Nokea
A 12-year-old male is brought to his primary care provider to determine whether sexual abuse has occurred. The mother states, 'Because there is no permanent physical damage, he does not need any more treatment.' The nurse's response should be based on which of the following pieces of information?
- A. Male victims of sexual abuse seldom have long-term psychological problems.
- B. Survivors of male sexual abuse might become confused about their sexual identity.
- C. Unless treated, all male sex abuse survivors grow up to abuse other children.
- D. All children who have been sexually abused have the same needs, regardless of gender.
Correct Answer: B
Rationale: Male children are sexually abused nearly as often as female children. Perpetrators are usually men but can be women. Needs of male children who have been sexually abused might be different from the needs of female survivors. Male survivors might respond in anger, question their sexuality, use alcohol and other drugs, and might try to prove their masculinity by performing daring acts.
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The kind of man who beats a woman is:
- A. from a minority culture in a low-income group.
- B. from a majority culture in a middle-income group.
- C. one who was never allowed to compete as a child.
- D. from any walk of life, race, income group, or profession.
Correct Answer: D
Rationale: Batterers cannot be predicted by demographic features related to age, ethnicity, race, religious denomination, education, socioeconomic status, or class. Ninety-five percent of domestic abuse cases involve male perpetrators and female victims.
Elderly persons with pernicious anemia should be instructed:
- A. to increase their dietary intake of foods high in B12.
- B. that they do not need to return for follow-up for at least a month after initiation of treatment.
- C. that oral B12 is safer and less expensive than parenteral replacement.
- D. that diarrhea can be a transient side effect of B12 injections.
Correct Answer: D
Rationale: Pernicious anemia is a megaloblastic, macrocytic, normochronic anemia caused by a deficiency of the intrinsic factor produced by the stomach. This results in malabsorption of vitamin B12, which is necessary for DNA synthesis and maturation of RBC. Education should include side effects of Vitamin B12, which can include pain and burning at the injection site, peripheral vascular thrombosis, and transient diarrhea.
The nurse is working with families who have been displaced by a fire in an apartment complex. What is the priority intervention during the initial assessment?
- A. Provide a liaison to meet housing needs.
- B. Attentively listen when clients describe their feelings.
- C. Offer nurturing support for clients who are confused by the events.
- D. Provide structure for clients exhibiting moderate to severe anxiety.
Correct Answer: A
Rationale: After physical needs of housing, clothing and food are met, the nurse should focus on assisting clients to manage the psychological effects of loss.
An 8-year-old Asian child is being examined during a school screening. The nurse notices small bruises on the anterior and posterior ribs. The nurse should ask the child:
- A. If the family practices coining
- B. Who hit him
- C. If the child has fallen
- D. How long the abuse has been occurring
Correct Answer: A
Rationale: Coining, a cultural practice in some Asian communities, can cause bruising and should be assessed to differentiate from abuse. Other options assume abuse prematurely.
The nurse should make which of the following responses when questioned by a client about the role of leptin in the body?
- A. It increases food intake in clients, thereby promoting obesity.
- B. It assists in the regulation of steroids.
- C. It increases the total fat mass of people who are obese.
- D. It might decrease the total fat mass in the bodies of people who are obese.
Correct Answer: D
Rationale: Leptin (recessive obesity gene-protein hormone) is expressed in fat cell coding for the protein that reacts to the percentage of fat cells in the body. Leptin is associated with increased energy expenditure and decreased food intake via hypothalamic control. Obese clients might have insensitivity or resistance to the effects of leptin. Leptin can affect other body hormones such as insulin. Genetic factors include leptin, uncoupling proteins, and the amount of brown/white fat in the body.