Test Bank Violence Nies: Community/Public Health Nursing, 7th Edition
MULTIPLE CHOICE
1. Which statement about homicide in 2015 is
... [Show More] accurate?
a. Almost 80% of homicide victims were male.
b. Approximately 70% of victims were killed by someone they knew.
c. Approximately 25% of the offenders were female.
d. Almost 75% of the murder victims were black, when race could be identified.
ANS: A
In the United States, homicide claimed the lives of 15,695 individuals in 2015; over 10,000 deaths involved the use of firearms. Of note, almost 80% of the murder victims were male and 90% of the offenders were male. When race of the murder victims could be determined, 53% were black, 44% were white, and 2.8% were other races. Approximately 50% of victims were killed by someone they knew.
DIF: Cognitive Level: Understand (Comprehension)
2. Which best describes the typical perpetrator of homicide?
a. A person trying to engage in rape with the woman fighting back
b. A person who wanted money and she refused to give it to him
c. A stranger
d. An intimate partner
ANS: D
NURSINGTB.COM
Approximately 50% of the victims were killed by someone they knew. Notably 37% of female murder victims are killed by an intimate partner. Thus, the typical perpetrator would be an intimate partner. It would be less likely to be a stranger, someone who wanted money, or someone trying to engage in rape.
DIF: Cognitive Level: Understand (Comprehension)
3. A nurse is assessing a client for suicide risk. Which question would the nurse most likely ask the client?
a. “How often do you use consume alcohol or other legal or illegal substances?”
b. “How much sleep do you get each night?”
c. “Do you have any children?”
d. “ How long have you lived at your current residence?”
ANS: A
Nurses have an important role in identifying individuals who are at risk for suicide. Risk factors for suicide include: history of depression or other psychiatric disorders, alcohol and/or substance abuse, physical illness, past history of attempted suicide, past history of violence, age, environmental stressors.
DIF: Cognitive Level: Analyze (Analysis)
4. For which group is suicide the second leading cause of death?
a. People aged 15 to 25 years
b. People aged 10 to 34 years
c. People aged 34 to 54 years
d. People over age 65 years
ANS: B
In 2014, suicide was the second leading cause of death for those between the ages of 10 and 34 years, and it is the fourth leading cause of death in people aged 34 to 54 years.
DIF: Cognitive Level: Remember (Knowledge)
5. A woman was seen in the emergency department with a greenstick broken arm and chest bruises. She explained she fell up a staircase at home while carrying laundry to the bedrooms. Besides assessing for other injuries, which action should be taken by the nurse?
a. Ask about and educate regarding intimate partner violence (IPV)
b. Assess for use of alcohol or other drugs that might have been a causative factor in the fall
c. Get the patient an x-ray examination to determine location and severity of the break
d. Immediately apply ice and immobilize in a sling
ANS: A
Intimate partner violence (IPV) includes four different types of behavior: physical violence, sexual violence, psychological aggression, and stalking. IPV is often repetitive, progressive, and escalates in frequency and severity. IPV crosses all ethnic, racial, socioeconomic, and educational lines. Thus, the nurse must assess for IPV.
DIF: Cognitive Level: Apply N(AUpRplSicaItiNonG) TB.COM
6. A woman is in the emergency department for the fifth time this year, each time with more severe injuries. Which is the primary responsibility of the nurse?
a. Insist she be discharged to a safe shelter where the perpetrator cannot find her
b. Provide information regarding safe shelters and sources of support
c. Report the assault and battery to the local police department so the perpetrator is arrested for the crime
d. Treat the injuries and inform the woman she may be killed if she stays with the perpetrator
ANS: B
Working with victims of intimate partner violence (IPV) requires the nurse to establish rapport and trust; deal with issues of confidentiality honestly; provide current information regarding shelters and sources of support; and recognize and accept that clients may “choose” to stay in an abusive relationship. Because the nurse wants to establish rapport and trust, it would not be in the best interest of building this relationship if the nurse insist that she go to a safe shelter (rather the nurse should provide her the necessary information) or inform the woman she may be killed (rather the nurse should recognize and accept that the client may “choose” to stay in an abusive relationship). Additionally, the nurse should recognize that even if the assault is reported, it may be denied by the woman and will not result in an arrest of the perpetrator.
DIF: Cognitive Level: Apply (Application)
7. A 4-year-old child is seen in the emergency department with a spiral fracture of the right arm. X-ray examination shows previously broken and healed bones. Which is the immediate responsibility of the nurse?
a. Call social services to immediately set up foster care for the child
b. Provide information about parenting and anger management classes
c. Report the child abuse to the local legal authorities
d. Try to establish rapport and trust with the child’s family
ANS: C
Spiral fractures are only possible from abuse, because they require a wringing motion to occur. When working with victims of child abuse, the primary obligation of all health care providers is to protect the child. The abuse must be reported as a legal and ethical obligation.
