Question 1

An individual who has been physically abused says,"When I called the police,I just wanted my spouse to stop shoving me around and kicking me.I didn't want anyone to get in trouble.It's easy to get angry with me because I spend too much money." Which comment by the nurse would be most therapeutic for this individual?

Accepted Answer

The correct option uses a therapeutic nursing communication to facilitate the victim of abuse to view the spouse's behavior in a more rational manner.Physical abuse is not excusable under any circumstances.

Question 2

Which patient is at greatest risk for physical abuse by a family member?

Accepted Answer

Among the aspects putting the 79-year-old patient at greatest risk for physical abuse by a family member are being elderly and experiencing a psychiatric illness.

Question 3

An adolescent claims to have been physically abused by a parent.The adolescent's other parent angrily tells the nurse,"It's ridiculous for our child to accuse my spouse,who is a prominent doctor respected by the community." The nurse responds:

Accepted Answer

The correct option effectively uses the therapeutic nursing communication of reflection.By reflecting back to the patient what she has said,the nurse assists the patient to view the statement in perspective.

Question 4

Which assessment finding most clearly indicates that a rape victim is exhibiting behavior typically seen in the acute stage of sexual assault? The victim:

Accepted Answer

The acute stage,immediately after the attack,is characterized by extreme confusion,fear,disorganization,and restlessness.Although many victims will be visibly upset,some may mask these feelings and appear to be outwardly calm or subdued.Overly assertive behavior and the use of profanity may or may not reflect the patient's ability to cope with the events.The panic attack months after the event describes the second stage of sexual assault,which involves long-term reorganization.

Question 5

Which statement best indicates use and abuse of power in a violent family situation?

Accepted Answer

The correct option shows clear indication that the husband has power over his wife as she expresses agreement with his expectations and indicates she "should know better." The other options are examples of individuals feeling victimized and partners who are able to leave or participate in the situation without becoming victims.

Question 6

A patient with swelling and a laceration above the right eye states,"I don't know what caused me to fall and cut my head on the door frame." The patient's spouse appears nervous but smiles when mentioning that the patient is "so clumsy at times." The nurse should give priority attention to which intervention when addressing this patient's needs?

Accepted Answer

The correct option reflects the nurse's appropriate attention to the determination of any physical indications that physical abuse may have occurred (Maslow's Hierarchy).The remaining options do not address this priority but rather focus on the emotional aspect of the situation.

Question 7

An Arab student new to an elementary school reports,"I don't want to go to gym class.It's never been a good class for me." Which factor would be of primary concern for a school nurse?

Accepted Answer

The child's complaint is vague.Although all the options are possible,the most common reason for a child to be resistant to a particular class relates to past experiences,such as having been a victim of bullying.This would be the most likely,and thus primary,concern.This option is the only one that reflects a safety issue.

Question 8

A person currently in an abusive relationship tells a nurse,"My partner is really sorry for hitting me and wants to come back and be part of the family again." The nurse should provide which intervention?

Accepted Answer

There are community groups that help abusive individuals relearn coping mechanisms that are appropriate.This option is the only one that provides an appropriate,therapeutic intervention.

Question 9

A nursing colleague says,"This patient was admitted claiming to have been raped by her boyfriend,but just look at the sexy clothes she's wearing." Which response reflects an understanding of the most likely source of the colleague's comment?

Accepted Answer

The correct option is the most professional response to a colleague who shows evidence of a bias.Although most nurses do not actually blame survivors for what has happened to them,research reveals that they are less tolerant of certain behaviors,such as going out late at night,not locking car doors,wearing provocative clothing,or not resisting the assault "enough." The first step in providing effective nursing care in this situation is exploring one's own attitudes toward victims of this crime.

Question 10

An individual whose boyfriend raped her tells the nurse,"It's no use reporting it.Everyone knows I've been sexually intimate with him many times before." The nurse's initial response should be:

Accepted Answer

Contrary to some thinking,if a person says "no," the partner is responsible for respecting and complying with the request.Violence counseling is appropriate for both individuals in order to stress the importance of communication and respect between sexual partners.

