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 is the nursing supervisor's most appropriate reply?

Accepted Answer

The most appropriate reply by the nursing supervisor highlights the complex dynamics of abusive relationships, where victims may feel trapped due to physical threats and a profound sense of powerlessness, making it difficult for them to leave the situation.

Question 2

A child is brought in to the emergency room with physical injuries being reported as an accident.The nurse should consider if the explanation is reasonable,if the injury is consistent with the explanation,and which of the following?

Accepted Answer

The nurse should consider if the injury is consistent with the child's developmental capabilities, as young children may accidentally injure themselves in ways that may seem unreasonable to adults. However, if the injury is not consistent with the child's developmental capabilities, further investigation may be necessary. The other options may also be considered, but A is the best choice for this question.

Question 3

Roger has been newly diagnosed with a Comorbid Psychosis.With an understanding of the neurobiology of violence,which of the following classifications of medication will the physician likely prescribe to help control aggression and violence?

Accepted Answer

Antipsychotics (both typical and atypical) are commonly prescribed for individuals with comorbid psychosis to help control aggression and violence. These medications work by targeting the underlying psychotic symptoms that may be contributing to the aggressive behaviors. While SSRIs may help with symptoms of anxiety or depression, they are not typically used to directly control aggression. Mood stabilizers and anti-adrenergic agents may also be useful in certain cases, but antipsychotics are generally the first line of treatment for aggression and violence in comorbid psychosis.

Question 4

A college student was sexually assaulted when out on a date.After several weeks of crisis intervention therapy,which client statement should indicate to the nurse that the student is handling this situation in a healthy manner?

Accepted Answer

This statement shows that the client is not blaming themselves for the assault and has accepted that they are not at fault. This is a healthy outlook and a positive step in the healing process. The other statements suggest victim-blaming or an unhealthy avoidance of dating, which could impact the client's ability to move forward and recover from the trauma.

Question 5

Which of the following medications could be used to reduce aggression by dampening excessive nonadrenergic activity?

Accepted Answer

Propranolol is a beta-blocker that can reduce aggression by dampening excessive nonadrenergic activity. Tegretol and Dilantin are anticonvulsants that are more commonly used to treat seizures and neuropathic pain. Lithium is typically used to treat bipolar disorder and can have mood-stabilizing effects but is not primarily used for reducing aggression.

Question 6

Which teaching should the nurse in an employee assistance program provide to an employee who exhibits symptoms of domestic physical abuse?

Accepted Answer

Having ready access to the number of a shelter for battered women is the safest choice as it provides the employee with a safe place to go and resources to help them leave the abusive situation. Access to a gun can escalate the level of danger, researching lawyers may not be feasible or safe at the moment, and filing charges may not be the best option for everyone and may not provide immediate safety.

Question 7

Which assessment data should the school nurse recognize as signs of physical neglect?

Accepted Answer

Physical neglect can manifest as consistent absence from school, apathy, and fatigue, indicating a lack of proper care and supervision at home.

Question 8

When Beverly told her sister Liz about the repeated episodes of abuse she'd experienced,her sister replied,"If you leave him,how will you be able to pay your bills?" Liz's reply supports which notion?

Accepted Answer

Liz's reply suggests that she is concerned about Beverly's financial well-being and implies that leaving the abusive relationship may not be a practical option. This supports the notion that battered women may be encouraged by their social network to remain in the abusive relationship.

Question 9

A client is brought to an emergency department after being violently raped.Which nursing action is most appropriate?

Accepted Answer

The most appropriate nursing action is to remain nonjudgmental and actively listen to the client's description of the event. This allows the client to feel heard and supported, and can help provide valuable information for medical and legal interventions. It is not appropriate to discourage the client from discussing the event, as this can lead to further emotional trauma and may impede the healing process. Assisting with self-care needs, such as showering and perineal care, is also important, but should be done with the client's consent and in a sensitive and respectful manner. Providing cues based on police information may be necessary later on in the investigation, but at this point in time, it is most important to prioritize the client's immediate needs and emotional wellbeing.

Question 10

In the emergency department,a client who was raped appears calm and exhibits a blunt affect.The client answers the nurse's questions in a monotone using single words.Which indicates the nurse interpretation of this client's responses?

Accepted Answer

The client's calm and monotone response may indicate a controlled response pattern, which is a coping mechanism used by some survivors of sexual assault to regain control over their emotions and their environment. It is not necessarily indicative of lying, a silent rape reaction, or a compounded rape reaction. It is important for the nurse to continue assessing and providing support for the client regardless of their response style.

