Chapter 19: Violence and Abuse Within the Community Mohr: Psychiatric Mental Health Nursing, 6th Edition
1. Viewing violence as a phenomenon with
... [Show More] its roots in the individual, family, community, and overall society is the underlying construct of
A) the holistic model of violence.
B) the environmental model of violence. C) the ecologic model of violence.
D) the social systems model of violence.
Ans: C Chapter: 19
Client Needs: C-1
Cognitive level: Comprehension Concepts & Processes: Teaching/learning Difficulty: Easy
Objective: 01
Feedback: The ecologic model understands violence as a social phenomenon with roots in the person, family, community, and larger society.
2. Pervasive media images of violence are an example of which level of influence?
A) Macrosystem
B) Microsystem
C) Exosystem
D) Ontogenic
Ans: A Chapter: 19
Client Needs: C-1
Cognitive level: Comprehension Concepts & Processes: Teaching/learning Difficulty: Easy
Objective: 02
Feedback: The macrosystem includes the formal and informal social structures and societal influences that make up children and their families' world: neighborhood, schools, workplaces, churches, and social service agencies.
3. Factors that affect the person's emerging capabilities and the environmental response are called
A) interpersonal factors.
B) microsystem factors.
C) maternal-child factors. D) ontogenic factors.
Ans: D Chapter: 19
Client Needs: C-1 Cognitive level: Knowledge
Concepts & Processes: Nursing process Difficulty: Easy
Objective: 02
Feedback: Ontogenic factors are biologic and neurodevelopmental factors within the person that in crease his or her potential for violence. Ontogenic factors indicate a view of development as an ongoing interaction between a person's emerging capabilities and the environmental response.
4. A school nurse is evaluating a family whose 8-year-old threw a rock at a child's head in the playground and has been hitting her classmates. Which factors in the child's recent history should the nurse address?
A) Three-day separation from her mother
B) Restriction of privileges for talking back to her father C) Rejection by her peers
D) Witnessing of a neighborhood argument about a loud party
Ans: C Chapter: 19
Client Needs: B-1 Cognitive level: Analysis
Concepts & Processes: Nursing process Difficulty: Moderate
Objective: 03
Feedback: Children in homes with intimate partner violence are at risk for a range of emotional, physical, and behavioral symptoms. In addition, these children are at risk for physical violence themselves. Findings have shown that children of abused mothers exhibit significantly more internalizing, externalizing, and total behavior problems than children of the same age and sex of nonabused mothers (McFarlane, 2003). Further assessment of the child's peer relationships, or other effects of possible abuse of the child, could promote early detection and treatment for violence in the home, interrupting and preventing behavioral problems for the child.
5. Which of the following statements about intimate partner violence (IPV) is accurate?
A) Screening tools to help the practitioner identify IPV are quite lengthy.
B) Knowledge deficits and biases of healthcare professionals limit its detection.
C) Failure of victims to seek medical treatment is the primary reason for the underdetection of IPV.
D) Victims often do not reveal the true cause of their injuries.
Ans: B Chapter: 19
Client Needs: B-2 Cognitive level: Knowledge
Concepts & Processes: Caring Difficulty: Moderate Objective: 04
Feedback: The literature confirms that a significant factor in the underdetection of IPV rests with professional behavior (Reid & Glasser, 1997). Healthcare practitioners often fail to identify and intervene with abused women. The underlying dynamics of poor screening practices are complex and include both biases and knowledge deficits.
6. Nurses at an urban emergency department seek to develop a plan to help women involved in abusive relationships. Which of the following components is critical to the success of the plan?
A) An intimate partner violence (IPV) counselor
B) Avenues for referral
C) A quality of life assessment tool
D) Educational materials
Ans: B Chapter: 19
Client Needs: C-1 Cognitive level: Application
Concepts & Processes: Nursing process Difficulty: Moderate
Objective: 04
Feedback: Nurses assume their appropriate role in the effort to screen and treat victims of IPV through simple screening and having readily available information and avenues for referral.
