Chapter 24 Nurs 2547

1. Which illustrates a nurse building a supportive relationship 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.”

a. “You are feeling violated because you thought you could trust your partner.”

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 violence is likely?
   a. Sexual
   b. Physical
   c. Emotional
   d. Economic

c. Emotional

3. Which feelings are 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

b. Helplessness regarding the victim and anger toward the abuser

4. Which rationale best explains the importance of being 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.

b. Strong negative feelings interfere with assessment and judgement.

5. The parents of a 15-year-old are seeking to have them declared a delinquent because of
   excessive drinking, habitually running away, and prostitution. The nurse assessing the
   patient recognizes these behaviours often occur in which group of 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

a. Adolescents who have been abused

6. Which is a legal responsibility and duty of practice, if a nurse suspects child abuse or
   neglect?
   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.

c. Report the suspicion according to provincial or territorial regulations.

7. Several children are seen in the emergency department for treatment of various illnesses
   and injuries. Which assessment finding would create suspicion of 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

c. The child with bruises on extremities

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

a. Chronic low self-esteem related to negative feedback from parents

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.
   Which is the occupational health nurse’s priority assessment?
   a. Interpersonal relationships
   b. Work responsibilities
   c. Socialization skills
   d. Physical injuries

d. Physical injuries

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.” Which 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.

d. Document injuries with a body map.

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.” Which risk factor is most predictive for the husband to become abusive?
    a. History of family violence
    b. Loss of employment
    c. Abuse of alcohol
    d. Poverty

a. History of family violence

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

c. Honeymoon

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

a. Risk for injury related to physical abuse from partner

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 re-examine cultural beliefs about marital commitment.

b. The patient will name two community resources for help.

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

c. Physical

16. An older person with Alzheimer’s disease lives with family in a rural are
    a. During the
    week, the person attends a treatment centre while the family is at work. In the evenings,
    members of the family provide care. Which factor makes this patient most vulnerable to
    abuse?
    a. Multiple caregivers
    b. Alzheimer’s disease
    c. Living in a rural area
    d. Being part of a busy family

b. Alzheimer’s disease

17. An older person with Lewy body dementia lives with family. After observing multiple
    bruises, the home health nurse talks with the daughter, who becomes defensive and says,
    “My mother often wanders at night. Last night she fell down the stairs.” Which nursing
    diagnosis has priority?
    a. Risk for injury related to poor judgement, cognitive impairments, and inadequate
    supervision.
    b. Wandering related to confusion and disorientation as evidenced by sleepwalking
    and falls.
    c. Chronic confusion related to degenerative changes in brain tissue as evidenced by
    nighttime wandering.
    d. Insomnia related to sleep disruptions associated with cognitive impairment as
    evidenced by wandering at night.

a. Risk for injury related to poor judgement, cognitive impairments, and inadequate
supervision.

18. An older woman diagnosed with Alzheimer’s disease lives with family and attends day
    care. After observing poor hygiene, the nurse talked with the caregiver. This caregiver
    became defensive and said, “It takes all my energy to care for my mother. She’s awake all
    night. I never get any sleep.” Which nursing intervention has priority?
    a. Teach the caregiver about the effects of sundown syndrome.
    b. Secure additional resources for the mother’s evening and night care.
    c. Support the caregiver to grieve the loss of the mother’s cognitive abilities.
    d. Teach the family how to give physical care more effectively and efficiently.

b. Secure additional resources for the mother’s evening and night care.

19. An adult has a history of physical violence against family when frustrated, followed by
    periods of remorse after each outburst. Which finding indicates a successful plan of care?
    a. The adult expresses frustration verbally instead of physically.
    b. The adult explains the rationale for behaviours to the victim.
    c. The adult identifies three personal strengths.
    d. The adult agrees to seek counselling.

a. The adult expresses frustration verbally instead of physically.

20. Which referral will be most helpful for an individual who was severely beaten by their
    intimate partner, has no relatives or friends in the community, is afraid to return home, and
    has limited financial resources?
    a. A support group
    b. A mental health centre
    c. A shelter
    d. Vocational counselling

c. A shelter

1. A 10-year-old cares for their siblings while the parents work because the family cannot
   afford a babysitter. This child says, “My father doesn’t like me. He calls me stupid all the
   time.” When the nurse speaks to the mom, the mother says “My husband is easily
   frustrated and has trouble disciplining the children.” The nurse should consider which
   resources as priorities to stabilize the home situation? (Select all that apply.)
   a. Parental sessions to teach childrearing practices
   b. Anger management counselling for the father
   c. Continuing home visits to give support
   d. A safety plan for the wife and children
   e. Contacting child protective services for support and further assessment

ABCE

2. A nurse assists a victim of intimate partner abuse to create a plan for escape if it becomes
   necessary. Which components should the plan include? (Select all that apply.)
   a. Keep a cell phone fully charged.
   b. Hide money with which to buy new clothes.
   c. Have the phone number for the nearest shelter.
   d. Take enough toys to amuse the children for 2 days.
   e. Secure a supply of current medications for self and children.
   f. Assemble birth certificates, passports, and other identification and licences.
   g. Determine a code word to signal children when it is time to leave.

ACEFG

3. A community health nurse visits a family with four children. The father behaves angrily,
   finds fault with the oldest child, and asks twice, “Why are you such a stupid kid?” The
   wife says, “I have difficulty disciplining the children. It’s so frustrating.” Which comments
   by the nurse will facilitate an interview with these parents? (Select all that apply.)
   a. “Tell me how you discipline your children.”
   b. “How do you stop your baby from crying?”
   c. “Caring for four small children must be difficult.”
   d. “Do you or your husband ever spank your children?”
   e. “Calling children ‘stupid’ injures their self-esteem.”

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