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Chapter 26 Physical and Sexual Abuse of Adults | Kaplan and Sadock

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Chapter 26: Physical and Sexual Abuse of Adults

MULTIPLE CHOICE

1. A young child is being evaluated in the Emergency Department for injuries her mother reports
resulted from a fall down the stairs. Which of these findings indicates that physical abuse may be
a chronic problem for the child?

a. The mothers description of the child as being clumsy

b. Several fractures revealed on x-ray in varying degrees of healing

c. Clinging to her mother as she attempted to leave the examining room

d. Struggling with the staff when attempts to obtain a blood specimen were made


ANS: B

Unhealed fractures indicate both numerous injuries and that medical intervention was not sought
at the time of injury. Although unkind, the mothers description of the child is not reason to
believe chronic abuse has occurred. The remaining options reflect normal behavior, especially if
pain or separation is suspected.

2. A child was admitted to the childrens unit, having been sexually abused by an acquaintance of
her family. The child refuses to talk and participate in unit activities, choosing to stay in her
room with her stuffed animals. Which therapeutic intervention will best help the child release
pent-up feelings about the abuse?

a. Family therapy

b. Play therapy

c. Individual communication with the nurse

d. Role-play with other children on the unit


ANS: B




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,Play helps communicate and release feelings about the childs problems. A child may have
difficulty expressing feelings verbally. Family therapy may be useful, but it is not designed for
releasing feelings. Role-playing is more effective with older children or adults.

3. The nurse is leading a support group for women who have experienced interpersonal violence.
When a patient asks about the characteristics of the perpetrators of interpersonal violence, the
nurse accurately responds that they are:

a. Usually under the influence of alcohol

b. Most often someone the victim knows

c. A stranger to the victim in most cases

d. Often in a psychotic state during the act


ANS: B

Statistics show that interpersonal violence is usually committed by someone the victim knows.
Drugs and alcohol are not necessarily involved. The victim usually knows the perpetrator. The
perpetrators are aware of what they are doing.

4. Which nursing intervention will assist a patient being treated in the Emergency Department
for extensive soft tissue injuries to disclose an experience of domestic violence?

a. Allowing the patient to initiate the topic of violence

b. Speaking with the patient in the absence of her husband

c. Providing a safe, nonintimidating, and supportive environment

d. Interviewing her in the presence of another healthcare professional


ANS: C

Providing a safe environment is the first step in assisting a patient who is a victim of domestic
violence. Including others in the conversation may increase anxiety and reluctance to disclose.
Isolating the husband is assumed in providing a safe, nonintimidating environment. The patient
may not disclose without prompting by the nurse.




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, 5. A patient admits to having been battered by her live-in boyfriend several times over the past 2
years. She states to the nurse, We plan to get married next June, and I think things will be better
then. He is always so sorry afterward, that I think I can trust him to change. Which intervention
should be included in the patients teaching plan?

a. Discourage her hope that the battering will end after they are married.

b. Assist her in enrolling in a class to learn techniques of self-defense.

c. Assist her in developing an emergency plan, because the pattern of violence is
likely to continue.
d. Emphasize that the battering pattern usually remains the same in frequency and
severity over time.


ANS: C

Developing an emergency plan is critical for any battered woman. The battering is not likely to
cease unless the batterer seeks help but stating that fact is not therapeutic by itself. This will not
stop the violence, although it might afford her some protection. Violence usually increases over
time.

6. The nurse in the Emergency Department is taking a history from a family accompanying a
child with suspicious traumatic injuries. The nurse should:

a. Be open, concerned, and honest.

b. Obtain information as covertly as possible.

c. Avoid responding to hints that abuse has occurred.

d. Separate the family from the child during the interview.


ANS: A

The nurse serves as a role model for the parents and the child. Being open and honest and
showing appropriate concern for the child is the most appropriate approach. Direct questioning is
necessary to obtain the history. Concerns about the possibility of abuse must be addressed in a
sensitive manner. The family will be able to remain with the child during history taking. It is
helpful for the nurse to observe family interactions.




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