7. A nurse is working with a child whose parents have subjected him to neglect and emotional
maltreatment, which primarily took the form of unavailability and general disinterest in his welfare. The nurse should expect that a child subjected to this type of maltreatment would experience problems in
A) emotional and intellectual functioning.
B) behavioral and physical functioning.
C) behavioral and emotional functioning.
D) multiple intellectual, physical, behavioral, and emotional arenas.
Ans: D Chapter: 19
Client Needs: B-2
Cognitive level: Comprehension Concepts & Processes: Nursing process Difficulty: Moderate
Objective: 05
Feedback: Maltreated children tend to have difficulties in social, behavioral, emotional, and intellectual functioning, as well as physical growth and development.
8. Mrs. Jones, 55 years old, is the primary caregiver for her 78-year-old uncle. The uncle's cognition is intact, but he is frail and cannot perform activities of daily living without assistance. Mrs. Jones brings her uncle to the clinic for a routine examination, and the nurse notes that she quickly answers the interview questions for her uncle, stating, “He's OK; everything's fine.” When the nurse directs her questions to the client, he looks to his niece before saying, “I'm OK, just old.” Findings of the physical examination are unremarkable. Which of the following interventions should the nurse implement?
A) Meet with the uncle privately to screen for elder abuse.
B) Meet with Mrs. Jones privately to ask if she can manage her role as caregiver.
C) Schedule a routine follow-up appointment; there are no signs of elder abuse.
D) Ask Mrs. Jones if she thinks her uncle is becoming depressed.
Ans: A Chapter: 19
Client Needs: A-2 Cognitive level: Application
Concepts & Processes: Nursing process Difficulty: Moderate
Objective: 06
Feedback: The nurse assesses communication between the caregiver and older adult. Agitation, fear, and reticence from the elder client are possible indicators of mistreatment. Suspicious caregiver behaviors include humiliating comments, frequent interruptions, use of an unfeeling voice, and a lack of caring (Cowen, 2001).
9. When healthcare professionals detect signs of elder abuse in clients, the law requires them to
A) report the abuse to the state authorities.
B) set up family counseling sessions.
C) find temporary housing for the client.
D) educate the client and family about elder abuse.
Ans: A Chapter: 19
Client Needs: A-2 Cognitive level: Knowledge
Concepts & Processes: Documentation Difficulty: Moderate
Objective: 06
Feedback: Once the nurse has detected elder abuse, he or she is responsible for reporting the mistreatment. Each state has its own guidelines to follow. Generally, after the nurse has reported the abuse, a state protective services worker meets with the victim (Fulmer, 1999).
10. The nurse coordinator of student healthcare at a large university is meeting with a group of female freshman to discuss rape and sexual assault. One girl comments that if she avoids strangers or situations where she is outdoors by herself at night, she will be safe from sexual attacks. The nurse informs the audience that rape by a stranger accounts for what percentage of total rapes?
A) 50%
B) 25%
C) 15%
D) 70%
Ans: C Chapter: 19
Client Needs: B-2 Cognitive level: Knowledge
Concepts & Processes: Teaching/learning Difficulty: Moderate
Objective: 07
Feedback: Rape by a stranger accounts for only approximately 15% of total rapes. In 85% of cases, the survivor knows the rapist (eg, acquaintance, close friend, lover, family member, neighbor) (National Institute of Justice & CDC, 2000).
11. Rape trauma syndrome refers to
A) a process that includes an acute disorganization phase and a long-term reorganization phase.
B) an abnormally severe psychological response to a sexual assault.
C) irritability and difficulty concentrating for extended periods after the attack.
D) physical injuries incurred during the assault.
