Question 1

Which behavior would the nurse expect in a person who commits psychic rape? The perpetrator:

Accepted Answer

A)   gives money to the victim after the rape.
B)   seduces the victim by providing wine, flowers, and music.
C)   threatens the victim to submit or else be severely beaten.
D)   always mentions including violent bondage in sexual activities. D

Question 2

Which comment by the nurse would be most effective when using an empowerment model of intervention with an individual who has been abused?

Accepted Answer

A)   "You have left your spouse many times only to return. Please tell me how you view this last time as being different from all the times you left before."
B)   "Last time we talked, you thought your children would miss their father, but you now think they seem happier and almost relieved by your separation."
C)   "So you're having doubts and want to return to your husband even though you know that he broke your arm and caused your miscarriage?"
D)   "I support you returning to your spouse until you finally decide you have suffered enough.'" B

Question 3

A person currently in an abusive relationship tells a nurse,"My partner is really sorry for hitting me and wants to come back and be part of the family again." The nurse should provide which intervention?

Accepted Answer

A)   Share with the patient that abusers seldom voluntarily stop abusing.
B)   Encourage the patient to demand the abuser seek psychiatric help.
C)   Advise the patient to focus on minimizing the abuse if the relationship continues.
D)   Inform the partner that any physical abuse will certainly be reported to the police. B

Question 4

An adolescent claims to have been physically abused by a parent.The adolescent's other parent angrily tells the nurse,"It's ridiculous for our child to accuse my spouse,who is a prominent doctor respected by the community." The nurse responds:

Accepted Answer

A)   "Do you believe that abuse does not exist in well-respected, professional families?"
B)   "I know that it is difficult to believe what your child is saying about your spouse, but abuse has occurred."
C)   "I know your spouse and I have never seen him be unkind or abusive to patients, but that is no proof of innocence."
D)   "Your spouse seems to have a very stressful, demanding practice. That can be a risk factor for losing one's temper when angry."

Question 5

Which intervention would be the best initial approach for a nurse to take when a young adult patient is verbally abusive?

Accepted Answer

A)   Ask the patient to define "verbally abusive language."
B)   Provide the patient with examples of assertive communication.
C)   Identify the patient's verbal abuse in order to set standards for future dialogue.
D)   Remove privileges from the patient until communications show less aggression.

Question 6

An individual whose boyfriend raped her tells the nurse,"It's no use reporting it.Everyone knows I've been sexually intimate with him many times before." The nurse's initial response should be:

Accepted Answer

A)   "It's not your fault. He needs to get help controlling his anger."
B)   "You will need to talk to someone. Do you have a best friend to talk to?"
C)   "The police need to be aware that your boyfriend is willing to act this way when he's angry."
D)   "If you said 'no,' your boyfriend needs to respect your wishes. He needs help so this will never happen again."

Question 7

A nursing colleague says,"This patient was admitted claiming to have been raped by her boyfriend,but just look at the sexy clothes she's wearing." Which response reflects an understanding of the most likely source of the colleague's comment?

Accepted Answer

A)   "Have you ever cared for other sexual assault victims?"
B)   "Your sister was raped when she was in college, wasn't she?"
C)   "You have three unmarried brothers about the patient's age, don't you?"
D)   "Are you saying that wearing sexy clothes caused her to be sexually assaulted?"

Question 8

An Arab student new to an elementary school reports,"I don't want to go to gym class.It's never been a good class for me." Which factor would be of primary concern for a school nurse?

Accepted Answer

A)   The student's family's cultural beliefs regarding females interacting with males in public
B)   Complaints from others of "bullying" that occurs in gym class
C)   The student's problems adjusting to the new school environment
D)   A concern that the gym class is overcrowded and too competitive

Question 9

Which patient is at greatest risk for physical abuse by a family member?

Accepted Answer

A)   A 15-year-old who lives with a single parent in an inner city apartment complex
B)   An 8-year-old who is mentally challenged and living with a foster family
C)   A 30-year-old adult who shares a home with a homosexual partner
D)   A 79-year-old with chronic depression who lives with a grandchild

Question 10

A young,newly married adult says,"My spouse never lets me out of sight.I'm not allowed to do anything on my own,and I'm constantly accused of cheating." Which nursing comment is most therapeutic for this individual?

Accepted Answer

A)   "Have you discussed the behavior with your spouse?"
B)   "How does your spouse's behavior make you feel?"
C)   "Are there other examples of controlling behaviors on your spouse's part?"
D)   "Do you feel that your spouse has anything to be upset or suspicious about?"

Question 11

A patient with swelling and a laceration above the right eye states,"I don't know what caused me to fall and cut my head on the door frame." The patient's spouse appears nervous but smiles when mentioning that the patient is "so clumsy at times." The nurse should give priority attention to which intervention when addressing this patient's needs?

