Nursing > Exam Review > Chapter 28: Child, Older Adult, and Intimate Partner Violence Halter: Varcarolis’ Foundations of P (All)
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.‖ ANS: A 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. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 28-12, 27 TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 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 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. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 28-3, 17 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 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 testbanks_and_xanax 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 common emotions of a nurse working with an abusive family. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 28-21, 22, 51 (Table 28-3) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 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 judgment. c. Strong positive feelings lead to healthy transference with the victim. d. Positive feelings promote the development of sympathy for patients. ANS: B Strong negative feelings cloud the nurse‘s judgment 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. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 28-21, 22, 51 (Table 28-3) TOP: Nursing Process: Planning MSC: Client Needs: Psychosocial Integrity 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 patient should recognize these behaviors often occur in adolescents who a. have been abused. b. are attention seeking. c. have eating disorders. d. are developmentally delayed. ANS: A Self-mutilation, alcohol and drug abuse, bulimia, and unstable and unsatisfactory relationships are frequently seen in teens who are abused. These behaviors are not as closely aligned with any of the other options. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 28-6, 55 (Box 28-1) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 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 state regulations. d. Continue the assessment. testbanks_and_xanax ANS: C Each state has specific regulations for reporting child abuse that must be observed. 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. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 28-25, 66 (Box 28-7) TOP: Nursing Process: Implementation MSC: Client Needs: Safe, Effective Care Environment 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? The child who has a. complaints of abdominal pain. b. repeated middle ear infections. c. bruises on extremities. d. diarrhea. ANS: C Injuries such as immersion or cigarette burns, facial fractures, whiplash, bite marks, traumatic injuries, bruises, and fractures in various stages of healing suggest the possibility of abuse. 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. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 28-15, 16, 66 (Box 28-7) TOP: Nursing Process: Assessment MSC: Client Needs: Safe, Effective Care Environment 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 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 nonself. Grieving may apply, but a specific loss is not evident in the scenario. Low selfesteem is more relevant to the child‘s statements. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 28-24, 52 (Table 28-4) TOP: Nursing Process: Diagnosis/Analysis MSC: Client Needs: Psychosocial Integrity testbanks_and_xanax 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 occupational health nurse‘s priority assessment? a. Interpersonal relationships b. Work responsibilities c. Socialization skills d. Physical injuries 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. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 28-23, 24, 66 (Box 28-7) TOP: Nursing Process: Assessment MSC: Client Needs: Safe, Effective Care Environment 10. A young adult has recently had multiple absences from work. After each absence, this adult returned to work wearing dark glasses and long-sleeved shirts. 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 adult protective agency. d. Document injuries with a body map. ANS: D Documentation of injuries provides a basis for possible legal intervention. In most states, the abused adult would need to make the decision to involve the police. Because the worker is not an older adult and is competent, the adult protective agency is unable to assist. Admission to the hospital is not necessary. [Show More]
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