B) mal de vaso
C) ventosos
D) veritas

Question 20

A child is brought to the pediatric clinic for immunizations for school. The parent wants the immunizations to be given in the arm. The nurse explains that at least one of the injections has to be given in the buttocks. When the nurse pulls the diaper down, the nurse sees bite marks around the genital and buttock area. Which of the following explanations is most likely?

A) A neighborhood toddler is in a biting stage.
B) This child is in a biting stage, and the parents bit him back to get him to stop biting.
C) The child is a victim of sexual or physical abuse.
D) This must have happened then the dog slept with the child.

Question 21

A parent brings a toddler to the pediatric clinic. The nurse observes a number of bruises on the child in various stages of healing. The parent claims the toddler bruises easily. The best action on the part of the pediatrician and the nurse would be to:

A) believe the parents and schedule an appointment in 2 weeks
B) report this to child and family services and order a screening battery of bleeding and clotting blood work
C) check with the other parent or another caregiver to see what he or she might be able to add to this history
D) tell the parent that it is clear that he or she is lying and to tell the truth

Question 22

When the nurse sees a child who has burns on the backs of the legs and the top of the buttocks, and an area that is not burned in the center of the buttocks, the nurse will:

A) tend to believe the parents who say the child got into the tub accidentally before it cooled off
B) suspect that the child's buttocks were held forcibly against the bottom of the tub
C) suspect that the parents poured hot liquids on some areas of the legs and buttocks
D) think that the child backed up against a heater or was held there by the parents

Question 23

A child comes to the clinic with bruises that are yellow-brown and fading. Based on the characteristics of these bruises, how old is the injury?

A) 3 days
B) 4 days
C) 6 days
D) over 1 week

Question 24

The nurse notices that a child has reddish blue to purple bruises that have margins. How old are these bruises?

A) 5 days
B) 7 days
C) more than 10 days
D) less than 1 day

Question 25

Which of the following explains why children between the ages of 1 and 5 are more at risk than older children for getting serious burn injuries?

A) They tend to aggravate and make their parents angry more than older children do.
B) Children this age are small and cannot fight back then parents are abusive.
C) The skin of a child is thinner and much more sensitive than an adult's skin.
D) Children this age are more curious and tend to get into things very quickly.

Question 26

Which of the following statements best describes the term stocking or glove type burn?

A) The burn has the look of a stocking or glove because the child tried to protect him- or herself from being immersed in hot scalding water.
B) The parents have dipped the child into hot liquid while he or she was asleep.
C) The child was wearing a stocking or a glove then immersed in hot liquid.
D) The parent was wearing heavy gloves or stockings on his or her hands while immersing the child in hot liquids or hot scalding water.

Question 27

What is meant by the term flexion burns?

A) a burn caused by a cigarette or other hot object applied to the elbow of a bent arm
B) the body part immersed in hot liquids is held in a flexed position
C) the burn is so serious the child cannot flex his or her extremity
D) the parent flexed his or her own arms to avoid being burned while burning the child

Question 28

What is the characteristic pattern of the burn in a flexion burn?

A) tiger pattern
B) zigzag
C) concentric circles
D) zebra pattern

Question 29

Most child abuse deaths occur for which of the following reasons?

A) neurological injuries, with most of these being head injuries
B) bleeding from cuts
C) smothering or serious lack of oxygen for any number of reasons
D) abdominal injuries

Question 30

Which of the following is a classic sign of shaken baby syndrome?

A) chills and fever
B) fear and withdrawal
C) edema of the extremities and bloated appearance to the abdominal area of the body
D) retinal hemorrhage, usually bilaterally with subdural or subarachnoid hemorrhages

Question 31

A father calls emergency medical services (EMS) for his 1-year-old infant who was vomiting and then experienced a series of seizures. Upon admission to the hospital, the infant was listless and irritable, had bradycardia, and had periods of apnea. The infant has now lapsed into a coma. Which of the following conditions will the nurse and the health care team members suspect and most want to rule out?

A) spinal meningitis
B) encephalitis
C) fever-induced seizures
D) shaken baby syndrome (SBS)

Question 32

Risk factors for shaken baby syndrome include:

A) stressful life events
B) gender with women mostly responsible
C) multiple births within a family
D) age of parents, especially elder parents

Question 33

Which of the following is the second major cause of abuse-related deaths?

A) burns
B) abdominal injuries
C) falls due to pushing or dropping
D) poisoning

Question 34

The school nurse notices a child who has a frightened look then adults approach, appears sad, hangs around after school, and seems reluctant to go home. This child seemed very distressed then a classmate was crying after falling on the playground. The nurse tried to console this child while consoling the injured child. The school nurse realizes that this child has some of the classic symptoms of:

A) a physically abused child
B) autism
C) mental retardation
D) early mental illness

Question 35

The nurse assessing a child who is suspected of being a victim of abuse will interview the child privately and will:

A) find out what the child was doing before the injuries occurred
B) reassure the child that he or she is not "in trouble" and that the child has not done anything wrong
C) tell the child that he or she has nothing to fear from the parents or the legal system
D) see what the child has done in response to any abusive behavior from the parents

Question 36

The nurse is developing a care plan for the parents of a toddler who was born prematurely and was in the neonatal intensive care unit for 2 months. The mother has been using a belt to discipline the child. The father is not very attentive to the needs of the mother or the baby. Which of the following nursing diagnoses would best fit this situation?

