Prepu 12, 13, 14, 15 - Mental Health PDF

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PREPU: Chapter 12: Abuse and Violence 1. Which is an inaccurate picture of the cycle of abuse that occurs over time? 

Violent episodes are less frequent

2. An 8-month-old infant has been brought to the emergency department by the infant's teenage parent. The infant is unresponsive, and after initial assessment, the care team suspects shaken baby syndrome. When providing care for this infant, the nurse should prioritize which assessment? 

Neurological assessment

3. A client has been in a physically abusive relationship for more than a decade. Which statement best demonstrates that the client understands of how fear can influence a reluctance to leave such a relationship? 

“My partner would hunt me down and kill me for sure."

4. A nurse is gathering information about a health history of a person who has experienced violence. Which are important caring behaviors a nurse should implement during the interview? Select all that apply.   

Establish trustworthiness. Maintain a nonjudgmental attitude. Secure open communication.

5. A nurse manager is working with the nursing staff of a busy community-based walk-in clinic that provides care to a large number of survivors of domestic violence. When helping the staff provide care, which information would be most important for the nurse manager to convey to the staff? 

Importance of measuring the clients' progress in small steps

6. A nurse is assessing a client in a community clinic who reports feeling anxious lately because she is considering leaving her marriage. The client describes a long history of partner abuse associated with this relationship. How should the nurse respond to this client? 

"You have the right to be safe and respected."

7. A 3-year-old who has been seen in the emergency department for various fall-related injuries is being treated for apparent blindness in the left eye as a result of retinal hemorrhage. The nurse should suspect that which form of child abuse is part of the cause of the child's condition? 

Shaken baby syndrome

8. What are some types of behavior that the nurse would recognize as qualifying as psychological abuse? Select all that apply.   

Criticizing Ridiculing Threatening a victim's dog

9. Which is a pattern of repeated unwanted contact, attention, and harassment that often increases in frequency? 

Stalking

10. A client is brought to the Emergency Department by a family member that reports being sexually assaulted while leaving work. What action by the nurse would best promote placing control back to the client? 

Allow the client to make decisions regarding care whenever possible

11. A nurse is preparing a presentation for an adolescent and young adult community group about stalking. Which group would the nurse identify as having the highest risk of being stalked? 

Women, ages 18 to 24 years

12. A middle-aged client with young children has been the victim of intimate partner violence (IPV). When providing initial care to this family, the nurse should: 

carefully assess the children for signs of trauma.

13. A school nurse is aware that a student has requested aspirin three times during the past week because his "back hurts." The nurse has noticed that he often wears long-sleeved sweaters and sweatshirts even in warm weather. The nurse suspects that the student may be the victim of physical abuse. The nurse is preparing to ask the child about his ongoing backache. Which of the following would the nurse anticipate being reported by the child if he was being abused? 

Be reluctant to report abuse because of shame or fear of retaliation

14. The nurse can assess potential victims of domestic violence by asking which question? 

"Has a past or current partner ever caused you to be afraid?"

15. Which are forms of psychological abuse? Select all that apply.   

Insulting Humiliating isolating a person from family

16. Which provides the most appropriate example of neglect according to the definition of the term? 

Rejecting a 3-year-old who cries and seek affection after falling

17. A client runs to the urgent care center because the spouse is at home drinking and waving a gun around while yelling at the children. Which action should the nurse take first? 

contact the police

18. Which statement made by a client raises the greatest concern that the client may be experiencing relationship violence? 

"I don't know what else I can do to keep him from getting angry at me."

19. Which three elements are necessary to legally define rape of a male, female, or mixed gendered person? 

Use of force; vaginal, oral, or anal penetration; nonconsent of victim

20.A nurse is giving a talk about child abuse to a local community group. When discussing risk factors for child abusers, which would the nurse identify as the most likely profile of the perpetrator of fatal child abuse? 

Unemployed young woman who dropped out of high school

21. A client comes to the clinic for an evaluation. The nurse assesses the client and suspects that the client is a victim of abuse. Which finding would support the nurse's suspicion? Select all that apply.   

The client is vague about the injuries on the body. The client minimizes the severity of the injuries. The client has a history of frequent visits to the emergency department for injuries.

22. A client comes to the clinic for a prenatal visit. While the client is in the examining room, her estranged husband appears and insists on seeing the client. The client tells the nurse that they are in the process of getting a divorce and she does not want to be around him. "He's been following me to work and at my home everyday." What should the nurse suspect? 

Stalking

23. A frightened young woman calls the emergency department and tearfully tells the nurse, “I've been raped! Please help me!” Before telling the client what to do, the nurse would need to know if 

If the client was injured, was in a safe place, and had transportation available

24. A nurse is working in the emergency department. Which situation would lead the nurse to suspect possible abuse of a client? Select all that apply.   

