MENTAL HEALTH: ABUSE AND NEGLECT
NCLEX QUESTIONS AND ANSWERS
A kindergarten student is frequently violent toward other children. A school nurse
notices bruises and burns on the child's face and arms. What other symptom should
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. - ANS: A
The nurse should determine that a child who shrinks at the approach of adults in
addition to having bruises and burns might be a victim of abuse. Whether or not the
adult intended to harm the child, maltreatment should be considered.
A woman describes a history of physical and emotional abuse in intimate relationships.
Which additional factor should a nurse 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 might be a victim of incest. - ANS: D
The nurse should suspect that this client might be a victim of incest. Women in abusive
relationships often grew up in abusive homes.
Which statement made 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." - ANS: A
The nurse accurately states 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.
A client is brought to an emergency department after being violently raped. Which
nursing action is appropriate?
A. Discourage the client from discussing the event as this may lead to further emotional
trauma.
B. Remain nonjudgmental and actively listen to the client's description of the event.
, C. Meet the client's self-care needs by assisting with showering and perineal care.
D. Provide cues, based on police information, to encourage further description of the
event. - ANS: B
The most appropriate nursing action is to remain nonjudgmental and actively listen to
the client's description of the event. It is important to also communicate to the victim that
he or she is safe and that it is not his or her fault. Nonjudgmental listening provides an
avenue for client catharsis needed in order to begin the process of healing.
In the emergency department, a raped client appears calm and exhibits a blunt affect.
The client answers a nurse's questions in a monotone using single words. How should
the nurse interpret this client's responses?
A. The client may be lying about the incident.
B. The client may be experiencing a silent rape reaction.
C. The client may be demonstrating a controlled response pattern.
D. The client may be having a compounded rape reaction. - ANS: C
This client is most likely demonstrating a controlled response pattern. In a controlled
response pattern, the client's feelings are masked or hidden, and a calm, composed, or
subdued affect is seen. In the expressed response pattern, feelings of fear, anger, and
anxiety are expressed through crying, sobbing, smiling, restlessness, and tension.
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 is the nursing supervisor's most appropriate reply?
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 KEY: Cognitive 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." - ANS: D
The nursing supervisor is accurate when stating that clients in severely abusive
relationships are paralyzed into inaction by a combination of physical threats and a
sense of powerlessness. Women often choose to stay with an abusive partner for some
of the following reasons: for the children, for financial reasons, fear of retaliation, lack of
a support network, religious reasons, and/or hopelessness.
A woman comes to an emergency department with a broken nose and multiple bruises
after being beaten by her husband. She states, "The beatings have been getting worse,
and I'm afraid that next time he might kill me." Which is the appropriate nursing reply?
A. "Leopards don't change their spots, and neither will he."
B. "There are things you can do to prevent him from losing control."
C. "Let's talk about your options so that you don't have to go home."
D. "Why don't we call the police so that they can confront your husband with his
behavior?" - ANS: C
NCLEX QUESTIONS AND ANSWERS
A kindergarten student is frequently violent toward other children. A school nurse
notices bruises and burns on the child's face and arms. What other symptom should
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. - ANS: A
The nurse should determine that a child who shrinks at the approach of adults in
addition to having bruises and burns might be a victim of abuse. Whether or not the
adult intended to harm the child, maltreatment should be considered.
A woman describes a history of physical and emotional abuse in intimate relationships.
Which additional factor should a nurse 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 might be a victim of incest. - ANS: D
The nurse should suspect that this client might be a victim of incest. Women in abusive
relationships often grew up in abusive homes.
Which statement made 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." - ANS: A
The nurse accurately states 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.
A client is brought to an emergency department after being violently raped. Which
nursing action is appropriate?
A. Discourage the client from discussing the event as this may lead to further emotional
trauma.
B. Remain nonjudgmental and actively listen to the client's description of the event.
, C. Meet the client's self-care needs by assisting with showering and perineal care.
D. Provide cues, based on police information, to encourage further description of the
event. - ANS: B
The most appropriate nursing action is to remain nonjudgmental and actively listen to
the client's description of the event. It is important to also communicate to the victim that
he or she is safe and that it is not his or her fault. Nonjudgmental listening provides an
avenue for client catharsis needed in order to begin the process of healing.
In the emergency department, a raped client appears calm and exhibits a blunt affect.
The client answers a nurse's questions in a monotone using single words. How should
the nurse interpret this client's responses?
A. The client may be lying about the incident.
B. The client may be experiencing a silent rape reaction.
C. The client may be demonstrating a controlled response pattern.
D. The client may be having a compounded rape reaction. - ANS: C
This client is most likely demonstrating a controlled response pattern. In a controlled
response pattern, the client's feelings are masked or hidden, and a calm, composed, or
subdued affect is seen. In the expressed response pattern, feelings of fear, anger, and
anxiety are expressed through crying, sobbing, smiling, restlessness, and tension.
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 is the nursing supervisor's most appropriate reply?
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 KEY: Cognitive 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." - ANS: D
The nursing supervisor is accurate when stating that clients in severely abusive
relationships are paralyzed into inaction by a combination of physical threats and a
sense of powerlessness. Women often choose to stay with an abusive partner for some
of the following reasons: for the children, for financial reasons, fear of retaliation, lack of
a support network, religious reasons, and/or hopelessness.
A woman comes to an emergency department with a broken nose and multiple bruises
after being beaten by her husband. She states, "The beatings have been getting worse,
and I'm afraid that next time he might kill me." Which is the appropriate nursing reply?
A. "Leopards don't change their spots, and neither will he."
B. "There are things you can do to prevent him from losing control."
C. "Let's talk about your options so that you don't have to go home."
D. "Why don't we call the police so that they can confront your husband with his
behavior?" - ANS: C
