Question 1

Which comment by the nurse would best support relationship building with a survivor of intimate partner abuse? a. “You are feeling violated because you thought you could trust your partner.” b. “I’m here for you. I want you to tell me about the bad things that happened to you.” c. “I was very worried about you. I knew you were living in a potentially violent situation.” d. “Abusers often target people who are passive. I will refer you to an assertiveness class.”

Accepted Answer

ANS: A Offering hope, identifying strengths, and displaying confidence that the person can take care of him- or herself are important aspects of nursing care. The correct option uses the therapeutic technique of reflection. It shows empathy, an important nursing attribute for establishing rapport and building a relationship. None of the other options would help the patient feel accepted.

Question 2

An 11-year-old reluctantly tells the nurse, “My parents don’t like me. They said they wish I was never born.” Which type of abuse is likely? a. Sexual b. Physical c. Emotional d. Economic

Accepted Answer

ANS: C Examples of emotional abuse include having an adult demean a child’s worth, frequently criticize, or belittle the child. No data support physical battering or endangerment, sexual abuse, or economic abuse.

Question 3

What feelings are most commonly experienced by nurses working with abusive families? a. Outrage toward the victim and discouragement regarding the abuser b. Helplessness regarding the victim and anger toward the abuser c. Unconcern for the victim and dislike for the abuser d. Vulnerability for self and empathy with the abuser

Accepted Answer

ANS: B Intense protective feelings, helplessness, and sympathy for the victim are common emotions of a nurse working with an abusive family. Anger and outrage toward the abuser are also common emotions of a nurse working with an abusive family.

Question 4

Which rationale best explains why a nurse should be aware of personal feelings while working with a family experiencing family violence? a. Self-awareness enhances the nurse’s advocacy role. b. Strong negative feelings interfere with assessment and judgement. c. Strong positive feelings lead to healthy transference with the victim. d. Positive feelings promote the development of sympathy for patients.

Accepted Answer

ANS: B Strong negative feelings cloud the nurse’s judgement and interfere with assessment and intervention, no matter how well the nurse tries to cover or deny feelings. Strong positive feelings lead to overinvolvement with victims rather than healthy transference.

Question 5

The parents of a 15-year-old seek to have this teen declared a delinquent because of excessive drinking, habitually running away, and prostitution. The nurse interviewing the teen should recognize that these behaviours often occur in which of the following adolescents? a. Adolescents who have been abused b. Adolescents who are attention-seeking c. Adolescents who have eating disorders d. Adolescents who are developmentally delayed

Accepted Answer

ANS: A Failing grades, alcohol and drug abuse, increased incidence of theft and violent behaviours, running away from home, and unstable and unsatisfactory relationships are frequently seen in teens who are abused. These behaviours are not as closely aligned with any of the other options.

Question 6

What is a nurse’s legal responsibility if child abuse or neglect is suspected? a. Discuss the findings with the child’s parent and health care provider. b. Document the observation and suspicion in the medical record. c. Report the suspicion according to provincial or territorial regulations. d. Continue the assessment.

Accepted Answer

ANS: C According to provincial or territorial legislation, any suspected or actual cases of child abuse must be reported to the official social service agency. The nurse is a mandated reporter. The reporter does not need to be sure that abuse or neglect occurred, only that it is suspected. Speculation should not be documented, only the facts.

Question 7

Several children are seen in the emergency department for treatment of various illnesses and injuries. Which assessment finding would create the most suspicion for child abuse? a. The child with complaints of abdominal pain b. The child who has repeated middle ear infections c. The child with bruises on extremities d. The child with diarrhea

Accepted Answer

ANS: C Determine whether a child demonstrates signs of physical abuse, including numerous injuries in various stages of healing; unexplained bruises and welts; unexplained pattern, immersion, and friction burns; facial, spiral, shaft, or multiple fractures; unexplained facial lacerations and abrasions. In older children, vague complaints such as back pain may also be suspicious. Ear infections, diarrhea, and abdominal pain are problems that were unlikely to have resulted from violence.

Question 8

An 11-year-old says, “My parents don’t like me. They call me stupid and say they wish I were never born. It doesn’t matter what they think because I already know I’m dumb.” Which nursing diagnosis applies to this child? a. Chronic low self-esteem related to negative feedback from parents b. Deficient knowledge related to interpersonal skills with parents c. Disturbed personal identity related to negative self-evaluation d. Complicated grieving related to poor academic performance

Accepted Answer

ANS: A The child has indicated a belief in being too dumb to learn. The child receives negative and demeaning feedback from the parents. The child has internalized these messages, resulting in a low self-esteem. Deficient knowledge refers to knowledge of health care measures. Disturbed personal identity refers to an alteration in the ability to distinguish between self and non-self. Grieving may apply, but a specific loss is not evident in the scenario. Low self-esteem is more relevant to the child’s statements.

