Exam 26: Child, Older Adult, and Intimate Partner Abuse

A woman has been severely beaten by her husband,has no relatives or friends in the community,is afraid to return home,has no financial resources of her own,and has no job skills.Which would be the most important referral for the nurse to make?

The plan of care for a patient who has demonstrated outbursts of physical violence against his family when frustrated,followed by periods of remorse after each outburst,would be considered successful when the patient:

The nurse is assisting a victim of spousal abuse to create a plan for escape if it becomes necessary.What components should the plan include? Select all that apply.

A woman who is a victim of severe emotional violence tells the nurse that her husband abuses her most often when he is intoxicated,just as his father had beaten him and his mother.The woman is aware of the location of a safe house and has considered leaving home with her two children,but she cites being brought up to believe "you keep quiet and stay together,no matter what happens." She states the husband is always apologetic and remorseful after an incident.The nurse responds,"You cannot live like this;you have to defend yourself and your children." Which statement most accurately describes the nurse's response?

A 45-year-old married woman who works full time in a factory has recently been absent for 3-day periods on several occasions.Each time,she returned to work wearing dark glasses.Facial and body bruises were apparent.Her supervisor became suspicious that she was a victim of battering and referred her to the occupational health nurse.What should the nurse first focus on as she meets the patient?

A woman has concerns about a man she recently began to date.She confides to her friend,a nurse in the clinic,that she recently discovered that he had been charged with domestic violence in a previous relationship.She asks if this means he will also hurt her and what signs would indicate that he is likely to be abusive.What should the nurse tell her friend?

A victim of physical abuse by her domestic partner is being treated for a broken humerus.Which indicator for the outcome of Abuse protection is most important to achieve before the patient leaves the emergency department?

A victim of partner abuse,parent of one child,describes the partner as someone who is easily frustrated and more likely to be abusive after a experiencing an event in which self-esteem is challenged.The most recent episodes of violence were related to feeling "upset" over a job loss.What type of therapy would provide the greatest help to the abuser?

A child,aged 11 years,stays home from school to care for his siblings while his mother works,because the family cannot afford a babysitter.The home is cluttered and dirty when the community mental health nurse visits to investigate the child's school absences.When the parents arrive home from work,the child's father behaves angrily.He orders his wife and son about.He finds fault with the son,asking him twice,"Why are you such a stupid kid?" The wife tells the nurse she has difficulty disciplining the children and gets frustrated easily.The nurse desires to build some trust and continue to gather assessment data.The remark or question that would interfere with the nurse's goals is:

A child,aged 11 years,stays home from school to care for his siblings while his mother works,because the family cannot afford a babysitter.The home is cluttered and dirty.When asked about his parents,the child reluctantly reveals that he thinks his father does not like him very much because he calls him "stupid" and says he can never do anything right.This should be assessed as:

The nurse at the clinic is interviewing a patient who offers a number of vague somatic complaints that might not ordinarily prompt a visit to a caregiver: fatigue,back pain,headaches,and sleep disturbance.The patient seems tense,and after having spoken of the symptoms,seems reluctant to provide more information and is in a hurry to leave.The nurse can best serve the patient by:

A child,aged 11 years,has to stay home from school to care for his siblings while his mother works,because the family cannot afford a babysitter.The father appears to be emotionally abusive.Which intervention could be used for the primary prevention of problems such as these?

A woman tells the nurse that her husband abuses her most often when he is intoxicated,just as his father had beaten him and his mother.The woman is aware of the location of a safe house and has considered leaving home with her two children,but she cites being brought up to believe "you keep quiet and stay together,no matter what happens." She states the husband is always apologetic and remorseful after an incident.What evidence exists that the husband is at risk of becoming a perpetrator of physical abuse? He:

An 82-year-old widow with Alzheimer's disease lives with her daughter's family,which owns a catering business.During the week,the patient attends a day care center for patients with dementia.During the evenings,members of the family care for the patient.One day,the nurse at the day care center notices the patient's appearance is disheveled and that she startles easily.She has a strong odor of urine,and her hair is uncombed.When the nurse escorts the patient to the bathroom,she notices bruises on her wrists and back.What most likely explains the nurse's observations?

Several children a day are seen in the emergency department for treatment of illnesses and injuries.The situation that would create a high index of suspicion of child abuse is a child who:

A patient,aged 82 years,has Alzheimer's disease.She lives with her daughter's family and goes to a day care facility on weekdays.The family cares for her during the evening and at night.Noting the patient had several bruises,the nurse discussed her observations with the daughter,who became defensive and said that her mother was very difficult to manage because she is confused and wanders all night.She says the bruises resulted from a fall down stairs.The daughter states,"I have lost my mother,and I cannot bear it anymore.It is wrecking my family." The nursing intervention that should take priority is:

An 11-year-old boy stays home from school to care for his siblings while his mother works,because the family cannot afford a babysitter.During the community mental health nurse's visit,he reveals that he thinks his father does not like him because he calls him "stupid" all the time.He states he is too dumb to learn much and has no friends at school because he does not deserve them.Which nursing diagnosis should be the priority for the child?

A patient,aged 77 years,has Alzheimer's disease.She goes to day care during the week and is otherwise cared for by her daughter and grandchildren.The nurse at the day care center noticed multiple bruises on the patient's palms,elbows,and buttocks.When the daughter arrived to pick her up,the nurse discussed her observations.The daughter became defensive and said that her mother was very difficult to manage.She stated,"My mother is not my mother anymore.She is confused,and she wanders all night.We have to watch her constantly.Last night I fell asleep,and she fell down the stairs.Sometimes she cannot recognize me and accuses me of trying to poison her.I can't concentrate at work,and it's wrecking the family.Sometimes I just cannot bear it." Which nursing diagnosis would be most important to address for this family?

A child,aged 11 years,stays home from school to care for his siblings while his mother works,because the family cannot afford a babysitter.The home is cluttered and dirty when the community mental health nurse visits to investigate the child's school absences.The nurse's legal responsibility if child abuse or neglect is suspected is to:

A nurse is working with a perpetrator of family violence who has a long history of violent rages when frustrated,with periods of remorse after each outburst.The nurse is most likely to establish the nursing diagnosis of: