38 - Violence and Human Abuse

Question 1

Homicide is the second leading cause of death among which population?

a. ) Individuals between 15 and 24 years of age
b. ) Native American infants
c. ) Caucasian women between 25 and 34 years of age
d. ) African American children between 15 and 19 years of age

Answer 1

a.) Individuals between 15 and 24 years of age

Homicide is the second leading cause of death for individuals between 15 and 24 years of age. Rates of homicide for children under the age of 1 were highest in Non-Hispanic blacks and American Indian/Alaska Native infants.

Question 2

A nurse is completing a community assessment. Which of the following community characteristics would be identified as a factor for violence?

a. ) Lack of family cohesion
b. ) High crime rate
c. ) Social isolation
d. ) Substance abuse

Answer 2

b.) High crime rate

High crime rate is the only “community characteristic.” Lack of family cohesion is a familial factor. Social isolation and substance abuse are individual factors.

Question 3

What factor associated with crime and violence is particularly important to community health nursing practice?

a. ) Violence is a universal problem.
b. ) Violence impacts everyone in the United States.
c. ) Nurses must spend a great deal of time on the results of violence.
d. ) Significant mortality and morbidity result from violence.

Answer 3

d.) Significant mortality and morbidity result from violence.

Communities across the United States are concerned about crime and violence rates because of significant mortality and morbidity that often result. These issues are closely related to community health nursing. While it is true that violence is universal, and so to some degree affects all citizens, resulting in the need for nursing care, these issues relate to nursing in general and especially those involved in direct care of the patient’s physical and emotional needs.

Question 4

A nurse is working with a recent rape survivor. Which of the following actions would be most appropriate for the nurse to implement?

a. ) Provide continuous care once the victim enters the health care system
b. ) Examine evidence for its authenticity
c. ) Work with the criminal justice system to find the rapist
d. ) Provide long-term therapy for psychological trauma

Answer 4

a.) Provide continuous care once the victim enters the health care system

Not only do nurses often provide continuous care, in some states nurses are trained as sexual assault examiners who gather forensic evidence. Nurses provide victims with privacy, respect, and assurance of confidentiality. The nurse would not be providing long-term therapy for the survivor or have the responsibility to find the rapist.

Question 5

A nurse working at a battered woman’s shelter is counseling a pregnant woman who has just entered the shelter. When assessing the client’s history, which information would the client most likely report?

a. ) A history of abuse before pregnancy
b. )A history of child abuse
c. ) A history of multiple pregnancies
d. ) A history of substance abuse

Answer 5

a.) A history of abuse before pregnancy

Abuse before pregnancy is the most important risk factor for physical battery during pregnancy. A history of child abuse, multiple pregnancies, and substance abuse are not as closely associated with the risk of physical battery during pregnancy.

Question 6

A nurse is caring for a woman who has been battered for a number of years. Which of the following has the client most likely seen an increase in over the years?

a. ) Self-blame
b. ) Remorse by the man
c. ) Severity of the abuse
d. ) Emotional strength

Answer 6

c.) Severity of the abuse

Severity of abuse and its frequency is most likely to increase over time. Both the man and the woman tend to blame the incident on something external. The man’s remorse tends to lessen over time.

Question 7

The greatest risk factor for suicide in adult women is:

a. ) divorce.
b. ) unemployment.
c. ) intimate partner violence.
d. ) terminal illness.

Answer 7

c.) intimate partner violence.

The greatest risk factor for actual and attempted suicide in adult women is intimate partner violence.

Question 8

A nurse is assisting with community planning. Which of the following facilities should the nurse encourage be developed to reduce the potential for crime and violence in the community? (Select all that apply.)

a. ) Playgrounds
b. ) Movie theaters
c. ) Swimming pools
d. ) Shopping malls
e. ) Restaurants

Answer 8

a.) Playgrounds

b.) Movie theaters

c.) Swimming pools

Recreational facilities including playgrounds, movie theaters, and swimming pools all provide socially acceptable outlets for a variety of feelings, including aggression.

Shopping malls and restaurants would not be considered recreational facilities.

Question 9

Homicides are least likely to be perpetrated by a(n):

a. ) friend.
b. ) acquaintance.
c. ) family member.
d. ) stranger.

Answer 9

d.) stranger.

Homicides are least likely to be committed by a stranger. When strangers are involved, many of these are related to the illegal substance abuse network. Homicides are usually perpetrated by friends, acquaintances, or family members during an argument.