Question 11

An older adult patient exhibits bilateral bruising for the second time on both upper outer arms.When the nurse questions the patient about the bruising,the patient starts to cry and pleads,"Please don't say anything.It's not my daughter's fault.I just bruise easily." Which intervention reflects the best management of this situation?

Accepted Answer

Although it is often difficult to differentiate elder abuse,bilateral bruising on the upper outer arms is a definitive sign.The nurse is responsible for reporting such findings and continuing vigilant observation for further signs of elder abuse and neglect.It is usually best to inform the family of your intention to report elder abuse with the expressed purpose of obtaining help for both; this makes protective services less threatening and preserves the nurse's therapeutic alliance.

Question 12

A young,newly married adult says,"My spouse never lets me out of sight.I'm not allowed to do anything on my own,and I'm constantly accused of cheating." Which nursing comment is most therapeutic for this individual?

Accepted Answer

The most therapeutic communication is the one that facilitates the patient's expression of feelings.

Question 13

When a nurse overhears the spouse of a patient threaten to "punch you in the face if you don't shut up" while sitting in the unit's dayroom,which action reflects the most immediate,therapeutic nursing intervention?

Accepted Answer

The most therapeutic nursing intervention is to address the immediate threat of harm.By notifying hospital security the situation can be managed by individuals trained to do so effectively.

Question 14

Which behavior would the nurse expect in a person who commits psychic rape? The perpetrator:

Accepted Answer

Psychic rape involves an assault on the victim's dignity and self-respect.Examples include verbal assault,street harassment,pornography in the media,and portrayals of violent sex.Giving money after rape describes an economic partnership.Gift giving describes a seduction rape.Threats describe a fear rape.

Question 15

Which is the most appropriate initial action for a nurse when attempting to overcome personal negative attitudes about a patient who has a history of returning to an abusive spouse?

Accepted Answer

The first step toward effective intervention with survivors of family violence is the exploration of one's own attitude toward and knowledge about violence.

Question 16

Which comment best reflects the nurse's use of an empowerment model with an individual who has been abused?

Accepted Answer

The correct option uses an empowerment model by assuming mutuality in sharing and providing respect for what the survivor knows.

Question 17

Which comment by the nurse would be most effective when using an empowerment model of intervention with an individual who has been abused?

Accepted Answer

The correct option is a therapeutic reflection that helps the patient to sort out the fears that many victims of abuse have that their children will suffer without the other parent present.Commenting on a patient's history is sarcastic and nontherapeutic since it likely reflects the nurse's bias against the battered individual's ambivalence rather than viewing it as a normal part of the process that individuals who have been abused experience.

Question 18

Which intervention would be the best initial approach for a nurse to take when a young adult patient is verbally abusive?

Accepted Answer

This question asks that behaviors for intervention be prioritized.First,it is necessary to help the patient identify the problem and to set criteria for future communications.

Question 19

What is the best initial approach for a nurse when managing the care of an individual with two children who works full-time and has been abused by a partner?

Accepted Answer

In order to best provide support,the nurse must fully understand the patient's needs.This is done before support options can be determined.The other options are examples of interventions for needs that have not yet been determined.

Question 20

Which comment by the nurse would be most effective in teaching a patient about abusive behavior?

Accepted Answer

The correct option is an illustration of how the nurse might help the patient to look at her husband's attempt to undermine her sexuality to inappropriately justify his infidelity.This is a form of sexual abuse.Questioning the son's behavior helps the patient to place fears (as yet unjustified by the patient's example) in perspective.The need to maintain control over the son's spending decisions describes a common parental error when first giving a child an allowance; the nurse will seek to clarify boundaries while remaining alert to the parent's attempts to maintain total control over all financial dealings of the child.Skepticism describes the patient's inability to acknowledge a parent's response as supportive.

Quiz 38: Care of Survivors of Abuse and Violence