Unit 9 - Maladaptive Behavior

Question 1

Definition of violence

Answer 1

Violence is the intentional use of physical force or power, threatened or actual, against oneself, another person, or a group or community, that either results in or has a high likelihood of resulting in injury, death, physiological harm, maldevelopment, or deprivation.

Question 2

Define interpersonal violence

Answer 2

When a violent act occurs between persons.

Question 3

Define patriarchal terrorism

Answer 3

Cases in which the male partner attempts to dominate and assume control over his partner.

Question 4

Define situational violence

Answer 4

Includes cases in which a situation produces an escalation of conflict and the partner initiates physical aggression based on the situational conflict.

Question 5

Define child abuse and neglect

Answer 5

Child abuse and neglect encompasses a wide variety of forms of child maltreatment, including physical abuse, sexual abuse, and neglect.

Question 6

Define bullying

Answer 6

Bullying is unwanted, aggressive behavior among school age children that involves a real or perceived power imbalance. The behavior is repeated, or has the potential to be repeated, overtime.

Question 7

Define youth violence

Answer 7

Youth violence typically involves young people hurting other peers who are unrelated to them and who they may or may not know well. Youth violence can take different forms. Examples include fights, bullying, threats with weapons, and gang related violence. A young person can be involved with youth violence as a victim, offender, or witness.

Question 8

Two health assessment questions for victims of intimate partner violence

Answer 8

Are you in a relationship with a person who physically hurts or threatens you? Do you feel controlled or isolated by your partner?

Question 9

Define elder abuse and neglect

Answer 9

Elder abuse includes physical abuse, emotional abuse, sexual abuse, exploitation, neglect, and abandonment. Offenders include youth, family members, and spouses – as well as staff at nursing homes, assisted-living, and other facilities.

Question 10

True or false?
It’s only child abuse if it’s violent.

Answer 10

False. Physical abuse is just one type of child abuse. Neglecting emotional abuse can be just as damaging, and since they are more subtle, others are less likely to intervene.

Question 11

True or false? Abused children do not always grow up to be abusers.

Answer 11

True.
It is true that abused children are more likely to repeat the cycle as adults unconsciously repeating what they have experienced as children. On the other hand, many adult survivors of child abuse have a strong motivation to protect their children against what they went through and become excellent parents.

Question 12

Define sexual violence

Answer 12

The term sexual violence is an all encompassing, non-legal term that refers to crimes like sexual assault, rape, and sexual abuse.

Question 13

True or false? Violence directed by an intimate partner toward the pregnant woman and her fetus, or during the first year after delivery, is often either not recognized by nurses or suspected but not addressed.

Answer 13

True.

Question 14

Describe depression as a mental health consequence of abuse.

Answer 14

Depression inhibits the ability of the abused individuals from formulating a plan to deal with the abuse. The inertia prevents the victim from taking proactive steps to leave the abusive situation, or if they leave, the ability to place the violence into a perspective that allows them to reinvest in an enjoyable and productive lifestyle.

Question 15

List some consequences of bullying for both a bully and the victim.

Answer 15

Risk for bullies to develop antisocial behavior. Victims of bullying often view themselves as outcasts and failures.
Risk for bullies includes criminal convictions and traffic violations. Victims have lasting affects such as anxiety, depression, psychological distress, poor physical health, and poor cognitive functioning.

Question 16

True or false. The most often ages for parents or caregivers to report child abuse are among infants from birth to one year of age.

Answer 16

True.

Question 17

Consequences of interpersonal violence for infants and children

Answer 17

Delinquency.
Adult criminality and violence
Aggression.
In cases of sexual abuse, PTSD, and developmentally inappropriate sexual behavior.
Learning problems.
Passivity.
Low self-esteem.
Emotional and social problems.
Behavioral risk factors.

Question 18

True or faults, in 2020, 3.9 million referral reports were received regarding child maltreatment.

Answer 18

True

Question 19

True or false? 26% of children who die from child abuse are under one year.

Answer 19

False. 46.4% of children who die from child abuse are under one year. Children younger than one year have the highest rate of abuse.

Question 20

Define physical child neglect

Answer 20

Deprivation of food, clothing, shelter, supervision, medical care, and education,

Question 21

True or false? 76% of interpersonal violence is neglect.

Answer 21

True.

Question 22

Neglect can look like…

Answer 22

Rejecting, isolating, terrorizing, ignoring, corrupting, verbally assaulting, and overpressuring.

Question 23

Define the acronym SNAT

Answer 23

Suspected non-accidental trauma

Question 24

Define the acronym PURPLE

Answer 24

Peak
Unexpectedly
Resistant to soothing
Pain – as in looks painful
Long lasting
Evening and late afternoon

Purple crying is normal for babies two weeks to three months old.

Question 25

Signs and symptoms of shaken baby syndrome

Answer 25

Vomiting and listlessness.
Bad signs are posturing, apnea and bradycardia.

