interpersonal violence

Question 1

interpersonal or domestic violence

Answer 1

a pattern of coercive behavior in which one person attempts to control another through threats or actual use of physical violence, sexual assault and/or verbal and psychological abuse.

Question 2

what is one of the most common causes of injury to women

Answer 2

battering

Question 3

what has changed over the years as far as domestic violence

Answer 3

Increased awareness, ability to obtain help, and more readily available information have helped in raising the rate of reporting.

Increasing incidence of men reporting victimization at the hands of women.

Question 4

effects of family violence

Answer 4

•It isolates the person being abused and robs inner strength, self-worth and the ability to make personal choices. Often people experiencing abuse begin to feel responsible for the abuse.
•
•It traumatizes children, destroying their ability to feel safe in the world and causing them to feel responsible for the abuse.

Question 5

effect on children with domestic violence

Answer 5

–Development adversely affected
Energy needed to accomplish developmental tasks successfully goes
to coping with family violence

Question 6

effect on adolescents domestic violence

Answer 6

–Poorer coping and social skills
–Higher incidence of dissociative
identity disorder
–Poorer impulse control

Question 7

secondary effects of violence

Answer 7

• Anxiety
• Depression
• Suicidal ideation

Question 8

Types of maltreatment

Answer 8

• Physical violence: infliction of physical pain or bodily harm
• Sexual violence: any form of sexual contact or exposure without consent
• Emotional violence: infliction of mental anguish; threatening, humiliating, intimidating, isolating behavior
• Physical neglect: failure to provide medical, dental, or psychiatric care as needed
• Developmental neglect: failure to provide nurturing and stimulation needed to ensure meeting developmental milestones
• Educational neglect: depriving a child of an education
• Economic maltreatment: illegal or improper exploitation of funds or other resources for own person gain or withholding of support

Question 9

actual occurence of violence requires

Answer 9

1. Perpetrator
2. Vulnerable person
3. Crisis situation

Question 10

characteristic of perpetrator

Answer 10

• Their needs are more important than the needs of others
• Extreme pathological jealousy
• May control family finances
• Likely to abuse alcohol or drugs
• Poor social skills, relationship with partner enmeshed and codependent

Question 11

characteristics of vunerable person (partner)

Answer 11

• Legal marriage or pregnancy may initiate or increase violence
• Greatest risk for violence when partner attempts to leave relationship

Question 12

characteristics of a vunerable person (child)

Answer 12

• Younger than 3 years
• Perceived as different
• Product of an unwanted pregnancy
• Premature
• Prolonged illness

Question 13

characteristics of a vulnerable person (elderly)

Answer 13

• Poor mental or physical health
• Dependent on perpetrator
• Female, older than 75 years, white, living with a relative
• Daughter is caring for elderly father who abused her when she was a child
• Elderly woman cared for by husband who has abused her in the past

Question 14

what is a crisis situation

Answer 14

•Situation that puts stress on a family with a violent member

Question 15

cycle of violence

Answer 15

•Process of escalation/de-escalation

Tension-building stage

Attempts to reduce tension by both partners

Acute battering stage

Honeymoon stage

Tension builds and cycle continues

Question 16

phase I (tension building phase)

Answer 16

•Abuser:
–Demonstrates increased tension by lashing out at victim/minor battering
–Has increased fear of abandonment, jealousy, possessiveness
–Interprets victim’s withdrawal as rejection -> more anger

Victim:

Becomes nurturing & compliant to prevent escalation

Often accepts abuse as legitimate

Denies own anger/rationalizes abuser’s behavior

Increased battering -> decreased ability to cope -> withdrawal

Question 17

phase II (acute battering incident)

Answer 17

•Abuser:
–Justifies behavior to self – wants to “just teach a lesson” -> severe battering
–Cannot understand what happened, doesn’t know how control was lost
–Often minimizes severity of battering

Victim:

May intentionally provoke abuser’s behavior because tension of Phase I has become unbearable

Knows from experience that once acute phase is over things will be better

Beating is severe & victim can often describe violence in detail, dissociating self from own body

Help is sought if severe injury, victim fears for own life or severe injury/death to children

Question 18

PHASE III: Calm, Loving, Respite (Honeymoon)

Answer 18

•Abuser:
–Loving, kind, contrite
–Promises to never repeat behavior
–Begs forgiveness, fears losing victim so attempts to charm
–Believes can control behavior & now that “lesson has been taught”, victim will not “act up” again
–Plays on victim’s feelings of guilt for having “provoked” the incident

Victim:

Desperately wants to believe abuse won’t happen again

Relives dream of “ideal” love & chooses to believe that the “ideal” is really what is shared with abuser

This loving phase becomes victim’s perception of relationship

Victim bases staying in the relationship on this “magical” ideal phase.

Question 19

Which rationale best explains why a nurse needs to be aware of feelings while working with a family experiencing family violence?

a.

Self-awareness protects one’s own mental health.

b.

Strong negative feelings interfere with assessment and judgment.

c.

Strong positive feelings lead to underinvolvement with the victim.

d.

Positive feelings promote the development of sympathy for patients.

Answer 19

b.

Strong negative feelings interfere with assessment and judgment.

Question 20

A person at the emergency department reports severe headaches. The individual is

accompanied by a spouse who insists on staying in the room during the examination and answering all questions. The patient avoids eye contact, has a sad affect, and has slumped shoulders. A concussion is diagnosed. Assessment of which additional problem has

priority?

a.

Risk of domestic abuse

b.

Phobia of crowded places

c.

Major depression

d.

Migraine headaches

Answer 20

a.

Risk of domestic abuse

Question 21

A married individual has recently been absent from work for 3-day periods on several occasions. Each time, the individual returned to work wearing dark glasses. Facial and body bruises were apparent. The assessment priority when the occupational health nurse interviews the patient is:

a.

interpersonal relationships.

b.

work responsibilities.

c.

socialization skills.

d.

physical injuries.

Answer 21

d.

physical injuries.

Question 22

A patient has a history of physical violence against family when frustrated and then periods of remorse after each outburst. The plan of care would be considered successful when the patient:

a.

expresses frustration verbally instead of physically.

b.

agrees to seek counseling.

c.

explains the rationale for behaviors to the victim.

d.

identifies three personal strengths.

Answer 22

a.

expresses frustration verbally instead of physically.

Question 23

A woman was grabbed by a man as she walked home from work. The attacker put a gun to her head, taped her mouth, tied her hands, took her to a remote location, and raped her. When she was found she was taken to the emergency department, where she received care. Which aspect of this crisis produced the greatest amount of psychological trauma?

a.

The threat to her life

b.

The memory of the event

c.

The physical pain experienced

d.

The collection of evidence

Answer 23

a.

The threat to her life

Question 24

A patient was abducted and raped at gunpoint by an unknown assailant. Which assessment finding best indicates the patient is in the acute phase of the Rape-trauma syndrome?

a.

Confusion and disbelief

b.

Flashbacks and dreams

c.

Decreased motor activity

d.

Fears and phobias

Answer 24

a.

Confusion and disbelief

Question 25

When an emergency department nurse teaches a victim of Rape-trauma syndrome about reactions that may be experienced during the long-term phase, which symptoms should be included? (More than one answer is correct.)

a.

Flashbacks, dreams

b.

Decreased motor activity

c.

Development of fears and phobias

d.

Feelings of numbness

e.

Syncopal episodes

Answer 25

a.

Flashbacks, dreams

c.

Development of fears and phobias

d.

Feelings of numbness