Ans: A Chapter: 19
Client Needs: C-1 Cognitive level: Knowledge
Concepts & Processes: Nursing process Difficulty: Moderate
Objective: 08
Feedback: Rape trauma syndrome is a two-phase process experienced by all rape survivors. The first phase, which may last days or weeks, is the acute phase of disorganization. The second phase of the rape trauma syndrome is the long-term process of reorganization.
-30
12. A 20-year-old homosexual man enters the emergency department after being beaten and sexually abused by a group of teenagers. Throughout the assessment, he does not appear upset and cooperates matter-of-factly. The nurse attributes the client's affect to which of the following explanations?
A) The client is handling the assault well emotionally.
B) The reaction is abnormal and suggests an underlying psychological problem.
C) As victims of social stigma, homosexuals are better prepared to deal with the emotional issues surrounding sexual assault.
D) The client's affect is a normal reaction and may represent an effort to regain control.
Ans: D Chapter: 19
Client Needs: C-1 Cognitive level: Analysis
Concepts & Processes: Nursing process Difficulty: Moderate
Objective: 08
Feedback: Whether the survivor is emotional or stoic, the nurse expresses concern. An accepting and caring attitude is critical for the survivor to begin to trust the nurse. Sometimes just being present with a survivor is the most therapeutic thing a nurse can do to help the person feel safe and comfortable. Empowerment also is important, and the nurse may communicate this by respecting the survivor's right to self-determination.
13. The nurse is counseling a trauma victim. In the second stage of trauma treatment, the nurse will plan to encourage the client to
A) develop a support system.
B) tell the story of the trauma in detail.
C) start antidepressant medication.
D) focus on issues of identity and intimacy.
Ans: B Chapter: 19
Client Needs: C-1 Cognitive level: Application
Concepts & Processes: Nursing process Difficulty: Moderate
Objective: 09
Feedback: The second phase of the rape trauma syndrome is the long-term process of reorganization. In this phase, the survivor works toward integration and resolution of the experience. In therapy, they can learn ways to feel safe again and to manage disturbing symptoms. Furthermore, they can remember and work through associated feelings. Telling the story of the trauma helps the victim address the reality of the event and resolve associated feelings.
14. A public health nurse is asked to develop secondary rape prevention strategies for the inner- city business community. Which of the following actions is consistent with this directive?
A) Identify situations that place the individual at risk.
B) Choose a specific hospital to which rape victims will be taken for assessment.
C) Design an education program that explores male/female relationships.
D) Create a press release that gives community members a toll-free number to call for information about sexual assault.
Ans: A Chapter: 19
Client Needs: B-2 Cognitive level: Application
Concepts & Processes: Teaching/learning Difficulty: Difficult
Objective: 05
Feedback: In 85% of rape cases, the survivor knows the rapist (eg, acquaintance, close friend, lover, family member, neighbor) (National Institute of Justice & CDC, 2000). Most rapes involve people who know each other. Survivors of date rapes include women of all ages: the 50-year-old woman who accepts an offer from a coworker for assistance with installing a ceiling fan, the 20- year-old coed who becomes drunk at a party and passes out, and the 70-year-old woman who accepts a ride from a kindly looking church member.
15. Nurses working with rape trauma victims need to be aware of their own attitudes about rape and sexual assault. Which of the following rationales best explains why?
A) Nurses can learn from the experiences of clients and thus help prevent becoming victims of assault themselves.
B) The attitudes of individual nurses reflect on the overall profession.
C) Nurses need to be able to sympathize with their clients.
D) Nurses need to be emotionally available to their clients.
Ans: D Chapter: 19
Client Needs: C-1 Cognitive level: Analysis
Concepts & Processes: Caring Difficulty: Moderate Objective: 10
Feedback: Knowing how to recognize when personal feelings are likely to interfere with optimal care is part of the nurse's professional responsibility. The nurse must be emotionally available to the survivor to empathize with her experience and at the same time view the information dispassionately. The ability to do so is directly proportional to the nurse's ability to acknowledge his or her own feelings. [Show Less]