Chapter 26: Survivors of Abuse or Neglect

Essentials of Psychiatric Mental Health Nursing 7th Edition By Mary C

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Chapter 26: Survivors of Abuse or Neglect

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   A kindergarten student is frequently violent toward other children. A school nurse notices bruises and burns on the child’s face and arms. What other symptom should indicate to the nurse that the child may have been physically abused?

1. The child shrinks at the approach of adults.
2. The child begs or steals food or money.
3. The child is frequently absent from school.
4. The child is delayed in physical and emotional development.

 

 

____     2.   A woman presents with a history of physical and emotional abuse in her intimate relationships. What should this information lead a nurse to suspect?

1. The woman may be exhibiting a controlled response pattern.
2. The woman may have a history of childhood neglect.
3. The woman may be exhibiting codependent characteristics.
4. The woman may be a victim of incest.

 

 

____     3.   A nursing instructor is developing a lesson plan to teach about domestic violence. Which information should be included?

1. Power and control are central to the dynamic of domestic violence.
2. Poor communication and social isolation are central to the dynamic of domestic violence.
3. Erratic relationships and vulnerability are central to the dynamic of domestic violence.
4. Emotional injury and learned helplessness are central to the dynamic of domestic violence.

 

 

____     4.   A client is brought to an emergency department after being violently raped. Which nursing action is appropriate?

1. Discourage the client from discussing the rape, because this may lead to further emotional trauma.
2. Remain nonjudgmental while actively listening to the client’s description of the violent rape event.
3. Meet the client’s self-care needs by assisting with showering and perineal care.
4. Probe for further, detailed description of the rape event.

 

 

____     5.   A raped client answers a nurse’s questions in a monotone voice with single words, appears calm, and exhibits a blunt affect. How should the nurse interpret this client’s responses?

1. The client may be lying about the incident.
2. The client may be experiencing a silent rape reaction.
3. The client may be demonstrating a controlled response pattern.
4. The client may be having a compounded rape reaction.

 

MULTIPLE CHOICE

 

  1. ANS:  1

Chapter: Chapter 26, Survivors of Abuse or Neglect

Objective: Discuss characteristics of victims and victimizers.

Page: 706–707

Heading: Application of the Nursing Process > Background Assessment Data > Physical Abuse

Integrated Process: Assessment

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application

Concept: Violence

Difficulty: Moderate

 

  Feedback
1 The nurse should determine that a child who shrinks at the approach of adults in addition to having bruises and burns may be a victim of abuse. Maltreatment is considered, whether or not the adult intended to harm the child.
2 Stealing money or food does not indicate physical abuse.
3 Frequently missing school does not indicate physical abuse.
4 Developmental delays do not indicate physical abuse.

 

 

PTS:   1                    CON:  Violence

 

  1. ANS:  4

Chapter: Chapter 26, Survivors of Abuse or Neglect

Objective: Discuss characteristics of victims and victimizers.

Page: 708–709

Integrated Process: Application of the Nursing Process > Background Assessment Data

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application

Concept: Violence

Difficulty: Moderate

 

  Feedback
1 The nurse would not expect that the client is exhibiting a controlled response pattern.
2 The nurse would not expect a history of childhood neglect.
3 The nurse would not expect codependency.
4 The nurse should suspect that this client may be a victim of incest. Many women who are battered have low self-esteem and have feelings of guilt, anger, fear, and shame. Women in abusive relationships often grew up in an abusive home.

 

 

PTS:   1                    CON:  Violence

 

  1. ANS:  1

Chapter: Chapter 26, Survivors of Abuse or Neglect

Objective: Discuss characteristics of victims and victimizers.

Page: 704–706

Heading: Application of the Nursing Process > Background Assessment Data

Integrated Process: Planning

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application

Concept: Violence

Difficulty: Moderate

 

  Feedback
1 The nursing instructor should include the concept that power and control are central to the dynamic of domestic violence. Battering is defined as a pattern of coercive control founded on physical and/or sexual violence or threat of violence. The typical abuser is very possessive and perceives the victim as a possession.
2 Poor communication and social isolation are not central to the dynamic of domestic violence.
3 Erratic relationships and vulnerability are not central to the dynamic of domestic violence.
4 Emotional injury and learned helplessness are not central to the dynamic of domestic violence.

 

 

PTS:   1                    CON:  Violence

 

  1. ANS:  2

Chapter: Chapter 26, Survivors of Abuse or Neglect

Objective: Identify nursing diagnoses, goals of care, and appropriate nursing interventions for care of survivors of intimate partner violence, child abuse, and sexual assault.

Page: 712–714

Heading: Table 26-1 Care Plan for Survivors of Abuse

Integrated Process: Assessment

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application

Concept: Violence

Difficulty: Moderate

 

  Feedback
1 The client should be encouraged to discuss the rape.
2 The most appropriate nursing action is to remain nonjudgmental and actively listen to the client’s description of the event. It is important to also communicate to the victim that he/she is safe and that it is not his/her fault. Nonjudgmental listening provides an avenue for catharsis, which contributes to the healing process.
3 Showering would not be an appropriate nursing intervention and may destroy evidence.
4 Probing for further detail would not be appropriate.

 

 

PTS:   1                    CON:  Violence

 

  1. ANS:  3

Chapter: Chapter 26, Survivors of Abuse or Neglect

Objective: Identify nursing diagnoses, goals of care, and appropriate nursing interventions for care of survivors of intimate partner violence, child abuse, and sexual assault.

Page: 711

Heading: Application of the Nursing Process > Background Assessment Data

Integrated Process: Assessment

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application

Concept: Violence

Difficulty: Moderate

 

  Feedback
1 The client is not likely lying about the incident.
2 The client is not likely to be experiencing a silent rape reaction.
3 This client is most likely demonstrating a controlled response pattern. In the controlled response pattern, the client’s feelings are masked or hidden, and a calm, composed, or subdued affect is seen. In the expressed response pattern, feelings of fear, anger, and anxiety are expressed through crying sobbing, smiling, restlessness, and tension.
4 The client is not likely having a compounded rape reaction.

 

 

PTS:   1                    CON:  Violence

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