RASMUSSEN: MENTAL HEALTH EXAM
Complete Exam Questions and Answers
A+ GRADED
Domestic Violence - ANSWER ✔ The four main categories of abuse are
emotional, physical, sexual, and neglect.
All abuse can harm the victim's self-esteem and spirit, damaging the ability to form
healthy emotional relationships and reach his or her full potential.
Recovering from abuse takes a large amount of attention and energy that could
better be spent in maturing and progressing through life.
The nurse is often the first point of contact for people experiencing domestic
violence and is in a position to contribute to prevention, detection, and effective
intervention.
Emotional Abuse - ANSWER ✔ Includes name calling, excessive criticism,
ignoring accomplishments, yelling and swearing, mocking, isolating, locking the
victim in a room, threats and intimidation, and denying abuse and blaming the
victim.
Child Abuse - ANSWER ✔ Takes place when a child is harmed physically,
psychologically, sexually, or through acts of neglect. It is generally believed that
the number of child abuse cases is grossly underreported.
When child abuse is suspected, NURSES ARE LEGALLY RESPONSIBLE FOR
REPORTING IT to the appropriate child protective agency. Each state mandates
that a report must be filed when suspected abuse or neglect is encountered. It is not
necessary to have proof of the abuse. If there is a suspicion or if the child says
something is happening, that is enough grounds to report. It is then up to the CPS
agency to investigate and make a determination.
Nursing Interventions - Suspected Child Abuse - ANSWER ✔ 1. Adopt a
nonthreatening, nonjudgmental relationship with parents.
2. Understand that the child does not want to betray his or her parents.
,3. Provide a complete physical assessment of the child.
4. Use of dolls or drawing might help the child to tell how the injury or accident
happened.
Forensic Issues:
1. Be aware of your agency's and state's policy in reporting child abuse. Contact
supervisor or social worker to implement appropriate reporting.
2. Ensure that proper procedures are followed and evidence is collected.
3. Keep accurate and detailed records of incident:
• Exact words of what the child or others involved say happened
• A body map to indicate size, color, shape, areas, and types of injuries with
explanation
• Physical evidence, when possible, of sexual abuse
Use of photos can be helpful. Check hospital policy. Police may be involved for
photographing injuries.
4. Forensic examination of the sexually assaulted child should be conducted
according to specific protocols:
• Provided by law enforcement agencies
• Follows state guidelines
Nursing Interventions - Sexual Assault - ANSWER ✔ 1. Have someone (friend,
neighbor, sexual assault advocate, or staff member) stay with the patient while he
or she is waiting to be treated in the emergency department (ED).
2. **Very important: Approach patient in a nonjudgmental manner.
3. Confidentiality is crucial.
4. Explain to the patient the signs and symptoms that many people experience
during the long-term phase, for example:
a. Nightmares
b. Phobias
c. Anxiety, depression
d. Insomnia
,e. Somatic symptoms
5. Listen and let the patient talk. Do not press the patient to talk.
6. Stress that the patient did the right thing to save his or her life.
7. Do not use judgmental language:
• Reported not alleged
• Declined not refused
• Penetration not intercourse
• Instead of reporting "no acute distress," describe the behavior
Forensic Exam and Issues Related to Sexual Assault - ANSWER ✔ 1. Assess the
signs and symptoms of physical trauma.
2. Explain and get permission from patient to take photos/videos and specimens.
3. Make a body map to identify size, color, and location of injuries. Ask
permission to take photos.
4. Carefully explain all procedures before doing them (e.g., "We would like to do a
vaginal [rectal] examination and do a swab. Have you had a vaginal [rectal]
examination before?").
5. Explain the forensic specimens you plan to collect; inform patient that
specimens can be used for identification and prosecution of the rapist, for example:
• Debris in head hair and pubic hair
• Skin from underneath nails
• Semen samples
• Blood
• Urine sample (if date rape drug is suspected)
6. Encourage patient to consider treatment and evaluation for sexually transmitted
infections before leaving the ED.
7. Offer prophylaxis to pregnancy.
8. All data must be carefully documented:
• Verbatim statements
• Detailed observations of physical trauma
, • Detailed observation of emotional status
• Results from the physical examination
• All lab tests should be noted
9. Offer support follow-up:
• Rape counselor
• Support group
• Group therapy
• Individual therapy
• Crisis counseling
Physical Aggression Signs and Symptoms - ANSWER ✔ These behaviors reflect
rage, hostility, and potential for physical assault or verbal destructiveness and can
be directed at others or oneself; aggression is a hostile reaction that occurs when
control over anger is lost.
Predictive Factors for Violent Outcomes - ANSWER ✔ 1. Signs and symptoms
that usually (but not always) precede violence:
a. Angry, irritable affect
b. Hyperactivity: most important predictor of imminent violence (e.g., pacing,
restlessness, slamming doors)
c. Increasing anxiety and tension: clenched jaw or fist, rigid posture, fixed or tense
facial expression, mumbling to self (patient may have shortness of breath,
sweating, and rapid pulse rate)
d. Verbal abuse: profanity, argumentativeness
e. Loud voice, change of pitch, or very soft voice forcing others to strain to hear
f. Intense eye contact or avoidance of eye contact
2. Recent acts of violence, including property violence
3. Stone silence
4. ***Suspiciousness or paranoid thinking
5. Alcohol or drug intoxication (withdrawal)
6. Possession of a weapon or object that may be used as a weapon (e.g., fork, knife,
rock)
Complete Exam Questions and Answers
A+ GRADED
Domestic Violence - ANSWER ✔ The four main categories of abuse are
emotional, physical, sexual, and neglect.
All abuse can harm the victim's self-esteem and spirit, damaging the ability to form
healthy emotional relationships and reach his or her full potential.
Recovering from abuse takes a large amount of attention and energy that could
better be spent in maturing and progressing through life.
The nurse is often the first point of contact for people experiencing domestic
violence and is in a position to contribute to prevention, detection, and effective
intervention.
Emotional Abuse - ANSWER ✔ Includes name calling, excessive criticism,
ignoring accomplishments, yelling and swearing, mocking, isolating, locking the
victim in a room, threats and intimidation, and denying abuse and blaming the
victim.
Child Abuse - ANSWER ✔ Takes place when a child is harmed physically,
psychologically, sexually, or through acts of neglect. It is generally believed that
the number of child abuse cases is grossly underreported.
When child abuse is suspected, NURSES ARE LEGALLY RESPONSIBLE FOR
REPORTING IT to the appropriate child protective agency. Each state mandates
that a report must be filed when suspected abuse or neglect is encountered. It is not
necessary to have proof of the abuse. If there is a suspicion or if the child says
something is happening, that is enough grounds to report. It is then up to the CPS
agency to investigate and make a determination.
Nursing Interventions - Suspected Child Abuse - ANSWER ✔ 1. Adopt a
nonthreatening, nonjudgmental relationship with parents.
2. Understand that the child does not want to betray his or her parents.
,3. Provide a complete physical assessment of the child.
4. Use of dolls or drawing might help the child to tell how the injury or accident
happened.
Forensic Issues:
1. Be aware of your agency's and state's policy in reporting child abuse. Contact
supervisor or social worker to implement appropriate reporting.
2. Ensure that proper procedures are followed and evidence is collected.
3. Keep accurate and detailed records of incident:
• Exact words of what the child or others involved say happened
• A body map to indicate size, color, shape, areas, and types of injuries with
explanation
• Physical evidence, when possible, of sexual abuse
Use of photos can be helpful. Check hospital policy. Police may be involved for
photographing injuries.
4. Forensic examination of the sexually assaulted child should be conducted
according to specific protocols:
• Provided by law enforcement agencies
• Follows state guidelines
Nursing Interventions - Sexual Assault - ANSWER ✔ 1. Have someone (friend,
neighbor, sexual assault advocate, or staff member) stay with the patient while he
or she is waiting to be treated in the emergency department (ED).
2. **Very important: Approach patient in a nonjudgmental manner.
3. Confidentiality is crucial.
4. Explain to the patient the signs and symptoms that many people experience
during the long-term phase, for example:
a. Nightmares
b. Phobias
c. Anxiety, depression
d. Insomnia
,e. Somatic symptoms
5. Listen and let the patient talk. Do not press the patient to talk.
6. Stress that the patient did the right thing to save his or her life.
7. Do not use judgmental language:
• Reported not alleged
• Declined not refused
• Penetration not intercourse
• Instead of reporting "no acute distress," describe the behavior
Forensic Exam and Issues Related to Sexual Assault - ANSWER ✔ 1. Assess the
signs and symptoms of physical trauma.
2. Explain and get permission from patient to take photos/videos and specimens.
3. Make a body map to identify size, color, and location of injuries. Ask
permission to take photos.
4. Carefully explain all procedures before doing them (e.g., "We would like to do a
vaginal [rectal] examination and do a swab. Have you had a vaginal [rectal]
examination before?").
5. Explain the forensic specimens you plan to collect; inform patient that
specimens can be used for identification and prosecution of the rapist, for example:
• Debris in head hair and pubic hair
• Skin from underneath nails
• Semen samples
• Blood
• Urine sample (if date rape drug is suspected)
6. Encourage patient to consider treatment and evaluation for sexually transmitted
infections before leaving the ED.
7. Offer prophylaxis to pregnancy.
8. All data must be carefully documented:
• Verbatim statements
• Detailed observations of physical trauma
, • Detailed observation of emotional status
• Results from the physical examination
• All lab tests should be noted
9. Offer support follow-up:
• Rape counselor
• Support group
• Group therapy
• Individual therapy
• Crisis counseling
Physical Aggression Signs and Symptoms - ANSWER ✔ These behaviors reflect
rage, hostility, and potential for physical assault or verbal destructiveness and can
be directed at others or oneself; aggression is a hostile reaction that occurs when
control over anger is lost.
Predictive Factors for Violent Outcomes - ANSWER ✔ 1. Signs and symptoms
that usually (but not always) precede violence:
a. Angry, irritable affect
b. Hyperactivity: most important predictor of imminent violence (e.g., pacing,
restlessness, slamming doors)
c. Increasing anxiety and tension: clenched jaw or fist, rigid posture, fixed or tense
facial expression, mumbling to self (patient may have shortness of breath,
sweating, and rapid pulse rate)
d. Verbal abuse: profanity, argumentativeness
e. Loud voice, change of pitch, or very soft voice forcing others to strain to hear
f. Intense eye contact or avoidance of eye contact
2. Recent acts of violence, including property violence
3. Stone silence
4. ***Suspiciousness or paranoid thinking
5. Alcohol or drug intoxication (withdrawal)
6. Possession of a weapon or object that may be used as a weapon (e.g., fork, knife,
rock)