DIF: Cognitive Level: Apply (Application)
8. A man was crying and said, “I didn’t mean to do it. She just got me so angry I lost control. It will never happen again.” The woman said, “It was my fault. I shouldn’t have upset him.”
Then, looking at the nurse, the woman added, “Please don’t report this. It will never happen again.” Which is the most appropriate response by the nurse?
a. “Abusers don’t stop unless intervention occurs. I have to report it.”
b. “If you’re sure it won’t happen again, I’ll let it go this time.”
c. “Legally, I’m required to put this in the medical record.”
d. “The decision is up to the physician, not me.”
ANS: A
It is a common myth that abusers will stop the abuse on their own. Professional intervention is required to break the cycle ofNaUbuRsSe.ITNheGoTnBly.wCaOy Mto effectively begin breaking the cycle of abuse is to report the incident. The nurse has a professional responsibility to report the abuse,
just as the physician does. Documenting the information in the medical record will not initiate stopping the cycle of abuse.
DIF: Cognitive Level: Apply (Application)
9. Which best describes the incidence of abuse among pregnant women?
a. It is too difficult to determine the actual incidence of abuse among this population.
b. It is estimated that approximately 1 out of every 10 women experiences abuse.
c. Approximately one out of every six women has been abused by a partner.
d. Abuse does not occur among pregnant women.
ANS: C
Pregnancy does not protect women from the danger of abuse. Indeed, pregnancy may increase stress within the family and provoke the first instances of battering. It is estimated that one in six pregnant women have been abused by a partner.
DIF: Cognitive Level: Understand (Comprehension)
10. A rape victim says to the nurse, “He said he loved me; he had been so nice; he said he wanted to show me how much he loved me. And then he.…” Which is the most appropriate response by the nurse?
a. “Anyone can lose control; I’m sure he’ll never do it again.”
b. “I’m not sure he loves you; he may just have wanted easy sex.”
c. “Rape isn’t about love or even sex; it’s about power and control.”
d. “You shouldn’t have gone up to his room alone when the two of you had both been drinking.”
ANS: C
Intimate partner violence is a crime of power and control. It is important the nurse is aware of the myths around IPV which include: victims deserve the abuse, victims can change the abusers’ behavior, and abusers will stop the abuse on their own without professional intervention.
DIF: Cognitive Level: Apply (Application)
11. A female student is at a fraternity party where alcohol is flowing freely, the music is loud, and people are dancing and talking. Most people seem to be having a great time. What action should the student take, if anything, when she overhears two men talking about having put
ketamine in a girl’s drink?
a. First get out of there, call the campus police, and then report what was heard
b. Nothing, because she had no idea which woman was targeted or even if she drank what was given to her
c. Talk to the two men about the dangers and side effects of ketamine
d. Watch to see if any young women pass out or are otherwise impaired
ANS: A
The text talks about date rape drugs, also known as predator drugs, including ketamine. The first priority is to keep oneself safe, so leaving would be prudent. Ideally, the police will allow the report to be made without sharing who reported the potential problem. Doing nothing,
talking to the men, and watchNinUgRySouInNg GwTomBe.nCaOt tMhe party will not protect the females at the
party from unknowingly consuming the ketamine.
DIF: Cognitive Level: Analyze (Analysis)
12. A nurse is developing secondary prevention strategies to reduce violence for individuals in the community. Which strategy would the nurse most likely select to implement?
a. Providing counseling services for victims of violence
b. Offering parenting classes at a local high school
c. Educating children on methods of conflict resolution
d. Creating of a safety plan for victims of violence
ANS: D
The public health nurse develops prevention strategies using the three levels of prevention: primary (promotion of optimal parenting and family wellness), secondary (diagnosis of and service for families in stress), and tertiary (reeducation and rehabilitation of violent families). Creation of a safety plan for victims of violence demonstrates the use of secondary prevention. Providing counseling services for victims of violence is done by using tertiary prevention. Primary prevention is used when educating children on the methods of conflict resolution and offering parenting classes at a local high school.
DIF: Cognitive Level: Apply (Application)
13. The 7-year-old boy’s hands were badly burnt; it was suspected that his mother had forced his hands into boiling hot water after she caught him masturbating. The staff did not want the mother to be allowed near the boy. Which statement would be made by the nurse to encourage the staff to interact more objectively with the mother?
a. “If we won’t let the mom near, who does the child have for support at this painful time?”
b. “Most abusers were themselves abused as children and need help to learn how to be a more effective parent.”
c. “The child may feel responsible; we have to let the mother fix their relationship.”
d. “We need to encourage the mother to continue parenting him or the boy will become a ward of the state.”
