Page 1 of 71
SURVIVORS OF ABUSE OR NEGLECT EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
Survivors of Abuse or Neglect Exam: 50 Practice Questions with Rationales
Section 1: Foundational Concepts and Assessment (Questions 1-15)
1. A kindergarten student is frequently violent toward other children. The school
nurse notices bruises and burns on the child's face and arms. Which additional
symptom would indicate to the nurse that the child might have been physically
abused?
A. The child shrinks at the approach of adults
B. The child begs or steals food or money
C. The child is frequently absent from school
D. The child is delayed in physical and emotional development
Answer: A. The child shrinks at the approach of adults
Rationale: A child who physically shrinks at the approach of adults, in addition to having
bruises and burns, may be a victim of physical abuse. This behavior indicates fear of
adults, a common response in abused children. Maltreatment is considered present
whether or not the adult intended to harm the child . Begging or stealing food suggests
neglect, while frequent absences and developmental delays may indicate broader
maltreatment but are less specific indicators of physical abuse.
2. Which statement by an emergency department nurse indicates accurate
knowledge of domestic violence?
A. "Power and control are central to the dynamic of domestic violence."
B. "Poor communication and social isolation are central to the dynamic of domestic
violence."
C. "Erratic relationships and vulnerability are central to the dynamic of domestic
violence."
D. "Emotional injury and learned helplessness are central to the dynamic of domestic
violence."
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Answer: A. "Power and control are central to the dynamic of domestic violence."
Rationale: The nursing instructor should include the concept that power and control are
central to the dynamic of domestic violence. Battering is defined as a pattern of
coercive control founded on physical and/or sexual violence or threat of violence. The
typical abuser is very possessive and perceives the victim as a possession .
3. A woman presents with a history of physical and emotional abuse in her intimate
relationships. What should this information lead a nurse to suspect?
A. The woman may be exhibiting a controlled response pattern
B. The woman may have a history of childhood neglect
C. The woman may be exhibiting codependent characteristics
D. The woman may be a victim of incest
Answer: D. The woman may be a victim of incest
Rationale: The nurse should suspect that this client may be a victim of incest. Many
women who are battered have low self-esteem and have feelings of guilt, anger, fear,
and shame. Women in abusive relationships often grew up in an abusive home
environment .
4. Battering is defined as:
A. A pattern of coercive control founded on physical and/or sexual violence or threat of
violence
B. A single incident of physical violence between intimate partners
C. An argument that results in minor injury
D. Any physical altercation between spouses
Answer: A. A pattern of coercive control founded on physical and/or sexual
violence or threat of violence
Rationale: Battering is defined as a pattern of coercive control founded on physical
and/or sexual violence or threat of violence. The typical abuser is very possessive and
perceives the victim as a possession. This definition emphasizes the pattern of control,
not isolated incidents .
5. A school nurse notices bruises and scars on a child's body. The nurse suspects
that the child is being physically abused. How should the nurse proceed with this
information?
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A. As a healthcare worker, report the suspicion to child protective services
B. Check the child again in a week and see if there are any new bruises
C. Meet with the child's parents and ask them how the child got the bruises
D. Initiate paperwork to have the child placed in foster care
Answer: A. As a healthcare worker, report the suspicion to child protective services
Rationale: Nurses are mandated reporters. When abuse is suspected, the nurse must
report the suspicion to child protective services or the appropriate authorities. Waiting,
confronting parents, or initiating placement without proper investigation are
inappropriate actions .
6. A woman who has a long history of being battered by her husband is staying at a
women's shelter. She has received emotional support from staff and peers and has
been made aware of the alternatives open to her. Nevertheless, she decides to
return to her home and marriage. The best response by the nurse to the woman's
decision is:
A. "I just can't believe you have decided to go back to that horrible man."
B. "I'm just afraid he will kill you or the children when you go back."
C. "What makes you think things have changed with him?"
D. "I hope you have made the right decision. Call this number if you need help."
Answer: D. "I hope you have made the right decision. Call this number if you need
help."
Rationale: The nurse should support the client's autonomy and provide resources.
Women often choose to stay with an abusive partner for various reasons—for the
children, financial reasons, fear of retaliation, lack of support network, religious
reasons, or hopefulness. The nurse should avoid judgment and ensure the client knows
help is available .
7. Jana, age 5, is sent to the school nurse's office with an upset stomach. She has
vomited and soiled her blouse. When the nurse removes her blouse, she notices
that Jana has numerous bruises on her arms and torso in various stages of healing.