A 6-year-old is being seen for the 5th time for a urinary tract infection A baby with contrecoup injuries to the brain A 3-month-old with a fractured femur

25. When interviewing an abused child, the nurse must first complete what? 

Establish a safe environment

26. Which provides the most appropriate example of neglect according to the definition of the term? 

Rejecting a 3-year-old who cries and seek affection after falling

27. A nurse is aware of the high incidence of intimate partner violence (IPV) and actively seeks opportunities to screen women for IPV. Which female client represents the best opportunity for assessing for IPV? 

A client who is in the third trimester of pregnancy and who is having biweekly prenatal appointments at a clinic

28. A psychiatric-mental health nurse is conducting a program for a women's group. When describing psychological abuse, which information would the nurse address? Select all that apply.    

Criticism Insults Public ridicule Isolating a person from family

29. A nurse is working on developing a safety plan with a client who is a survivor of violence. Which would the nurse address first? 

Recognizing the signs of danger

30. The school health nurse is asked to see a child who has been coming to school with no lunch for the past week. The child tells the nurse, "I don't get a lunch this week, I have been wetting the bed." The nurse identifies that this child is experiencing which type of abuse? 

neglect

31. Which would not increase the likelihood that an older adult will incur physical abuse? 

The older adult is independent with activities of daily living.

32. A 27-year-old has been brought to the emergency department by emergency medical services following a violent sexual assault that took place in the parking garage of the client's building. Which task would fall most clearly within the scope of practice of a forensic nurse? 

Collecting specimens from the client for use as evidence

33. When attempting to preserve evidence from a possible rape with no report of oral sex, the female victim should be instructed that which self-care activities are permitted? 

Drinking a glass of water

34. The nurse provides care to individuals who have been sexually assaulted during their childhood. Which characteristic is most commonly noted by the nurse during an assessment of such clients? 

Unusually aggressive

35. A nurse is seeing a 3-year-old child who is brought to a pediatric clinic by the mother with concerns about toilet training. The nurse notes the child has multiple bruises of various ages on the arms, trunk, and legs. The nurse should suspect: 

physical abuse.

36. A nurse is working with a child whose parents have subjected him to neglect and emotional maltreatment, which primarily took the form of unavailability and general disinterest in his welfare. The nurse should expect that a child subjected to this type of maltreatment would experience problems in which of the following? 

Multiple intellectual, physical, behavioral, and emotional arenas

37. The nursing student learning about intimate partner violence correctly identifies its prevalence in same-sex couples as what? 

Same frequency as in heterosexual couples

38. When the school nurse is assessing an adolescent who reports trouble sleeping, which characteristics of the client indicate there may be violence in the home? (Select all that apply.)   

the client's father monitors contact with friends has a family history of alcohol abuse must go straight home after school each day

39. Which statement, made by a nurse who experienced sexual abuse as as a child, demonstrates being best prepared to work with sexual abuse and trauma survivors? 

"I've been supported by health care professionals and now I want to support other survivors."

40. A female client states that she has been receiving numerous text and phone messages from a co-worker. Which type of harrassment should be documented in the nurse's notes? 

Cyberstalking

41. A group of nursing students is reviewing information about the types of abuse. The students demonstrate understanding of the information when they identify stalking as a crime of which of the following? 

Intimidation

42. A young adult client female is assessed after being raped. The client reports being tied up and beaten while the perpetrator forced sexual intercourse. She recalls the perpetrator saying, "I will make you pay." What most accurately describes this category of rapist? 

anger retaliation

43. The nurse is aware that fewer than half of rapes and sexual assaults are reported. Which are some of the reasons people do not report being sexually assaulted? Select all that apply.   

The client is embarrassed of the assault. They have a fear of being blamed for the incident. The perpetrator may use coercion or threats to control the victim.

44. A nurse is caring for a family in which the elderly mother has been a victim of abuse and neglect by her son 48 years of age. Which of the following would be most important for the nurse to keep in mind before interviewing the family? 

The nurse must allow the older adult mother to decide whether she wants to leave the situation.

45. Which assessment question should the nurse ask of a client suspected of being ostracized by a school bully? 

"Do you feel like a part of a group in school?"

46. A nurse is caring for a family in which the elderly mother has been a victim of abuse and neglect by her son 48 years of age. Which of the following would be most important for the nurse to keep in mind before interviewing the family? 

The nurse must allow the older adult mother to decide whether she wants to leave the

47. What percentage of women can expect to be a victim of an ongoing unwanted pursuit from stalking? 

12-32%

48. When assessing a 6-year-old child believed to be a victim of emotional abuse, the possibility is supported when the child is ... 

observed to be anxious and rejecting adult attention.

49. Approximately what percentage of women rape victims are raped by someone they know? 

65%

50. Which type of elder abuse involves leaving an older adult and no longer providing care for the individual? 

Abandonment

51. When noted in an assessment of a child, the nurse should suspect child abuse if which common physical findings signaling abuse are present? 

Bruises, burns, lacerations, missing teeth, and skeletal injuries

52. A nursing student learning about intimate partner violence (IPV) correctly identifies the percentage of deaths attributed to IPV to be what? 

70% women and 30% men

53. After a series of admissions to the emergency department over the past several months, an 80-year-old client's malnutrition, vague history, and pattern of physical injuries lead the nurse to suspect elder abuse. Which aspect of the client's situation may contribute to elder abuse? Select all that apply.   

The client is physically dependent on the client's son since losing mobility. The client has no income or savings of the client's own. The client's son describes the client as “needy, helpless, and pathetic.”

54. The nurse in the emergency room is assessing a client who was brought in by the police for evaluation after receiving a call from a neighbor. The client reports to the nurse that the person who has been cooking and helping around the house has not been home for days. Which type of abuse does the nurse suspect based on the client's statement? 

Abandonment

55. Nurses at an urban emergency department seek to develop a plan to help women involved in abusive relationships. Which component is critical to the success of the plan? 

Access to community resources for referral

56. A client who has been victimized repeatedly by a spouse is angry and verbally lashing out on the nurse. Based on the client's behavior, which technique would the nurse use with this client? 

use “I feel” statements

57. A mental health nurse presenting an educational program on rape for high school students responds to the statement, "Women cry rape often times just to get even with the guy," by offering which answer? 

"Actually, fewer than 2% of all reported rapes are found to be false."

58. A group of nursing students is reviewing information about intimate partner violence (IPV). The group demonstrates understanding of this topic when they identify which of the following? 

Men may not consider behaviors such as slapping or shoving as abuse.

59. Which characteristics are found in violent families? Select all that apply.   

Abuse of power and control Alcohol use disorder Social isolation

60. The nurse completes screening of an adult client and determines that abuse is occurring in the home. What should the nurse do before completing a physical assessment? 

Offer the client the use of the telephone.

61. A nurse is preparing to gather a health history of a client. Which questions can elicit disclosure if a client has been abused? Select all that apply.   

"When there are arguments at home, have you ever been hurt or afraid?" "It looks like someone has hurt you. Tell me about it." "Some other women I have cared for have described problems like yours. If this is happening to you, can we talk about it."

62. A nurse is interviewing a client who is a survivor of abuse. The client is telling the nurse about how the violence occurred. Which statement would the nurse interpret as reflecting the honeymoon phase of the cycle of violence? 

“He told me that he was sorry and that he would never hit me again.”

63. The nurse asks the parent of a school-age child about intimate partner violence in the home. Which assessment finding caused the nurse to complete this assessment? 

child crying and appearing sad

64. Nurses working with rape trauma victims need to be aware of their own attitudes about rape and sexual assault. Which rationale best explains why? 

Giving back the survivor as much control as possible is important.

65. The nurse's suspicion that a child has been sexually abused is supported by what assessment data? Select all that apply.    

The anal area is bruised The child reports "itching down there" The vulva appears edematous The urinalysis reports a bacterial infection

Chapter 13 Trauma and Stressor-related Disorder 1. A nurse is developing a care plan for a client who has post-traumatic stress disorder. Which intervention by the nurse is a priority? 

Promote discussion of the client’s thoughts and feelings about the stressful event.

Explanation: In order to adequately assess the client and plan for interventions, the nurse must understand the client’s thoughts and feelings about the stressful event. Delaying coping measures can result in maladaptation, which may cause illness, a lowered self-concept, and decrease in social functioning. The client must learn coping strategies to deal with the memory of a stressful event. Distractions will not allow the client to resolve emotional issues with the stressor. 2 A nurse is caring for a client with dissociative disorder. The nurse tells the client, “Hello, I'm Robin, your nurse. It is 9 o'clock in the morning now. You are in room number 303. My name is Robin, I'm your nurse.” What is the most appropriate reason for the nurse to repeat this statement? 

The client may need to be reoriented.

Explanation: Dissociation causes disruption in the integrated functions of consciousness, memory, identity, or environmental perception. The nurse may need to repeat relevant information to orient the client to reality. The client is not likely to have difficulty hearing, short-term memory loss, or difficulty understanding the nurse's language. 3 A client has developed posttraumatic stress disorder (PTSD) after a violent sexual assault committed by a close family member. When planning this client's care, the nurse should follow what guideline? 

The nurse should avoid touching the client during interactions unless necessary

Explanation: The nurse should use touch with great caution when working with a client who has experienced a sexual assault. There is no clear need for two caregivers to be present during an assessment. If medications have been prescribed, the nurse should never encourage the client to not take them. The client's support network should be accessed as much as possible. 4 A client with a diagnosis of posttraumatic stress disorder (PTSD) has been brought to the emergency department (ED) by concerned family members, who state that the client is experiencing a “nervous breakdown.” The ED nurse should prioritize what aspect of care during the initial care of t...