Question 9

An adult has recently been absent from work for 3-day periods on several occasions. Each time, the individual returned wearing dark glasses. Facial and body bruises were apparent. What is the occupational health nurse’s priority assessment? a. Interpersonal relationships b. Work responsibilities c. Socialization skills d. Physical injuries

Accepted Answer

ANS: D The individual should be assessed for possible battering. Physical injuries are abuse indicators and are the primary focus for assessment. No data support the other options.

Question 10

A young adult has recently had multiple absences from work. After each absence, this adult returned to work wearing dark glasses and a long-sleeved shirt. During an interview with the occupational health nurse, this adult says, “My partner beat me, but it was because I did not do the laundry.” What is the nurse’s next action? a. Call the police. b. Arrange for hospitalization. c. Call the relevant social services agency. d. Document injuries with a body map.

Accepted Answer

ANS: D Documentation of injuries provides a basis for possible legal intervention. In most provinces and territories, the abused adult needs to make the decision to involve the police, unless there are issues of age or competency. Because the worker is not a child and is competent, a provincial or territorial social services agency is unable to assist. Admission to the hospital is not necessary.

Question 11

A patient tells the nurse, “My husband lost his job. He’s abusive only when he drinks too much. His family was like that when he was growing up. He always apologizes and regrets hurting me.” What risk factor was most predictive for the husband to become abusive? a. History of family violence b. Loss of employment c. Abuse of alcohol d. Poverty

Accepted Answer

ANS: A An abuse-prone individual is an individual who has experienced family violence and was often abused as a child. This phenomenon is part of the cycle of violence. The other options may be present but are not as predictive.

Question 12

An adult tells the nurse, “My partner abuses me when I make mistakes, but I always get an apology and a gift afterward. I’ve considered leaving but haven’t been able to bring myself to actually do it.” Which phase in the cycle of violence prevents this adult from leaving? a. Tension-building b. Acute battering c. Honeymoon d. Stabilization

Accepted Answer

ANS: C The honeymoon stage is characterized by kind, loving behaviours toward the abused spouse when the perpetrator feels remorseful. The victim believes the promises and drops plans to leave or seek legal help. The tension-building stage is characterized by minor violence in the form of abusive verbalization or pushing. The acute battering stage involves the abuser beating the victim. The violence cycle does not include a stabilization stage.

Question 13

After treatment for a detached retina, a survivor of intimate partner abuse says, “My partner only abuses me when I make mistakes. I’ve considered leaving, but I was brought up to believe you stay together, no matter what happens.” Which diagnosis should be the focus of the nurse’s initial actions? a. Risk for injury related to physical abuse from partner b. Social isolation related to lack of a community support system c. Ineffective coping related to uneven distribution of power within a relationship d. Deficient knowledge related to resources for escape from an abusive relationship

Accepted Answer

Risk for injury is the priority diagnosis because the partner has already inflicted physical injury during violent episodes. The other diagnoses are applicable, but the nurse must first address the patient’s safety.

Question 14

A survivor of physical spousal abuse was treated in the emergency department for a broken wrist. This patient said, “I’ve considered leaving, but I made a vow and I must keep it no matter what happens.” Which outcome should be met before discharge? a. Staff will lay charges against the abuser with police. b. The patient will name two community resources for help. c. The patient will demonstrate insight into the abusive relationship. d. The patient will reexamine cultural beliefs about marital commitment.

Accepted Answer

ANS: B The only outcome indicator clearly attainable within this time is for staff to provide the victim with information about community resources that can be contacted. Development of insight into the abusive relationship and reexamining cultural beliefs will require time. The patient may or may not press charges against the abuser with the police; however, this is not an outcome to be met before discharge.

Question 15

An older adult with Lewy body dementia lives with family and attends a day care centre. A nurse there noticed the adult had a disheveled appearance, strong odor of urine, and bruises on the limbs and back. What type of abuse might be occurring? a. Psychological b. Financial c. Physical d. Sexual

Accepted Answer

Lewy body dementia results in cognitive impairment. The assessment of physical abuse would be supported by the nurse’s observation of bruises. Physical abuse includes evidence of improper care as well as physical endangerment behaviours, such as reckless behaviour toward a vulnerable person that could lead to serious injury. No data substantiate the other options

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Chapter 27: Interpersonal Violence: Child, Older Adult, and Intimate Partner Abuse Flashcards

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