ANS: B
Most child maltreatment occurs within the family. Maltreatment is more commonly seen in families who are under a great deal of stress, are living in poverty or isolation, or when a family member has a history of violence. Child maltreatment can have serious long-term effects. Thus, it is most important that the staff provide support to the mother. The purpose of allowing the mother with the child is not for additional support for the child or mother, rather the recognition that the mother may have a history of abuse as well and needs assistance to change the patterns of behavior that have been learned through her own life experience.
DIF: Cognitive Level: Apply (Application)
14. A 6-month-old infant was brought in unresponsive by both parents. X-ray examination showed evidence of shaken baby syndrome. Which person is most likely responsible?
a. The babysitter
b. The dad
c. The grandparents
d. The mom
ANS: B
NURSINGTB.COM
In approximately 70% of abusive head trauma cases, also known as shaken baby syndrome, a male is the perpetrator.
DIF: Cognitive Level: Apply (Application)
15. An 80-year-old woman lived with her eldest daughter, the daughter’s husband, and their three children. On this visit, the nurse noted the woman looked dehydrated and seemed depressed. Both wrists were red and scabbed. When asked if she was all right, the woman protested she was fine and her daughter took good care of her. Which action should be taken by the nurse?
a. Begin the paperwork to have the elderly woman put in a nursing home
b. Discuss respite care and other stress relief measures with the daughter
c. Report the elder abuse to the state department of aging
d. Review with the total family how to share responsibilities for the woman’s care
ANS: B
Working with victims of elder abuse, the nurse must establish rapport and trust. The nurse should remember that competent adults have the right to make decisions about their own care, including staying in an abusive situation. The nurse should support the family in examining potential respite care options and support groups for the elderly woman and her caregivers.
DIF: Cognitive Level: Apply (Application)
16. Which best explains why more nurses do not report violence against themselves to authorities?
a. Assumption that the nurse somehow “asked for it” by not being cautious enough or alert enough to avoid it
b. Assumption that nothing would be done about the situation anyway
c. Assumption that nurses can accept anything, from taking blame to being scapegoats for when outcomes are not positive
d. Assumption that patients and families cannot be held responsible; being assaulted is part of the job
ANS: D
Workplace violence tends to be higher in some service-oriented work environments, including health care. In the health care field, frequent areas for the occurrence of violence include emergency departments, psychiatric units, geriatric units, and waiting rooms. Nurses and nursing assistants who work directly with patients are often at risk. Nurses who work in public health roles are not immune to violence because their work may bring them in direct contact with individuals prone to violent behavior.
DIF: Cognitive Level: Understand (Comprehension)
17. Where is youth violence most likely to occur?
a. At home
b. At recreational facilities
c. In inner city schools
d. In fast-food facilities wheNre yRounIg aGdultBs .arCe emMployed
ANS: C
U S N T O
Youth-related violence is more concentrated in minority communities and inner cities, causing a disproportionate burden on these communities. Children are often not taught peaceful ways of resolving differences and learn by default from what they observe on television, in movies, and through video games. Consequently, schools have become a common site for violence.
DIF: Cognitive Level: Remember (Knowledge)
18. Which best describes why all citizens should care about young people joining gangs?
a. Gangs are beginning to be seen in suburban areas.
b. Gangs are responsible for destroying lives and property in inner cities.
c. Gangs use violence to control neighborhoods.
d. Gangs help give the young person protection, respect, and sense of belonging.
ANS: C
Gangs are increasingly responsible for crimes and violence throughout the United States. Gangs use violence to control neighborhoods and increase their illegal money-making activities which include robbery, fraud, drug trafficking, prostitution, and human trafficking. Gangs exist throughout the country, in urban and suburban areas. Destruction of lives and property is not the major reason why citizens should be concerned with gangs. Although gangs do give young persons protection, respect, and sense of belonging, the major concern would be the amount of crime that is associated with gangs.
DIF: Cognitive Level: Understand (Comprehension)
19. Which best describes why hate crimes involving violence are often considered worse than other crimes involving violence?
a. Because hate crimes cannot be avoided because one cannot change one’s race or religious or sexual orientation
b. Because hate crimes often are committed by groups rather than individuals
c. Because more damage is typically done in a hate crime than in a typical assault and battery
d. Because the crime is personal, attacking the victim’s identity
ANS: D
Hate crimes are crimes based on an individual’s race, sexual orientation, religious beliefs, ethnic background, or national origin. Hate crimes may include rape, sexual or physical assault, harassment, attacks on homes or on places of worship, and vandalism. Because hate crimes attack an individual’s identity, the emotional effects are compounded.
