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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.
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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.
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 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 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.'