Question 26

Münchausen syndrome by proxy

Answer 26

Munchhausen syndrome by proxy is a mental illness and a form of child abuse. The caretaker of a child, most often a mother, either makes up fake symptoms or causes real symptoms to make it look like the child is sick.

Question 27

Factors predisposing to physical abuse
Parental characteristics

Answer 27

Socially isolated parents, young parents, single parents.
Poor parenting skills plays a role.

Question 28

Factors predisposing to physical abuse. Characteristics of the child

Answer 28

Younger than one year, disabled, born prematurely. 

Question 29

Factors predisposing to physical abuse. Environmental characteristics

Answer 29

Divorce, poverty, unemployment, poor housing, frequent relocation, alcoholism, drug addiction.

Question 30

Define sexual abuse

Answer 30

The use, persuasion, or coercion of any child to engage in sexually explicit conduct; the simulation of such conduct for producing visual depiction of such conduct; the rape, molestation, prostitution, or incest with children.

Question 31

True or false? Before they turn 18. One and six boys experience some form of sexual abuse, and one in four girls experience some form of sexual abuse.

Answer 31

True

Question 32

Characteristics of sexual abusers

Answer 32

Typical abuser: male whom victim knows but may be anyone, siblings and mothers.
People of all levels of society.
 80% adults, and 20% male adolescences.

Question 33

Characteristics of sexual abuse victims

Answer 33

Boys who are sexually abused can have subtle findings; often abused by stepfather’s or mothers boyfriend. They often show a lack of emotional closeness and have communication difficulties.

Question 34

Nursing care of the maltreated child

Answer 34

Identification of abusive situation as early as possible.
Documentation of history pertaining to incident.
Thorough physical examination.
Observation of caregiver - child interactions.
Protection of the child from further abuse.

Question 35

True or false? Nurses are mandatory reporters and our documentation can be subpoenaed.

Answer 35

True

Question 36

Nursing care guideline.
Care for the victim of sexual assault.
What is the timeframe that a victim of sexual assault should receive an examination by a sexual assault nurse examiner?

Answer 36

Within 72 hours of the assault

Question 37

What is a SANE

Answer 37

A sexual assault nurse examiner.
A sexual assault nurse examiner is trained and certified as a forensic nurse who has been designated as an expert in evidence collection and legal proceedings.

Question 38

What is a SART

Answer 38

A sexual abuse response team.

Question 39

True or false? A sexual assault nurse examiner (SANE) Is also a victims advocate.

Answer 39

False. A sexual assault nurse examiner (SANE) works as a member of a sexual abuse response team (SART) in a facility setting and the sexual assault response team (SART) usually includes an advocate for the victim.

Question 40

Care for the victim of sexual assault. Procedural concerns:

Answer 40

-Evidence to be collected includes: DNA evidence, seminal fluid evidence, physical injury evidence, blood and urine evidence, genital trauma evidence through colposcopic examination.
-The sexual assault nurse examiner (SANE) and sexual assault response team (SART) members comfort the patient throughout the examination and provide: education and information regarding STI’s; information on prophylactic against pregnancy; crisis intervention and information on counseling.

Question 41

Care for the victim of sexual assault; documentation concerns

Answer 41

-Accuracy and legibility are essential.
-Never use the term “alleged sexual assault.”
-use the phrases “patient states” or “patient reports.”
-document both subjective and objective findings.

Question 42

True or false? Sexual assault response teams (SARTs) have been shown in an increase in frequency of victims being referred to support services improved legal outcomes, and decrease secondary trauma victims. Also, the use of sexual assault nurse examiners (SANEs) has improved the assessment and documentation of anogenital injury as well as STI testing.

Answer 42

True

Question 43

Facts about domestic violence

Answer 43

Domestic violence does not have to be physical violence. It includes a threat or promotion of fear to exert power or control over another person. It can occur through intimidation or isolation or through someone else. It can be emotional, financial, sexual, or physical. It can occur to anyone by anyone.
Leaving a domestic violence situation can be just as dangerous is staying. Nurses are required to screen for domestic violence by asking questions on admission of the patient to the facility. A cycle of violence is common.

Question 44

Procedural concerns for care of the victim of domestic violence 

Answer 44

It is imperative to take screening seriously:
-Provide total and complete privacy – no exceptions.
-Listen without judging.
-Provide emotional support.
-advocate contact with support services.
-Patient and family safety is the top priority.
-Discuss safety plans.
-Victims may refuse to accept printed or written information out of fear. Repeat important information such as: phone numbers of crisis centers, addresses of shelters.
* Reassure patients that we are keeping their records confidential!

Question 45

Documentation concerns for caring for victims of domestic violence.

Answer 45

-accuracy and legibility are essential.
-Use of the phrase “patient states” or “patient reports.”
-detail new and old physical injuries. Photograph injuries Dash with patient consent only.
-Document information that is provided both orally and in writing, including patient education and resources that were suggested are provided.
-Document consultants and referrals.

Question 46

True or false? Older adult neglect and abuse can be physical, financial, and or emotional.

Answer 46

True