She also notices some small scars. Jana's abdomen protrudes on her small, thin
frame. From the objective physical assessment, the nurse suspects that:
A. Jana is experiencing physical and sexual abuse
B. Jana is experiencing physical abuse and neglect
C. Jana is experiencing emotional neglect
D. Jana is experiencing sexual and emotional abuse
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Answer: B. Jana is experiencing physical abuse and neglect
Rationale: The physical assessment reveals bruises in various stages of healing and
scars (indicative of physical abuse) along with a protruding abdomen on a small, thin
frame (indicative of malnutrition/neglect). The nurse suspects physical abuse and
neglect based on these objective findings .
8. A school nurse notices bruises and scars on a child's body, but the child refuses
to say how she received them. Another way in which the nurse can get information
from the child is to:
A. Have her evaluated by the school psychologist
B. Tell her she may select a "treat" from the treat box if she answers the nurse's
questions
C. Explain to her that if she answers the questions, she may stay in the nurse's office
and not have to go back to class
D. Use a "family" of dolls to role-play the child's family with her
Answer: D. Use a "family" of dolls to role-play the child's family with her
Rationale: Using dolls to role-play allows children to express themselves in a non-
threatening manner. This technique can help children disclose abuse when they are
unable or unwilling to verbalize directly. Rewards, coercion, or bribes are inappropriate
methods .
9. A client who is in a severely abusive relationship is admitted to a psychiatric
inpatient unit. The client fears for her life. A staff nurse asks, "Why doesn't she just
leave him?" Which reply by the nursing supervisor is most appropriate?
A. "These clients don't know life any other way, and change is not an option until they
have improved insight."
B. "These clients have limited skills and few vocational abilities to be able to make it on
their own."
C. "These clients often have a lack of financial independence to support themselves
and their children, and most have religious beliefs prohibiting divorce and separation."
D. "These clients are paralyzed into inaction by a combination of physical threats and a
sense of powerlessness."
Answer: D. "These clients are paralyzed into inaction by a combination of physical
threats and a sense of powerlessness."
Rationale: The nursing supervisor is accurate when stating that clients who are in
abusive relationships are paralyzed into inaction by a combination of physical threats
SURVIVORS OF ABUSE OR NEGLECT EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
Survivors of Abuse or Neglect Exam: 50 Practice Questions with Rationales
Section 1: Foundational Concepts and Assessment (Questions 1-15)
1. A kindergarten student is frequently violent toward other children. The school
nurse notices bruises and burns on the child's face and arms. Which additional
symptom would indicate to the nurse that the child might have been physically
abused?
A. The child shrinks at the approach of adults
B. The child begs or steals food or money
C. The child is frequently absent from school
D. The child is delayed in physical and emotional development
Answer: A. The child shrinks at the approach of adults
Rationale: A child who physically shrinks at the approach of adults, in addition to having
bruises and burns, may be a victim of physical abuse. This behavior indicates fear of
adults, a common response in abused children. Maltreatment is considered present
whether or not the adult intended to harm the child . Begging or stealing food suggests
neglect, while frequent absences and developmental delays may indicate broader
maltreatment but are less specific indicators of physical abuse.
2. Which statement by an emergency department nurse indicates accurate
knowledge of domestic violence?
A. "Power and control are central to the dynamic of domestic violence."
B. "Poor communication and social isolation are central to the dynamic of domestic
violence."
C. "Erratic relationships and vulnerability are central to the dynamic of domestic
violence."
D. "Emotional injury and learned helplessness are central to the dynamic of domestic
violence."
, Page 2 of 71
Answer: A. "Power and control are central to the dynamic of domestic violence."
Rationale: The nursing instructor should include the concept that power and control are
central to the dynamic of domestic violence. Battering is defined as a pattern of
coercive control founded on physical and/or sexual violence or threat of violence. The
typical abuser is very possessive and perceives the victim as a possession .
3. A woman presents with a history of physical and emotional abuse in her intimate
relationships. What should this information lead a nurse to suspect?
A. The woman may be exhibiting a controlled response pattern
B. The woman may have a history of childhood neglect
C. The woman may be exhibiting codependent characteristics
D. The woman may be a victim of incest
Answer: D. The woman may be a victim of incest
Rationale: The nurse should suspect that this client may be a victim of incest. Many
women who are battered have low self-esteem and have feelings of guilt, anger, fear,
and shame. Women in abusive relationships often grew up in an abusive home
environment .
