A guest lecturer from a treatment program for perpetrators of abuse is describing the program to a group of nursing students. The program uses cognitive behavioral techniques. Which of the following would the lecturer include as a focus of the program? Select all that apply.
- A. Identifying what the perpetrator thinks about before the incident
- B. Determining the perpetrator?s emotional and physical responses to the thoughts
- C. Exploring the perpetrator?s actions that eventually lead to violence
- D. Identifying the behaviors in the survivor that led to the violence
- E. Determining the extent of guilt or remorse experienced by the perpetrator
Correct Answer: A,B,C
Rationale: Cognitive behavioral techniques focus on identifying thoughts (A), emotional/physical responses (B), and actions (C) leading to violence to modify behavior. Blaming the survivor (D) is inappropriate, and assessing guilt/remorse (E) is secondary to addressing the cognitive-behavioral cycle.
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A nurse is assessing a survivor of intimate partner violence. During the interview, the nurse determines that the survivor?s partner is using power and control over the client through coercion and threats. Which client statement would lead the nurse to suspect this?
- A. He always tells me that the abuse never happened.
- B. He tells me who I can and cannot see.
- C. He tells me that he?ll tell child services I?m a bad mother.
- D. He acts like he?s the master of his castle and I?m his servant.
Correct Answer: C
Rationale: Threatening to report to child services (C) is a clear example of coercion and threats, a tactic of power and control in IPV. Denying abuse (A) is gaslighting, controlling social interactions (B) is isolation, and acting superior (D) is emotional abuse, but threats (C) are most indicative of coercion.
A nurse is assessing a client who is a survivor of abuse. Which of the following would be most appropriate to use when conducting a lethality assessment?
- A. Danger Assessment Screen
- B. Abuse Assessment Screen
- C. Burgess-Partner Abuse Scale
- D. Beck Depression Inventory
Correct Answer: A
Rationale: The Danger Assessment Screen (A) is specifically designed to assess the risk of lethal violence in abuse survivors, focusing on factors like threats or weapon use. The Abuse Assessment Screen (B) identifies abuse but not lethality, the Burgess scale (C) is less specific, and the Beck Depression Inventory (D) assesses depression, not lethality.
The 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?
- A. Explain that his father is beating him on a regular basis.
- B. Give a far-fetched explanation not logically connected to his injuries.
- C. Give the same reason his sister would give were she asked to explain his injuries.
- D. Carefully explain that his mother disciplines him because she loves him.
Correct Answer: B
Rationale: Children experiencing abuse often provide far-fetched or illogical explanations (B) to conceal the abuse due to fear or shame. Direct admission (A) is unlikely, matching a sibling?s story (C) is not typical, and justifying discipline as love (D) is less common in children.
The emergency department nurse is assessing a female client with traumatic injuries. To assess whether or not the client?s injuries have resulted from abuse, which question would be most appropriate for the nurse to ask the client?
- A. Is your partner being mean to you?
- B. Why do you think your husband has beaten you?
- C. It looks like someone has hurt you. Tell me about it.
- D. Can you describe the person who did this to you?
Correct Answer: C
Rationale: The open-ended, nonjudgmental question 'It looks like someone has hurt you. Tell me about it.' (C) encourages the client to share details without assuming abuse or blaming her. Option A is vague, option B implies blame, and option D focuses on the perpetrator rather than the client?s experience.
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 phase 3 of the cycle of violence?
- A. He threw me against the wall and started punching my face.
- B. He yells at me for not having dinner waiting for him when he came home.
- C. He calls me stupid and incompetent, asking himself why he ever married me.
- D. He tells me that he is sorry and that he will never hit me again.
Correct Answer: D
Rationale: Phase 3 of the cycle of violence, the honeymoon phase, involves the abuser expressing remorse and promising not to repeat the violence (D). Phase 1 (tension-building) includes yelling or verbal abuse (B, C), and phase 2 (acute battering) involves physical violence (A).
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