Question 10

A nurse is developing a community program to prevent violence. Which of the following should be the first action taken by the nurse?

a. ) Talk to people who are victims of violence for their opinion
b. ) Identify factors that lead to violence
c. ) Develop a plan of action to combat violence
d. ) Evaluate current community programs

Answer 10

b.) Identify factors that lead to violence

A community’s population can influence the potential for violence. The starting point is the identification of factors that lead to violence, such as poverty, urban crowding, and racial inequality. In addition, one’s perceptions of the safety in a community can be influenced by racism and perceptions of criminality.

Question 11

A nurse is making a home visit to a low-income, frail, older person’s home. Which of the following would most likely cause the nurse to suspect adult maltreatment?

a. ) The older person reports giving money to family members on a regular basis.
b. ) The windows of the house are in need of repair.
c. ) The older person spends a great deal of time watching television.
d. ) There are dogs running loose in the yard of the home.

Answer 11

a.) The older person reports giving money to family members on a regular basis.

Older adults are at risk for financial abuse through fraud, coercion to relinquish property rights, and money mismanagement. A low-income, frail, older person would most likely not be giving money to family members on a regular basis, because the client would need the money to meet basic needs.

Question 12

A nurse is assessing a school-age child whose parents have reported recent violent activity from the child that is atypical from this child. Which of the following may have contributed to the child’s change in behavior?

a. ) Getting a new pet
b. ) Watching too much television
c. ) Playing violent video games
d. ) Having a new sibling at home

Answer 12

c.) Playing violent video games

Research on violent television and films, video games, and music demonstrates that media violence increases the likelihood of aggressive and violent behavior, both immediately and long-term. Parents and caregivers are critical in monitoring what reaches their children.

Question 13

A nurse is caring for a child who lives in extreme poverty. Which of the following types of abuse is this child at greatest risk for?

a. ) Sexual abuse
b. ) Emotional neglect
c. ) Physical neglect
d. ) Child abuse

Answer 13

c.) Physical neglect

Physical neglect is failure to provide adequate food, proper clothing, shelter, hygiene, or necessary medical care.

Emotional neglect is the omission of basic nurturing, acceptance, and caring of a child.

Child abuse ranges from violent physical attacks to passive neglect.

Sexual abuse is a form of child abuse when a child has had nonconsensual sexual contact of any kind.

Question 14

A nurse is providing care to a child who has been abused. Which characteristics are most likely present in this child’s family? (Select all that apply.)

a. ) The parents are unemployed.
b. ) There is no support network willing to offer assistance.
c. ) The parents are not knowledgeable about child development.
d. ) The mother seems frightened of her partner.
e. ) There is no primary caregiver in the home.

Answer 14

a.) The parents are unemployed.

b.) There is no support network willing to offer assistance.

c.) The parents are not knowledgeable about child development.

d.) The mother seems frightened of her partner.

Risk factors for child abuse include unemployed parents, no support network, parents not knowledgeable about child development, and a mother who is scared of her partner.

Question 15

Which statement about rape is true?

a. ) Rural areas are high-risk areas for rape to occur.
b. ) Most rapes occur in the winter.
c. ) Male victims suffer more emotional trauma than females.
d. ) College women are at high risk for experiencing rape.

Answer 15

d.) College women are at high risk for experiencing rape.

College women are at particularly high risk for sexual victimization in the United States, with research estimating that approximately 25% of female college students will experience an attempted or completed rape at some point during their college experience.
It appears that the emotional trauma for a male rape victim is at least as serious as that for a woman.

Question 16

What type of abuse is occurring when a child does not receive the basic nurturing and caring needed for healthy development?

a. ) Sexual abuse
b. ) Emotional neglect
c. ) Physical neglect
d. ) Child abuse

Answer 16

b.) Emotional neglect

Emotional neglect is the omission of basic nurturing, acceptance, and caring of a child.

Physical neglect is failure to provide adequate food, proper clothing, shelter, hygiene, or necessary medical care and is most often associated with extreme poverty.

Child abuse ranges from violent physical attacks to passive neglect.

Sexual abuse is a form of child abuse when a child has had nonconsensual sexual contact of any kind.

Question 17

A nurse is assessing an individual who has been the victim of domestic violence. Which part of the body should the nurse assess first?

a. ) Front of the body
b. ) Back of the body
c. ) Proximal parts of the body
d. ) Distal parts of the body

Answer 17

c.) Proximal parts of the body

Attacks are often inflicted on proximal parts of the body that can easily be disguised by clothing, so the nurse should assess this area first.