DIF: Cognitive Level: Understand (Comprehension)
20. Which must be involved for an act to be considered a terrorist act?
a. A commitment to a political or religious belief
b. An attempt to force compliance with a particular set of religious or political beliefs and behaviors
c. Fear, intimidation, and violence
d. Violence resulting in plural deaths
ANS: C
All terrorist acts include threNe kUeRy SelIemNeGnTts—B.viCoOlenMce, fear, and intimidation.
DIF: Cognitive Level: Remember (Knowledge)
21. A male strong firearms advocate stressed his guns were for self-protection, and he wanted all criminals to know his family had loaded guns in their home. Which best explains why a nurse would not support his actions?
a. Criminals carry more powerful and illegal guns.
b. Guns in the home typically result in dead family members and friends.
c. His children may be less careful than the adults in the family.
d. Less trained individuals might think the guns were unloaded.
ANS: B
Although some persons suggest that firearms provide protection, substantial evidence indicates that firearms increase the likelihood of homicide or, even more commonly, suicide (Weinberger et al., 2015). It is important for health care professionals to be comfortable speaking with their patients in a nonjudgmental manner about firearms, provide patients with factual information about firearms relevant to their health and the health of those around them, fully answer their patients’ questions, and advise them on safe gun protection.
DIF: Cognitive Level: Apply (Application)
MULTIPLE RESPONSE
1. Although violence seems endemic in human society, which causative factors could be reduced if society agreed action was necessary? (Select all that apply.)
a. Access to firearms
b. Alcohol and other drug abuse
c. Mental illness
d. Intolerance of those with a different religious ideology
e. Video games, television shows, and movies
f. Pacifism as a belief system
ANS: A, B, C, D, E
Pacifism is a belief in peaceful resolution of conflicts and refusal to participate in war. All other factors are universally recognized factors that contribute to violence. These factors are poverty, unemployment, economic dependency; polydrug and alcohol abuse; mental illness; media influence (e.g., violent video games, television shows, and movies); access to firearms; political and/or religious ideology; and intolerance and ignorance.
DIF: Cognitive Level: Remember (Knowledge)
2. In which clinical areas are nurses most at risk for workplace violence? (Select all that apply.)
a. Acute care/intensive care units
b. Community health clinics
c. Emergency departments
d. Geriatric units
e. Psychiatric units
f. Rehabilitation units
ANS: C, D, E
In the health care field, the mNoUstRfrSeqIuNenGt TarBea.s CfoOr Mthe occurrence of violence are the emergency departments, psychiatric units, geriatric units, and waiting rooms.
DIF: Cognitive Level: Remember (Knowledge)
3. Which actions would public health professionals want to use as primary prevention against widespread community violence? (Select all that apply.)
a. Women seen in emergency departments should be asked about abuse
b. Courses for prisoners about avoiding violence and resolving conflict
c. Classes on parenting and supportive follow-up for new parents
d. Courses on anger management and conflict resolution
e. Community media campaigns to decrease acceptance of violence
f. Home visits to elderly clients should include screening for elder abuse
ANS: C, D, E
The goal of primary prevention is to stop violence, abuse, or neglect before it occurs. Education plays a major part in primary prevention and may include parenting and family wellness, and anger management or conflict resolution. Professionals should increase their awareness of violence, identification of cases, and provision of early treatment. The nurse can work in or with the community to educate citizens about the problem of violence, potential causes of violence, and available community services. Screening is secondary prevention, and courses for those already known to be violent are tertiary prevention.
DIF: Cognitive Level: Understand (Comprehension)
4. Which actions should a nurse take to ensure personal safety when engaging in home visits? (Select all that apply.)
a. Always sit between the client and the exit, and, when in doubt, leave the situation
b. Be sure of the correct address and always have a GPS system
c. Carry a cell phone and drive in a well-maintained car with a full gas tank
d. Have enough money that you can buy your way out of trouble
e. Only accept assignments within a few blocks of your own home
f. Take self-protection courses such as karate and carry a weapon for your own defense
ANS: A, C
Plan ahead with the correct address, directions, and information about who will be in the home; tell the office where you will be and check in regularly; carry a cell phone, possibly a pager, and a small amount of money; dress for function and mobility, wear a name tag, and be sure your vehicle is in good repair with a full gas tank and emergency equipment. Carrying a weapon typically results in the weapon being used against you.
DIF: Cognitive Level: Understand (Comprehension)
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