PARAPHILIA, FAMILY VIOLENCE, ABUSE

AND CRISIS INTERVENTION

Total points36/50
 
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PARAPHILIAS
12 of 13 points
 
In disorders of sexuality and sexual functioning, the term paraphilias refers to: *
1/1
Sexual urges or fantasies involving unusual sources of gratification problems
 
Problems with sexual fantasies
An individual is dissatisfied with their own biological sex and have a strong desire to be a member
of the opposite sex.
Problems with the normal sexual response cycle

 
When considering components of human sexuality, which of the following is related to
sexual function? *
1/1
Orientation, intention
Gender identity
Desire, arousal, orgasm
 
Emotional satisfaction

 
A diagnosis of fetishism involves which of the following? *
Intense sexually arousing fantasies that occur while observing an unsuspecting person who is
naked, in the process of undressing, or engaging in a sexual activity
 
Intense sexually arousing fantasies and urges involving non-animate objects, and this causes
them personal distress or affects social and occupational functioning
Intense, recurrent sexual urges to touch and rub up against non-consenting people
Sexual arousal and satisfaction from the psychological or physical suffering of others

 
Which of the following is NOT considered to be a risk factor for the development of
paraphilias? *
1/1
Childhood abuse
Childhood neglect
Early drug abuse
 
Hypersexuality

 
Ken works in a department store and enjoys watching female customers try on
clothing through an undisclosed, small hole in the dressing room that only he knows
about. Ken suffers from ____ *
1/1
Frotteurism
Exhibitionism
Voyeurism
 
Pedophilia

 
Which of these individuals is demonstrating frotteurism? *
1/1
A man who rubs up against a woman in the grocery store
 
A man who spies on his neighbor while she takes a shower
A man who has sexual fantasies about his friend's seven-year-old daugher
A man who fantasizes about having an affair with his extremely overweight coworker

 
Persistent or recurrent tendency to observe unsuspecting persons, naked disrobing or
engaged in sexual activity is termed as *
1/1
Exhibitionism
Sadism
Voyeurism
 
Frotteurism

 
For several years, Julianne has found herself becoming more and more aroused by
being tied up and flogged while also being humiliated by her partner. Which of the
following paraphilias is she suffering from? *
1/1
Fetishism
Masochism
 
Frotteurism
Sadism

 
Getting sexual gratification by inflicting injuries to opposite partner is : *
1/1
Masochism
Voyuerism
Sadism
 
Transvestism

 
Sexual gratification by rubbing against or touching a nonconsenting person is termed
as *
1/1
Exhibitionism
Frotteurism
 
Fetishism
Voyeurism

 
Psychodynamic explanations of sexual sadism propose that the sadist is searching
relief from castration anxiety by: *
1/1
Performing castration on a consenting partner
Dressing in womens clothing
Taking on the role of castrator rather than castrated
 
Seeking out partners who have been castrated

 
Sexual masochists can often cause their own suffering, when an individual uses a
noose or plastic bag to induce oxygen deprivation during masturbation, this is known
as: *
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Hypoxyphilia
 
Pedophilia
Corpophilia
Necrophilia

 
An example of a coercive paraphilia is: *
1/1
Obscene phone calling.
 
Fetishism.
Gender dysphoria.
Cross-dressing.

 
Pedophiles become sexually aroused by sexually immature children, an alternative
term for this type of behavior is: *
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Non consent molesters
Preference molesters
Minor molester
 
Pre-teen molester
Feedback
Preference molesters: Non-incestuous pedophiles who will normally only become sexually aroused
by sexually immature children.

ABUSE AND FAMILY VIOLENCE

12 of 16 points
 
Which situation would Nurse Sally identify as placing a client at high risk for caregiver
abuse? *
1/1
Antonia. an adult child. quits her job to move in and care for a parent with severe dementia.
 
Mrs. C. an elderly parent with limited mobility. lives alone and receives help from several adult
children.
Mr. Arron. an elderly man with severe heart disease. resides in a personal care home and is
frequently visited by his adult child.
Antoinette cares for her husband who is in early stages of Alzheimer’s disease and has a network
of available support persons.