A) interrupted family processes due to disrupted attachment
B) deficient knowledge related to lack of parenting instructions
C) high risk for injury to others related to mood disturbance
D) marital discord in need of therapy related to lack of information

Question 37

Which of the following outcomes is most important in the nursing care plan for a family engaging in physical abuse of the children?

A) The child will remain safe with no evidence of physical abuse or neglect.
B) The parents will demonstrate at least one nurturing behavior.
C) The parents will discuss normal growth and development for the age of the child.
D) The child will report all instances of threatened or actual abuse and neglect.

Question 38

Which of the following statements best describes Munchausen syndrome by proxy?

A) The child has uncontrollable facial and vocal tics as a result of emotional abuse by caregivers.
B) Caregivers make up signs and symptoms of disease or unnecessarily expose their child to harmful medical interventions and painful invasive procedures.
C) The parents give the children no attention unless they are exhibiting signs and symptoms of illness.
D) Relatives of a child get all the attention in the family and the child is forced to fake illness to get any attention at all.

Question 39

The adult abuser who receives a diagnosis of Munchausen syndrome by proxy:

A) is the victim of unnecessary medical treatment at the hands of another adult
B) was the victim of unnecessary treatment in the past and now carries this pattern on
C) uses this disease to escape from poor self-esteem, marital, physical, or mental problems
D) is an uncaring and cunning individual who has psychological problems similar to antisocial behavior

Question 40

The nurse will establish which of the following kinds of relationships with the family and the person suspected of having Munchausen syndrome by proxy?

A) distant
B) trusting
C) uninvolved
D) opponent

Question 41

The school nurse is working with a child who seems angry and hits or hurts other children. Children who hurt other children are most often:

A) victims of abuse themselves
B) victims of manic depressive illness
C) individuals who are neurologically impaired
D) persons with brain damage

Question 42

Which of the following statements best describes child abandonment?

A) leaving town quickly and never looking back
B) failure to pick up children promptly then others are caring for them or failure to let the children know there you are
C) desertion of a child without arranging for reasonable care and providing no communication about caregiver's location
D) caregivers intentionally withholding, without cause or excuse, care, presence, love, protection, maintenance, and affection

Question 43

Which of the following statements best describes child neglect?

A) not giving one's child all the toys and advantages that other parents provide
B) not sending a brilliant child to college or otherwise providing for the child's future
C) not providing special dance lessons or music lessons then the child asks for these lessons
D) then a child experiences predictable injury or impairment because of caregiver inattention

Question 44

The school nurse notices a child who is wearing old, dirty, poor-fitting clothes; is always hungry; has no lunch money; and is always tired. When the nurse asks the boy about his tiredness, he talks of playing outside until midnight. The nurse will suspect that this child is:

A) a victim of child neglect
B) the victim of poverty
C) an orphan
D) being raised by a parent of low intelligence quotient (IQ)

Question 45

Which of the following is the best example of psychological abuse that is an act of commission?

A) not attending parents' night at the school
B) telling a child that he or she is dumb and will not amount to anything
C) forgetting to give a child money or food for lunch
D) not getting a child his or her vaccinations for school and having problems from this

Question 46

Theorists believe that the behavior of caregivers who psychologically abuse their children stem from:

A) not having experienced warm, caring parenting as children, not having their emotional needs met, and getting low levels of support
B) criminal minds who are cunning and calculate how to be mean to children and punish them
C) biochemical changes in the brain causing some people to have increased and even insatiable sexual urges toward children
D) a childish mind that relates better to children than to adults who engage in problem solving and more adult behaviors

Question 47

Which of the following signs or symptoms would most lead the nurse to believe a child is being psychologically abused?

A) working hard to get along well with other children
B) high self-esteem and good academic performance
C) a close peer group since preschool
D) self-defeating and self-mutilating behaviors

Question 48

The nurse is working with a teenage girl who has been having sex with an adult male. The nurse is aware that this constitutes

A) statutory rape
B) permissive sex
C) sex with permission
D) an offense

Question 49

Which of the following statements best describes acquaintance rape or date rape?

A) then two people don't love each other and engage in sexual activities
B) sexual intercourse committed with force or the threat of force without a person's consent
C) then someone on a date tricks the other person into having sexual intercourse
D) sexual intercourse then one person engaging in the activity is unsure about wanting to do so

Question 50

Incest is most likely to occur between:

A) family members in a household of poverty
B) parents and children
C) high achievers
D) siblings

Question 51

Nudity, disrobing, and genital exposure by an adult in front of a child, as well as observing a child undressed, sexual touching, and contact for prostitution or child pornography, are said to be:

A) traumatization
B) familiarization
C) exploitation
D) fraternization

Question 52

Nurses have an integral role in preventing child abuse and family violence through which of the following interventions? Select all that apply.

A) educating the public
B) supporting mental health initiatives
C) becoming involved in health policy
D) supporting family health initiatives

Question 53

A nurse is asked to describe the concept of attachment between a young child and the caregiver to a group of families planning to adopt internationally. Which of the following statements made by the nurse describes the qualities involved in attachment of the parent and child? Select all that apply.

A) being emotionally available
B) allowing the child to grieve independently for the loss of his or her familiar surroundings
C) offer protection and warmth to the child despite attachment challenges
D) set firm parameters and allow the child to deal with disappointment