Jarvis Chapter 7: Domestic and Family Violence Assessment Review Questions

a

Increased bruising and bleeding in older adults may be r/t which of the following?

a. Ingestion of nonsteroidal anti-inflammatory drugs

b. A reduction in the integrity of blood vessels

c. Thinning of the skin

d. Decreased fluid intake

a

An extremely important part of the history and examination in situations of intimate partner violence or older adult abuse is the

a. mental status examination.

b. family genogram.

c. history of the present illness.

d. skin assessment.

d

The nurse caring for an older adult suspects older adult abuse. Which action is appropriate?

a. Confront the caregivers about the suspicion of abuse.

b. Collect proof of abuse before notifying the authorities.

c. Report the abuse if the older adult gives permission.

d. Notify the authorities of the suspected older adult abuse.

b, d, e

The nurse is assessing a person who is a suspected victim of abuse. When documenting assessment data, which of the following is the most important concept for the nurse to remember? (Select all that apply.)

a. Words used when documenting should be sanitized.

b. It must be detailed and unbiased.

c. Speculation on the cause of injury should be included.

d. Use the exact terms the abused person uses to describe sexual organs.

e. Quotation marks should be used for severe threats of harm.

d

Dehydration and malnutrition can be manifestations of ________________ in older adults.

a. physical abuse

b. intimate partner violence

c. psychological abuse

d. neglect

b

Women and men who have been physically abused are most often abused by

a. a man with a substance use problem.

b. an intimate male partner.

c. a known sex offender.

d. a man convicted of a serious crime.

d

The health care system may help abused women by

a. providing financial and supportive services.

b. estimating the ages of bruises.

c. providing shelter from the abusive individual.

d. identifying abuse in the early stages.

c

Abused women have been found to have significantly more health problems, including

a. cardiovascular disease.

b. chronic anemia.

c. chronic pain.

d. cancer.

a

A woman seeks medical attention for a cut made by a knife during a physical assault. The health care provider would document the cut as an

a. incision

b. ecchymosis.

c. avulsion.

d. abrasion.

d

Which scenario is an example of intimate partner violence?

a. An ex-boyfriend stalks his ex-girlfriend

b. Marital rape

c. Hitting a date

d. All of the above

a

Routine universal screening for domestic violence includes:

a. Asking everyone each time they come to the health care system if they are abused

b. Asking everyone who has injuries if they are abused

c. Asking everyone who has symptoms of depression and PTSD if they are abused

d. Asking everyone ages 18 to 30 years if they are abused

b

Patients are at high risk for which mental health problem associated with intimate partner violence?

a. Hallucinations

b. Suicidality

c. Schizophrenia

d. Attention-deficit/hyperactivity disorder (ADHD)

b

Which gynecologic problem is not usually associated with intimate partner violence?

a. Pelvic pain

b. Ovarian cysts

c. STIs

d. Vaginal tearing

a

Risk factors for intimate partner homicide include:

a. Abuse during pregnancy

b. Victim substance abuse

c. Victim unemployment

d. History of victim childhood sexual assault

e

Elder abuse and neglect assessments include:

a. willful infliction of force

b. withholding prescription medications without medical orders

c. not replacing broken eyeglasses

d. threatening to place someone in a nursing home

e. all of the above

d

When assessing an injury on a child, which should be considered?

a. the child's developmental level

b. the child's medical and medication history

c. the history of how the injury occured

d. all of the above

d

What is a known risk factor for child maltreatment?

a. substance abuse

b. intimate partner violence

c. physical disability and/or mental retardation in the child

d. all of the above

b

Bruising on a nonwalking or noncruising child:

a. Is a common finding from normal infant activity

b. Needs to be further evaluated for either an abusive or medical explanation

c. Is commonly seen on the buttocks

d. Cannot be reported until after a full medical evaluation

c

Which is a forensic term that is related to "purpura" but is not related to blunt force trauma?

a. wound

b. incision

c. ecchymosis

d. bruise

b

Which should be routinely included in evaluating a case of elder abuse?

a. corroborative interview from caregiver

b. baseline laboratory tests

c. testing for STIs

d. TB testing

d

During examination, you notice a patterned injury on a patient's back. Which is most likely?

a. a blunt force trauma

b. a friction rub

c. a stabbing

d. a welt from a leather belt

b

During an interview, a woman has answered "yes" to 3 of the Abuse Assessment Screen questions. How should you proceed?

a. ask the patient if she has filed a restraining order

b. proceed by asking more questions about the items she answered "yes."

c. respond by confirming that the patient was abused

d. interview the woman's partner and compare notes

d

Which clinical situation would require the examiner to report to the proper authorities?

