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A nurse assists a victim of intimate partner violence to create a plan for escape if it becomes necessary. The plan should include which components? (Select all that apply.)
- A. Keep a cell phone fully charged.
- B. Hide money with which to buy new clothes.
- C. Have the telephone number for the nearest shelter.
- D. Take enough toys to amuse the children for 2 days.
- E. Secure a supply of current medications for self and children.
- F. Determine a code word to signal children that it is time to leave.
- G. Assemble birth certificates, Social Security cards, and licenses.
Correct Answer: A,C,E,F,G
Rationale: The victim must prepare for a quick exit and so should assemble necessary items. Keeping a cell phone fully charged will help with access to support persons or agencies. The individual should be advised to hide a small suitcase containing a change of clothing for self and for each child. Taking a large supply of toys would be cumbersome and might compromise the plan. People are advised to take one favorite small toy or security object for each child, but most shelters have toys to further engage the children. Accumulating enough money to purchase clothing may be difficult.
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An older adult diagnosed with Alzheimer's disease lives with family. During the week, the person attends a day care center while the family is at work. In the evenings, members of the family provide care. Which factor makes this patient most vulnerable to abuse?
- A. Dementia
- B. Living in a rural area
- C. Being part of a busy family
- D. Being home only in the evening
Correct Answer: A
Rationale: Older adults, particularly those with cognitive impairments, are at high risk for abuse. The other characteristics are not identified as placing an individual at high risk for abuse.
An adult has recently been absent from work for 3-day periods on several occasions. Each time, the individual returns to work wearing dark glasses. Facial and body bruises are apparent. What is the occupational health nurse's priority assessment?
- A. Interpersonal relationships
- B. Work responsibilities
- C. Socialization skills
- D. Physical injuries
Correct Answer: D
Rationale: The individual should be assessed for possible battering. Physical injuries are abuse indicators and are the primary focus for assessment. No data support the other options.
Which rationale best explains why a nurse should be aware of personal feelings while working with a family experiencing family violence?
- A. Self-awareness protects one's own mental health.
- B. Strong negative feelings interfere with assessment and judgment.
- C. Strong positive feelings lead to under involvement with the victim.
- D. Positive feelings promote the development of sympathy for patients.
Correct Answer: B
Rationale: Strong negative feelings cloud the nurse's judgment and interfere with assessment and intervention, no matter how well the nurse tries to cover or deny personal feelings. Strong positive feelings lead to overinvolvement with the victim.
After treatment for a detached retina, a victim of intimate partner violence says, 'My partner only abuses me when intoxicated. I've considered leaving, but I was brought up to believe you stay together, no matter what happens. I always get an apology, and I can tell my partner feels bad after hitting me.' Which nursing diagnosis applies?
- A. Social isolation, related to lack of community support system
- B. Risk for injury, related to partner's physical abuse when intoxicated
- C. Deficient knowledge, related to resources for escape from the abusive relationship
- D. Disabled family coping, related to uneven distribution of power within a relationship
Correct Answer: B
Rationale: Risk for injury is the priority diagnosis because the partner has already inflicted physical injury during violent episodes. The episodes are likely to become increasingly violent. Data are not present that show social isolation or disabled family coping, although both are common among victims of violence. Deficient knowledge does not apply to this patient's use of defense mechanisms.
A clinic nurse interviews an adult patient accompanied by a partner who reports fatigue, back pain, headaches, tension, and sleep disturbances. The patient then becomes reluctant to provide more information and wants to leave. How can the nurse best serve the patient?
- A. Explore the possibility of patient social isolation.
- B. Have the partner leave the patient alone to continue the assessment.
- C. Ask whether the patient has ever had psychiatric counseling in the past.
- D. Ask the patient to disrobe so that assessment for signs of physical abuse can occur.
Correct Answer: B
Rationale: In this situation, the nurse should consider the possibility that the patient is a victim of intimate partner violence. Although the patient is reluctant to discuss issues, he or she may be willing to speak more candidly if the partner is not in the room. None of the other options focus on the client's reluctance to continue the assessment process.