Question 1

A community health nurse is reviewing the medical records of several families in the community who have experienced varying crises. The nurse identifies which as developmental crises? Select all that apply.

Accepted Answer

Developmental crises are periods of disruption that occur at transition points during normal growth and development. Developmental crises, as a rule, do not occur suddenly. They are more evolutionary than revolutionary. Even the advancing age, illness, or death of a grandparent or parent is a developmental expectation. However, the actual event may occur suddenly. Experiencing damage from a windstorm, a home invasion, and an automobile crash are situational crises.

Question 2

A community health nurse is preparing a presentation for a community center group about crisis. Which concepts about situational crises should be included in the presentation? Select all that apply.

Accepted Answer

A situational crisis is a stressful, disrupting event arising from external circumstances that occur suddenly to a person, group, aggregate, or community. Situational crises often occur without warning. Situational crises occur to people because of where they are in time and space. Situational crises cannot be predicted, expected, or planned. Some situational crises arise from positive events such as significant job promotion or sudden acquisition of great wealth because the change makes increased demands on individuals who must make major life adjustments.

Question 3

Which statement about primary prevention for family violence is most accurate?

Accepted Answer

Primary prevention includes planned activities undertaken by the nurse to prevent an unwanted event from occurring. The cycle of violence within the family can be interrupted, and persons who have been victims of family violence can learn to use more appropriate coping strategies. It is possible for the community health nurse to foster healthful practices that will counteract unhealthful influences.

Question 4

The nursing student reads the textbook in preparation for a class meeting about primary, secondary, and tertiary prevention related to families in crisis. The student associates which statement as being most accurate regarding the levels of prevention?

Accepted Answer

Often people in crisis are temporarily helpless and unable to cope on their own, but understand the need for outside help and are receptive to other people's suggestions. Primary prevention, not secondary prevention, involves actions that help to prevent an unwanted event from occurring. Tertiary prevention focuses on moving past the crisis, although returning to the precrisis state may not be possible. Primary prevention is the most effective level of intervention in terms of promoting client's health and containing costs.

Question 5

After teaching a class about family and domestic violence directed toward children as a community health problem, which, if stated by the class, indicates to the instructor that the teaching was effective?

Accepted Answer

The history of family and domestic violence is long. For centuries, children were thought of as the property of their parents, and any treatment doled out by the parents was their prerogative. It is only fairly recently in history (early 1900s) that groups have become concerned and begun to do something about family violence. Family violence is brought to the attention of officials more frequently today than in yesteryear, especially in urban areas where more people live, but it occurs throughout the world-in urban, rural, and remote areas with no signs of decreasing. Family violence in the United States occurs mostly in the urbanized areas where exposure to crime is more prevalent. Family violence is decreasing in industrialized countries in the world as a result of more public awareness.

Question 6

After teaching a group of students about abuse and families, the instructor determines that the students have an understanding of this issue when they state:

Accepted Answer

Intimate partner violence is a leading cause of morbidity and mortality in women worldwide and is a public health issue. It is estimated that between 10% and 52% of women report being physically abused by an intimate partner at some point in their lives worldwide. A woman's risk of intimate partner violence increases during pregnancy with 44% to 48% of all women being abused at least once during the pregnancy.

Question 7

In preparation for an examination on the history of family violence, a group of students review the various laws enacted for protection. The students demonstrate understanding when they identify which as one of the earliest laws enacted?

Accepted Answer

In 1974, the Child Abuse Prevention and Treatment Act was passed, becoming Public Law 93-247 (PL 93-247). The Child Abuse Prevention and Treatment and Adoption Reform Act of 1978 was followed by the Family Violence Prevention and Services Act of 1984. Later, all three acts were consolidated into the Child Abuse Prevention, Adoption, and Family Services Act of 1988 (Public Law 100-294), and most recently, the Act was amended and reauthorized as the Keeping Children and Families Safe Act.

Question 8

A community health nurse suspects Munchausen's syndrome by proxy when a child:

Accepted Answer

Experiencing seizures only when a parent is present would be a "red flag" for this syndrome if it were occurring in a child. Stunted growth, limp, or acting out are not associated with Munchausen's syndrome by proxy.

Question 9

Which would lead a community health nurse to suspect possible child neglect? Select all that apply.

Accepted Answer

Educational neglect involves Lucy missing school to watch her baby sister, and general neglect is evident for the twins and Samantha. Sam may be appropriately dressed based on how hard and long he is playing-he may be comfortable. Although Tommy is missing a number of days of school, he has a legitimate excuse. Fourteen is an appropriate and legal age to babysit.