Question 18

A community health nurse visits a home and notices multiple bruises on a 4-year-old child. The mother reports that her husband is an alcoholic and is currently sleeping. What is the most appropriate action for the nurse to take?

a. ) Question the mother about sexual abuse
b. ) Initiate interventions directed at family violence
c. ) Report the case of suspected child abuse to authorities
d. ) Refer the mother to a social worker or Al-Anon group

Answer 18

c.) Report the case of suspected child abuse to authorities

It is required by law that nurses report all cases of suspected child abuse. The mandatory reporting laws protect reporters from legal action on cases that are never substantiated. It is essential that this is the first action to be taken by the nurse. After this action is taken, it may be appropriate to initiate interventions related to decreasing family violence or asking specifically about abuse. Referral of the mother to a social worker would not assist in decreasing the potential abuse that may be occurring.

Question 19

A nurse assists an injured victim in finding a safe location to live after being abused. Which of the following levels of prevention is being implemented?

a. ) Primary
b. ) Secondary
c. ) Tertiary
d. ) Primary care

Answer 19

b.) Secondary

Secondary prevention focuses on early detection and prompt treatment of disease, injury, or disability. Finding shelter for a victim of abuse demonstrates secondary prevention.

Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability.

Tertiary prevention refers to interventions aimed at treatment and rehabilitation.

Primary care is not a level of prevention.

Question 20

A nurse is working with children who may be at risk for experiencing abuse. In which situation is child abuse most likely to occur?

a. ) When the parents have high expectations for their children
b. ) When the parents’ sense of control is threatened
c. ) When the parents are sensitive to their children’s needs
d. ) When the parents lack a social support network

Answer 20

d.) When the parents lack a social support network

Parents with a lack of social support, history of abuse as a child, or who have minimum education, a tendency toward depression, or multiple stress factors may be at risk for abusing their children. Parents who have high expectations for their children or are sensitive to their children’s needs do not have a tendency toward abuse. Parents who have their sense of control threatened do not have a tendency toward abuse.

Question 21

A public health nurse (PHN) is working in a community where there have been multiple closures of large factories, leaving many individuals without employment. Which of the following is this population most at risk for?

a. ) Becoming an abuser at home
b. ) Committing violence in and outside the home
c. ) Developing addictive behaviors
d. ) Neglecting the needs of their children

Answer 21

b.) Committing violence in and outside the home

Unemployment is associated with violence within and outside the home. Abuse may increase both in and outside of the home due to unemployment. Applying for unemployment benefits is not a risk for this population. Neglecting the needs of their children only addresses what could happen inside of the home and not outside of the home.

Question 22

A nurse is providing tertiary prevention. Which of the following interventions should be included?

a. ) Education
b. ) Prevention
c. ) Referral
d. ) Detection

Answer 22

c.) Referral

Tertiary prevention refers to interventions aimed at treatment and rehabilitation. Nurses should know about available community resources for abuse victims and perpetrators. Education and prevention primarily deal with primary prevention strategies. Detection is part of secondary prevention.

Question 23

Which group has the highest rate of violence?

a. ) Older, Caucasian men
b. ) Young, minority men
c. ) Young, Caucasian women
d. ) Older, minority women

Answer 23

b.) Young, minority men

Young, minority men have the highest rate of unemployment in the United States, ranging upward to 50% even in times of prosperity. Unemployment may precipitate aggressive outbursts. Most analyses conclude that the differential rates of violence between African Americans and Caucasians in the United States have more to do with socioeconomic disparities, such as poverty, unemployment, and overcrowding, than with race.

Question 24

A nurse helps the community to take a stand against violence and advocates for elected officials and local media to make nonviolence a priority. Which of the following levels of prevention is being implemented?

a. ) Primary
b. ) Secondary
c. ) Tertiary
d. ) Primary care

Answer 24

a.) Primary

Primary prevention refers to those interventions aimed at preventing the occurrence of disease, injury, or disability. Being an advocate for nonviolence demonstrates primary prevention.

Secondary prevention refers to interventions aimed at early detection and screening.

Tertiary prevention refers to interventions aimed at treatment and rehabilitation.

Primary care is not a level of prevention.

Question 25

A nurse is counseling a client who has been abusive toward a spouse. Which of the following experiences has the client most likely had in the past?

a. ) Perceived or actual crisis
b. ) History of social isolation
c. ) Previous exposure to violence
d. ) Long-term marital strain

Answer 25

c.) Previous exposure to violence

Perpetrators of intimate partner violence often believe that violence within an interpersonal relationship is a normal behavior pattern, based on their upbringing, living conditions, and increased stress.

Question 26

A child has reported to the school nurse that he is being bullied. Which of the following is most likely happening to this child?

a. ) Difficulty talking to the guidance counselor
b. ) Inclusion in group activities
c. ) Intimidation by a peer
d. ) Discipline from parents at home

Answer 26

c.) Intimidation by a peer

Bullying has become a major problem in schools. Bullying can be physical and/or psychological abuse, intimidation, or verbal abuse; the exclusion of some children in group activities is another form of bullying.