Accepted Answer

A)   Directly asking the patient if spousal abuse is occurring or has ever occurred
B)   Completing a thorough assessment that includes a focus on signs of old injuries
C)   Interviewing the patient regarding the circumstances surrounding this suspicious fall
D)   Notifying security that there is a possibility that this patient is a victim of physical abuse

Question 12

Which comment by the nurse would be most effective in teaching a patient about abusive behavior?

Accepted Answer

A)   "So when your husband says he needs other women because you aren't sexually satisfying his needs, do you believe what he is telling you is true?"
B)   "You say that your son has been pulling another child's hair and you are worried he's becoming violent and abusive like your brother?"
C)   "You say that you placed your son on an allowance but that you also want to regulate everything he spends and saves?"
D)   "I noticed that when your mother paid you a compliment about your new hairstyle, you seemed skeptical."

Question 13

Which patient statements would be considered a potential risk factor for family-directed violence towards them? (Select all that apply.)

Accepted Answer

A)   "My parents certainly believed in not spoiling a child."
B)   "I'm angry that I had to get a part-time job to help buy food."
C)   "My family thinks I'm just a burden, but they'll be sorry that they treated me so badly."
D)   "When my spouse gets upset he tells me I'm no longer attractive because I've gained weight."
E)   "I work long hours to pay the bills and put food on the table but I can't seem toMake my spouse happy."

Question 14

What is the best initial approach for a nurse when managing the care of an individual with two children who works full-time and has been abused by a partner?

Accepted Answer

A)   Teach the individual how to avoid provoking the abuser.
B)   Assist the individual in filing a police report describing the abuse.
C)   Help the individual identify needs to best obtain the appropriate support.
D)   Facilitate the individual's move into a safe house located near the current workplace.

Question 15

An older adult patient exhibits bilateral bruising for the second time on both upper outer arms.When the nurse questions the patient about the bruising,the patient starts to cry and pleads,"Please don't say anything.It's not my daughter's fault.I just bruise easily." Which intervention reflects the best management of this situation?

Accepted Answer

A)   Calling the daughter to discuss both the bruising and her parent's reaction
B)   Reporting the elder abuse and informing the patient and the daughter of the action
C)   Notifying the patient's social worker of the bruising after a complete assessment has been completed
D)   Informing the patient and the daughter of the nurse's obligation to document the bruising and report the findings to protective services

Question 16

Which comment best reflects the nurse's use of an empowerment model with an individual who has been abused?

Accepted Answer

A)   "Let me share with you my knowledge of what happens psychologically to individuals who have been abused."
B)   "I know that you feel that your partner will change, but the current research does not validate your thinking."
C)   "It's up to you to end the violence. You are the only one who can set limits on how your partner is allowed to treat you."
D)   "Let's consider what you believe your options are in terms of your relationship with your partner in light of the behavior toward you."

Question 17

Which is the most appropriate initial action for a nurse when attempting to overcome personal negative attitudes about a patient who has a history of returning to an abusive spouse?

Accepted Answer

A)   Exploring own attitudes and values toward survivors of violence
B)   Identifying the dysfunctional behaviors exhibited by the violent family
C)   Concentrating on identifying any possible personal abusive relationships
D)   Attending seminars on the psychological impact of being the victim of abuse

Question 18

When a nurse overhears the spouse of a patient threaten to "punch you in the face if you don't shut up" while sitting in the unit's dayroom,which action reflects the most immediate,therapeutic nursing intervention?

Accepted Answer

A)   Notify hospital security immediately that the situation exists.
B)   Tell the spouse, "Your presence is no longer permitted on the unit."
C)   Ask the patient if the spouse has ever engaged in abusive behavior.
D)   Tell the spouse, "The police will be called unless you leave immediately."

Question 19

Which statement best indicates use and abuse of power in a violent family situation?

Accepted Answer

A)   "I admit I was mad and yelling and swinging my fists in the air, but I wasn't trying to hit our child. I was letting off some steam. My spouse just overreacted."
B)   "When she found out I watched television instead of taking the kids to the park, she starting yelling about how I don't care about the kids. She has no right to get mad at me. I should have some time to myself."
C)   "I thought he would like this new recipe. I should have known better. I will not do that again. He was right. He works all day and should come home to a good meal that he can enjoy. It's not too much to ask of a wife."
D)   "All I did was tell him I need some money. I can't understand why he can't just give me what I need. I stay home and take care of his house and kids, and I have to almost beg before he gives me money to spend on myself."

Question 20

An individual who has been physically abused says,"When I called the police,I just wanted my spouse to stop shoving me around and kicking me.I didn't want anyone to get in trouble.It's easy to get angry with me because I spend too much money." Which comment by the nurse would be most therapeutic for this individual?

Accepted Answer

A)   "You feel your spouse was justified in the abuse because you overspent?"
B)   "Tell your spouse that if this happens again, I will report it to the police."
C)   "Your spouse abuses you when you overspend. So you think it will stop if you do not spend money?"
D)   "I can understand that you don't want to press charges, but your spouse needs help controlling anger."

Exam 38: Care of Survivors of Abuse and Violence