Question 10

Which would the community health nurse identify as an act of sexual exploitation of a child?

Accepted Answer

Sexual exploitation of children includes conduct or activities related to pornography that depict minors in sexually explicit situations and promotion of prostitution by minors. Sexual assault includes rape, gang rape, incest, sodomy, lewd, or lascivious acts with a child younger than 14 years of age (in most states), oral copulation, fondling of the child's genitals, penetration of the genital or anal opening by a foreign object, and child molestation.

Question 11

A community health nurse assesses a child during a home visit. Which would lead the nurse to suspect that the child is a victim of sexual abuse?

Accepted Answer

A sign of sexual abuse would be complaints of pain on urination or defecation. Bruising on the arms and back and burns on the hands and feet would suggest physical abuse. Numerous dental caries may suggest neglect.

Question 12

A group of families are attending a local community group for a class on Internet safety and children. Which statement by the group indicates effective teaching?

Accepted Answer

To promote Internet safety with children, the computer should be placed in a high traffic area in the home so that others can easily observe what is going on. Parents need to monitor the time as well as the sites that the child uses. The Internet security browser should be set to high. With the advances in technology, a firewall program that is 2 years old may not be adequate to protect the child. However, it would be better than no firewall program at all.

Question 13

While visiting a family in their home, a community health nurse hears a parent screaming who says, "Everything you do is wrong. Can't you do anything right ever?" Which does the nurse suspect?

Accepted Answer

Emotional abuse involves psychological mistreatment or neglect and may involve verbal abuse such as statements like, "Everything you do is wrong. Can't you do anything right?" Neglect occurs when physical, emotional, medical, or educational resources necessary for healthy growth and development are withheld or unavailable. Sexual abuse involves acts of sexual assault or sexual exploitation of a minor. Physical abuse is intentional harm that results in pain, physical injury, or death.

Question 14

When describing the cycle of violence to a group of students, the instructor includes which as occurring as the cycle continues?

Accepted Answer

As the cycle of violence continues, the frequency of the cycle increases, with the tension-building phase and the acute battering incident occurring more often, and elimination of the loving reconciliation phase. Without intervention, this shorter, more violent cycle becomes increasingly risk filled, for outcomes that may lead to injury or maiming of a partner, incarceration, or death of a partner.

Question 15

Which would a community health nurse expect to assess in a perpetrator of intimate partner violence?

Accepted Answer

Characteristics of perpetrators of intimate partner violence include a belief in strict gender roles, such as male dominance, heavy alcohol and drug use, low academic achievement, and desire for power and control in relationships.

Question 16

When discussing elder abuse with a senior citizen group, which would the community health nurse include?

Accepted Answer

Types of elder abuse include physical abuse, emotional abuse, neglect, and exploitation. Older women experienced abuse at a higher rate than older men. The perpetrators of elder abuse may be either known or unknown to the elder. Some elders are especially vulnerable to elder abuse.

Question 17

A community health nurse is designated as a "mandated reporter." Which best describes this designation?

Accepted Answer

The abuse or neglect simply needs to be suspected in order for the nurse to report. In most states, the nurse can receive a jail sentence and a fine for not reporting suspected abuse. Reporters may never witness the actual abusive event, but they can often see the resulting damage. Each nurse follows through with reporting abuse and neglect cases she or he suspects according to the community's laws.

Question 18

A community health nurse is providing a community education program about suicide. Which is the age group that has the second leading cause of death?

Accepted Answer

Suicide is the second leading cause of death among 10- to 34-year-olds. It is the fourth leading cause of death for those at 35 to 54 years and eighth leading cause of death among 55 to 64 years.

Question 19

Which action would be least appropriate for a community health nurse to include when developing plan of care at the secondary prevention level for families who may need to respond in a case of crisis in the future?

Accepted Answer

Helping to reestablish a sense of safety would be appropriate at the secondary level of prevention. Teaching social problem-solving skills, helping women develop assertiveness skills, and providing parenting classes are appropriate primary prevention level activities.

Question 20

When assessing a family in crisis, which action would the community health nurse need to take first?

Accepted Answer

Initially, the nurse must assess the nature of the crisis and the client's response to it. Next, the nurse focuses on the clients' perceptions of the event. Then, the nurse determines who is available for support to the individual or family. Finally, the nurse assesses the clients' coping abilities.

Quiz 18: Violence Abuse