4. Battering is defined as:
A. A pattern of coercive control founded on physical and/or sexual violence or threat of
violence
B. A single incident of physical violence between intimate partners
C. An argument that results in minor injury
D. Any physical altercation between spouses
Answer: A. A pattern of coercive control founded on physical and/or sexual
violence or threat of violence
Rationale: Battering is defined as a pattern of coercive control founded on physical
and/or sexual violence or threat of violence. The typical abuser is very possessive and
perceives the victim as a possession. This definition emphasizes the pattern of control,
not isolated incidents .
5. A school nurse notices bruises and scars on a child's body. The nurse suspects
that the child is being physically abused. How should the nurse proceed with this
information?
, Page 3 of 71
A. As a healthcare worker, report the suspicion to child protective services
B. Check the child again in a week and see if there are any new bruises
C. Meet with the child's parents and ask them how the child got the bruises
D. Initiate paperwork to have the child placed in foster care
Answer: A. As a healthcare worker, report the suspicion to child protective services
Rationale: Nurses are mandated reporters. When abuse is suspected, the nurse must
report the suspicion to child protective services or the appropriate authorities. Waiting,
confronting parents, or initiating placement without proper investigation are
inappropriate actions .
6. A woman who has a long history of being battered by her husband is staying at a
women's shelter. She has received emotional support from staff and peers and has
been made aware of the alternatives open to her. Nevertheless, she decides to
return to her home and marriage. The best response by the nurse to the woman's
decision is:
A. "I just can't believe you have decided to go back to that horrible man."
B. "I'm just afraid he will kill you or the children when you go back."
C. "What makes you think things have changed with him?"
D. "I hope you have made the right decision. Call this number if you need help."
Answer: D. "I hope you have made the right decision. Call this number if you need
help."
Rationale: The nurse should support the client's autonomy and provide resources.
Women often choose to stay with an abusive partner for various reasons—for the
children, financial reasons, fear of retaliation, lack of support network, religious
reasons, or hopefulness. The nurse should avoid judgment and ensure the client knows
help is available .
7. Jana, age 5, is sent to the school nurse's office with an upset stomach. She has
vomited and soiled her blouse. When the nurse removes her blouse, she notices
that Jana has numerous bruises on her arms and torso in various stages of healing.
She also notices some small scars. Jana's abdomen protrudes on her small, thin
frame. From the objective physical assessment, the nurse suspects that:
A. Jana is experiencing physical and sexual abuse
B. Jana is experiencing physical abuse and neglect
C. Jana is experiencing emotional neglect
D. Jana is experiencing sexual and emotional abuse
, Page 4 of 71
Answer: B. Jana is experiencing physical abuse and neglect
Rationale: The physical assessment reveals bruises in various stages of healing and
scars (indicative of physical abuse) along with a protruding abdomen on a small, thin
frame (indicative of malnutrition/neglect). The nurse suspects physical abuse and
neglect based on these objective findings .
8. A school nurse notices bruises and scars on a child's body, but the child refuses
to say how she received them. Another way in which the nurse can get information
from the child is to:
A. Have her evaluated by the school psychologist
B. Tell her she may select a "treat" from the treat box if she answers the nurse's
questions
C. Explain to her that if she answers the questions, she may stay in the nurse's office
and not have to go back to class
D. Use a "family" of dolls to role-play the child's family with her
Answer: D. Use a "family" of dolls to role-play the child's family with her
Rationale: Using dolls to role-play allows children to express themselves in a non-
threatening manner. This technique can help children disclose abuse when they are
unable or unwilling to verbalize directly. Rewards, coercion, or bribes are inappropriate
methods .
9. A client who is in a severely abusive relationship is admitted to a psychiatric
inpatient unit. The client fears for her life. A staff nurse asks, "Why doesn't she just
leave him?" Which reply by the nursing supervisor is most appropriate?
A. "These clients don't know life any other way, and change is not an option until they
have improved insight."
B. "These clients have limited skills and few vocational abilities to be able to make it on
their own."
C. "These clients often have a lack of financial independence to support themselves
and their children, and most have religious beliefs prohibiting divorce and separation."
D. "These clients are paralyzed into inaction by a combination of physical threats and a
sense of powerlessness."
Answer: D. "These clients are paralyzed into inaction by a combination of physical
threats and a sense of powerlessness."
Rationale: The nursing supervisor is accurate when stating that clients who are in
abusive relationships are paralyzed into inaction by a combination of physical threats
