Nokea
A patient tells the nurse, 'My husband is abusive only when he drinks too much. His family was like that when he was growing up. He always apologizes and regrets hurting me.' What risk factor was most predictive for the husband to become abusive?
- A. History of family violence
- B. Loss of employment
- C. Abuse of alcohol
- D. Poverty
Correct Answer: A
Rationale: An abuse-prone individual is an individual who has experienced family violence and was often abused as a child. This phenomenon is part of the cycle of violence. The other options may be present but are not as predictive.
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An older adult diagnosed with dementia lives with family and attends an adult day care center. A nurse at the center notices the adult has a disheveled appearance, a strong odor of urine, and bruises on the limbs and back. What type of abuse might be occurring?
- A. Psychological
- B. Financial
- C. Physical
- D. Sexual
Correct Answer: C
Rationale: The assessment of physical abuse is supported by the nurse's observation of bruises. Physical abuse includes evidence of improper care, as well as physical endangerment behaviors such as reckless behavior toward a vulnerable person that could lead to serious injury. No data substantiate the other options.
A patient at the emergency department is diagnosed with a concussion. The patient is accompanied by a spouse who insists on staying in the room and answering all questions. The patient avoids eye contact and has a sad affect and slumped shoulders. Assessment of which additional problem has priority?
- A. Risk of intimate partner violence
- B. Phobia of crowded places
- C. Migraine headaches
- D. Depressive symptoms
Correct Answer: A
Rationale: The diagnosis of a concussion suggests violence as a possible cause. The patient is exhibiting indicators of abuse including fearfulness, depressed affect, poor eye contact, and a possessive spouse. The patient may be also experiencing depression, anxiety, and migraine headaches, but the nurse's advocacy role necessitates an assessment for intimate partner violence.
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.
An adult has recently been absent from work for 3-day periods on several occasions. Each time, this person returns to work wearing dark glasses. Facial and body bruises are apparent. What is the occupational health nurse's priority assessment question?
- A. Do you drink excessively?
- B. Did your partner beat you?
- C. How did this happen to you?
- D. What did you do to deserve this?
Correct Answer: C
Rationale: Obtaining the person's explanation is necessary. If the explanation does not match the injuries or if the victim minimizes the injuries, abuse should be suspected.
A nurse visits the home of an 11-year-old child and finds the child caring for three younger siblings. Both parents are at work. The child says, 'I want to go to school but we can't afford a babysitter. It doesn't matter; I'm too dumb to learn.' What preliminary assessment is evident?
- A. Insufficient data are present to make an assessment.
- B. Child and siblings are experiencing neglect.
- C. Children are at high risk for sexual abuse.
- D. Children are experiencing physical abuse.
Correct Answer: B
Rationale: A child is experiencing neglect when the parents take away the opportunity to attend school. The other children may also be experiencing physical neglect, but more data should be gathered before making the actual assessment. The information presented does not indicate a high risk for sexual abuse, and no concrete evidence of physical abuse is present.