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What is a nurse's legal responsibility if child abuse or neglect is suspected?
- A. Discuss the findings with the child's teacher, principal, and school psychologist.
- B. Report the suspected abuse or neglect according to state regulations.
- C. Document the observations and speculations in the medical record.
- D. Continue the assessment.
Correct Answer: B
Rationale: Each state has specific regulations for reporting child abuse that must be observed. The nurse is usually a mandated reporter. The reporter does not need to be sure that abuse or neglect has occurred but only that it is suspected. Speculation should not be documented; only the facts are recorded.
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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.
An older adult diagnosed with dementia lives with family and attends day care. After observing poor hygiene, the nurse at the center talks with the patient's adult child. This caregiver becomes defensive and says, 'It takes all my time and energy to care for my mother. She's awake all night. I never get any sleep.' Which nursing intervention has priority?
- A. Teach the caregiver more about the effects of dementia.
- B. Secure additional resources for the mother's evening and night care.
- C. Support the caregiver to grieve the loss of the mother's ability to function.
- D. Teach the family how to give physical care more effectively and efficiently.
Correct Answer: B
Rationale: The patient's child and family were coping with care until the patient began to stay awake at night. The family needs assistance with evening and night care to resume their pre-crisis state of functioning. Secondary prevention calls for the nurse to mobilize community resources to relieve overwhelming stress. The other interventions may then be accomplished.
What feelings are most commonly experienced by nurses working with abusive families?
- A. Outrage toward the victim and sympathy for the abuser
- B. Sympathy for the victim and anger toward the abuser
- C. Unconcern for the victim and dislike for the abuser
- D. Vulnerability for self and empathy with the abuser
Correct Answer: B
Rationale: Intense protective feelings, sympathy for the victim, and anger and outrage toward the abuser are common emotions of a nurse working with an abusive family.
An 11-year-old child is absent from school to care for siblings while the parents work. The family cannot afford a babysitter. When asked about the parents, the child reluctantly says, 'My parents don't like me. They call me stupid and say I never do anything right.' Which type of abuse is likely?
- A. Sexual
- B. Physical
- C. Emotional
- D. Economic
Correct Answer: C
Rationale: Examples of emotional abuse include having an adult demean a child's worth or frequently criticize or belittle a child. No data support physical battering or endangerment, sexual abuse, or economic abuse.
A victim of physical abuse by an intimate partner is treated for a broken wrist. The patient has considered leaving but says, 'You stay together, no matter what happens.' Which outcome should be met before the patient leaves the emergency department? The patient will:
- A. limit contact with the abuser by obtaining a restraining (protective) order.
- B. name two community resources that can be contacted.
- C. demonstrate insight into the abusive relationship.
- D. facilitate counseling for the abuser.
Correct Answer: B
Rationale: The only outcome indicator clearly attainable within this time is for a staff member to provide the victim with information about community resources that can be contacted. The development of insight into the abusive relationship requires time. Securing a restraining (protective) order can be quickly accomplished but not while the patient is in the emergency department. Facilitating the abuser's counseling may require weeks or months.