Question 11

A nursing student asks an emergency department nurse,"Why does a rapist use a weapon during the act of rape?" Which nursing reply is most accurate?

Accepted Answer

A weapon is often used as a means to intimidate and overpower the victim, causing fear and submitting to the perpetrator's demands. It can also be used to gain control over the situation and increase the likelihood of the victim not putting up resistance. It is a tactic used to exercise power and control over the victim, and not necessarily to cause physical harm.

Question 12

A client who has been raped is crying,pacing,and cursing her attacker in an emergency department.Which behavioral defense should the nurse recognize?

Accepted Answer

Expressed response pattern involves a display of intense emotional reactions, such as crying, screaming, or aggression, immediately after the assault. The client's crying, pacing, and cursing suggest an expressed response pattern. Controlled response pattern involves hiding the emotional reaction and appearing calm and composed. Compounded rape reaction involves experiencing a delayed reaction and exhibiting symptoms of post-traumatic stress disorder. Silent rape reaction involves suppressing the emotional reaction and not seeking help or support.

Question 13

When questioned about bruises,a woman states,"It was an accident.My husband just had a bad day at work.He's being so gentle now and even brought me flowers.He's going to get a new job,so it won't happen again." The nurse recognizes this client is in which phase of the cycle of battering?

Accepted Answer

The woman's behavior and statements indicate that she is in the honeymoon phase of the cycle of battering. She is minimizing and excusing the abuse, and accepting her partner's apologies and gestures of affection. This phase is characterized by a period of calm and/or kindness after an abusive incident, where the abuser may offer gifts or promises that the abuse won't happen again. However, this phase is usually temporary and the cycle of abuse typically continues.

Question 14

A kindergarten student is frequently violent toward other children.The school nurse notices bruises and burns on the child's face and arms.Which other symptom should indicate to the nurse that the child might have been physically abused?

Accepted Answer

The child shrinking at the approach of adults can indicate fear or trauma from physical abuse, as it suggests the child associates adults with harm or danger. This behavior, combined with physical injuries like bruises and burns, strongly points to physical abuse.

Question 15

An anorexic client states to the nurse,"My father has recently moved back to town." Since that time,the client has experienced insomnia,nightmares,and panic attacks that occur nightly.She has never married or dated,and lives alone.Which should the nurse suspect?

Accepted Answer

The client's symptoms, including insomnia, nightmares, and panic attacks, suggest the possibility of a trauma-related disorder such as post-traumatic stress disorder (PTSD) or a history of childhood sexual abuse. The fact that the client has never married or dated and lives alone is also consistent with a history of trauma. While major depressive disorder and bulimia nervosa can co-occur with PTSD, they do not fully explain the client's symptoms. Histrionic personality disorder is not a likely explanation for the client's symptoms.

Question 16

A woman comes to an emergency department with a broken nose and multiple bruises after being beaten by her husband.She states,"The beatings have been getting worse,and I'm afraid that next time he might kill me." Which is the most appropriate nursing reply?

Accepted Answer

Option C is the most appropriate nursing response as it acknowledges the patient's fear and offers support and options to leave the abusive situation. Options A and B are not helpful as they blame the patient or suggest that she is responsible for her husband's behavior. Option D may not always be appropriate as it could put the patient in further danger.

Question 17

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.With all those people around,why didn't Mrs.Smith accuse her husband then?" What is the most likely and most appropriate rationale?

Accepted Answer

Intimate partner violence often involves a cycle of violence and manipulation, in which the abuser seeks to isolate the victim and control their behavior. Victims may be accompanied by their abuser to the emergency room or other settings and feel pressure to minimize or deny the abuse in order to prevent further violence. Therefore, it is not uncommon for victims to be untruthful about the cause of their injuries, particularly when their abuser is present.

Question 18

What is the main goal of crisis intervention for sexual assault?

Accepted Answer

The answer of What is the main goal of crisis...

Question 19

Which statement by an emergency department nurse indicates accurate knowledge of domestic violence?

Accepted Answer

Choice A accurately reflects the central dynamic of power and control in domestic violence. Choices B, C and D do not accurately reflect the central dynamic of domestic violence.

Question 20

A woman describes a history of physical and emotional abuse in intimate relationships.Which additional factor should the nurse suspect?

Accepted Answer

The answer of A woman describes a history of physical...

Quiz 35: Survivors of Abuse or Neglect