a. statements from the victim

b. statements from witnesses

c. proof of abuse/or neglect

d. suspicion of elder abuse and/or neglect

a

Which would you include on the chart of the patient who has been the victim of abuse?

a. photographic documentation of injuries

b. a summary of the abused patient's statements

c. verbatim documentation of every statement made

d. a general description of injuries in the progress notes

intimate partner violence (IPV)

______________ ___________ _____________ can be divided into 4 main categories: physical violence, sexual violence, stalking, and psychological aggression.

physical violence (IPV)

the use of force that could cause death, disability, or injury

sexual violence (IPV)

any attempted or completed sex acts without the consent of the other person (includes: rape, unwanted sexual contact, exposure to sexual situations)

stalking (IPV)

repeated, unwanted attention that leads to fear (examples: repeated phone calls, spying, damaging personal property)

psychological aggression (IPV)

form of emotional abuse wherein the aggressor uses verbal or nonverbal communication to exert control or harm the person emotionally.

teen dating violence

physical, sexual, psychological, or emotional violence that occurs in a dating relationship during the adolescent years.

neglect (child)

the failure to provide for child's basic needs (physical, medical, and supervision)

[also includes prenatal drug exposure, child abandonment, and manufacturing of amphetamines, failure to educate the child, in some states]

physical abuse (child)

nonaccidental physical injury caused by punching beating, kicking, biting, burning, shaking, or otherwise harming a child.

sexual abuse (child)

includes fondling child's genitals, incest, penetration, rape, sodomy, indecent exposure, and exploitation through prostitution or production of pornographic materials

emotional abuse (child)

any pattern of behavior that harms child's emotional development or sense of self-worth; includes frequent belittling, rejection, threats, and withholding of love and support

elder

forms of __________ abuse include the following: physical abuse, sexual abuse/abusive sexual contact, psychological/emotional abuse, neglect, financial abuse/exploitation.

physical abuse (elder)

when an elder is intentionally injured, assaulted, threatened with a weapon, or inappropriately restrained.

sexual abuse (elder)

includes any sexual contact against the elder's will, including sexual contact with a person unable to understand the act or communicate consent.

psychological abuse (elder)

includes verbal and nonverbal behavior meant to inflict fear and distress; humiliation, embarrassment, controlling behavior, social isolation, damaging/destroying property.

neglect (elder)

failure of caregiver to prevent harm (failure to meet basic needs: hygiene, nutrition, hydration, clothing, shelter, medical care)

financial abuse (elder)

unauthorized or improper use of the elder's resources for monetary or personal benefit, profit or gain, such as forgery, theft, or improper use of guardianship or power of attorney.

are not

You ARE or ARE NOT required to have proof before reporting suspected abuse

true

true or false:

verbatim documentation of the reported perpetrator's threats interlaced with curses and expletives can be useful in future court proceedings.

should not

you SHOULD or SHOULD NOT sanitize the words reportedly heard by a victim.

b

should you:

a. speculate on what caused an injury

b. document what you observed and what the victim said

abrasion

a wound caused by rubbing the skin or mucous membrane

avulsion

the tearing away of a structure or part

bruise

Superficial discoloration caused by hemorrhage into the tissues from ruptured blood vessels beneath the skin surface, without the skin itself being broken; also called a contusion.

contusion

A bruise; injury to tissues without breakage of skin; blood from broken blood vessels accumulates, producing pain, swelling, tenderness.

ecchymosis

a hemorrhagic spot or blotch, larger than petechia, in the skin or mucous membrane, forming a nonelevated, rounded, or irregular blue or purplish patch.

hematoma

A localized collection of extravasated blood, usually clotted in an organ, space, or tissue

hemorrhage

escape of blood from a ruptured blood vessel, which can be external, internal, and/or into the skin or other organ.

incision

A cut or wound made by a sharp instrument; the act of cutting

laceration

The act of tearing or splitting; a wound produced by the tearing and/or splitting of body tissue, usually from blunt impact over a bony surface.

lesion

a broad term referring to any pathologic or traumatic discontinuity of tissue or loss of function of a part

patterned injury

An injury caused by an object that leaves a distinct pattern on the skin and/or organ (e.g., being whipped with an extension cord) or an injury caused by a unique mechanism of injury (e.g., immersion burns to the hands [glove burns] or feet [sock burns]).

pattern of injuries

usually bruises and fractures in various stages of healing

petechiae

Minute, pinpoint, nonraised, perfectly round purplish-red spots caused by intradermal or submucous hemorrhage, which later turn blue or yellow.

puncture

the act of piercing or penetrating with a pointed object or instrument

stab wound

a penetrating, sharp, cutting injury that is deeper than it is wide

traumatic alopecia

loss of hair from pulling and yanking or by other traumatic means

wound

a general term referring to a bodily injury caused by physical means