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An employee has recently been absent from work on several occasions. Each time, this employee returns to work wearing dark glasses. Facial and body bruises are apparent. During the occupational health nurse's interview, the employee says, 'My partner beat me, but it was because there are problems at work.' What should the nurse's next action be?
- A. Notify the police.
- B. Refer the employee to a shelter.
- C. Notify the adult protective agency.
- D. Document injuries with a body map.
Correct Answer: D
Rationale: Documentation of the injuries provides a basis for possible legal intervention. The abused adult will need to make the decision to involve the police. Because the worker is not an older adult and is competent, the adult protective agency is unable to assist. A shelter may be suggested later, but it is not the next action.
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Which referral is most appropriate for a woman who is severely beaten by her husband, has no relatives or friends in the community, is afraid to return home, and has limited financial resources?
- A. Support group
- B. Law enforcement
- C. Women's shelter
- D. Vocational counseling
Correct Answer: C
Rationale: Because the woman has no safe place to go, referral to a shelter is necessary. The shelter will provide other referrals as necessary. None of the other options proves the necessary level of safety.
A community health nurse visits a family with four children. The father behaves angrily, finds fault with a child, and asks twice, 'Why are you such a stupid kid?' The wife says, 'I have difficulty disciplining the children. It's so frustrating.' Which comments by the nurse will facilitate the interview with these parents? (Select all that apply.)
- A. Tell me how you punish your children.
- B. How do you stop your baby from crying?
- C. Caring for four small children must be difficult.
- D. Do you or your husband ever beat the children?
- E. Calling children 'stupid' injures their self-esteem.
Correct Answer: A,B,C
Rationale: An interview with possible abusing individuals should be built on concern and carried out in a nonthreatening, nonjudgmental way. Empathic remarks are helpful in creating rapport. Questions requiring a descriptive response are less threatening and elicit more relevant information than questions that can be answered by 'yes' or 'no.'
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.
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.
Which family scenario presents the greatest risk for family violence?
- A. An unemployed husband with low self-esteem, a wife who loses her job, and a developmentally delayed 3-year-old child
- B. A husband who finds employment 2 weeks after losing his previous job, a wife with stable employment, and a child diagnosed with attention deficit disorder
- C. A single mother with an executive position, a gifted and talented child, and a widowed grandmother living in the home to provide child care
- D. A single homosexual male parent and an adolescent son who has just begun dating girls
Correct Answer: A
Rationale: The family with an unemployed husband with low self-esteem, a newly unemployed wife, and a developmentally challenged young child has the greatest number of stressors. The other families described have fewer negative events occurring.