 
Which nursing assessment findings are physical signs of sexual abuse of a female
child? Select all that apply. *
1/1
Enuresis
 
Vaginal tears
 
Red and swollen labia and rectum
 
Injuries in different stages of healing

 
Nurse Meredith is observing 8-year-old Anna during a community visit. Which of the
following findings would lead the nurse to suspect that Anna is a victim of sexual
abuse? *
1/1
The child has interest in things of a sexual nature
 
The child has a lack of peer relationships.
The child has self-injurious behavior.
The child is fearful of the caregiver and other adults.

 
A nurse visits the home of an 11-year-old child and finds the child caring for three
younger siblings. Both parents are at work. The child says, "I want to go to school, but
we cant afford a babysitter. It doesn't matter; I'm too dumb to learn." What preliminary
assessment is evident? *
1/1
Children are experiencing physical abuse.
Child and siblings are experiencing neglect.
 
Children are at high risk for sexual abuse.
Insufficient data are present to make an assessment.

 
Nurse Angela is working in the emergency department is conducting an interview with
a victim of spousal abuse. Which step should the nurse take first? *
1/1
Request the presence of a security guard
Ensure privacy for interviewing the victim away from the abuser.
 
Contact the appropriate legal services.
Establish a rapport with the victim and the abuser.

 
During a home visit to a family of three: a mother, a father, and their child, The mother
tells the community nurse that the father (who is not present) has hit the child on
several occasions when he was drinking. The mother further explains that she has
talked her husband into going to Alcoholics Anonymous and asks the nurse not to
interfere, so her husband won't get angry and refuse treatment. Which of the following
is the best response of the nurse? *
1/1
The nurse agrees not to interfere if the husband attends an Alcoholics Anonymous meeting that
evening.
The nurse commends the mother's efforts and also contacts protective services.
 
The nurse confronts the mother's failure to protect the child.
The nurse commends the mother's efforts and agrees to let her handle things.

 
During a well-child checkup, a mother tells the Nurse Rio about a recent situation in
which her child needed to be disciplined by her husband. The child was slapped in the
face for not getting her husband breakfast on Saturday, despite being told on
Thursday never to prepare food for him. Nurse Rio analyzes the family system and
concludes it is dysfunctional. All of the following factors contribute to this dysfunction
except: *
1/1
inconsistent communication patterns.
rigid, authoritarian roles.
conflictual relationships of parents.
 
use of violence to establish control

 
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 may have been physically abused? *
1/1
The child begs or steals food or money.
The child shrinks at the approach of adults.
 
The child is frequently absent from school.
The child is delayed in physical and emotional development.

 
A woman presents with a history of physical and emotional abuse in her intimate
relationships. What should this information lead a nurse to suspect? *
0/1
The woman may have a history of childhood neglect.
The woman may be exhibiting codependent characteristics.
The woman may be a victim of incest.
The woman may be exhibiting a controlled response pattern.
 
Feedback
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.

 
Which behavior best demonstrates aggression? *
1/1
Stomping away from the nurses station, going to another room, and grabbing a snack from
another patient.
 
Telling the primary nurse, I felt angry when you said I could not have a second helping at lunch.
Telling the medication nurse, I am not going to take that or any other medication you try to give
me.
Bursting into tears, leaving the community meeting, and sitting on a bed hugging a pillow and
sobbing.

 
A community nurse conducts a primary prevention. home-visit assessment for a
newborn and mother. Mrs. Salas has three other children. the oldest of whom is age
12. She tells the nurse that her 12-year-old daughter is expected to prepare family
meals. to look after the young children. and to clean the house once a week. Which of
the following is the most appropriate nursing diagnosis for this family situation? *
···/1
Delayed growth and development. related to performance expectations of the child.
Impaired parenting. related to the role reversal of mother and child.
 
Social isolation. related to lack of extended family assistance.
Anxiety (moderate). related to difficulty managing the home situation.

 
A group of nursing students is currently learning about family violence. Which of the
following is true about the topic mentioned? *
0/1
Family violence rarely occurs during pregnancy
Family violence predominantly occurs in lower socioeconomic levels.
 
Family violence affects every socioeconomic level.
Family violence is caused by drugs and alcohol abuse.
Feedback

Rationale: Family violence occurs in all socioeconomic levels, races, religions, and cultural groups.
Although violence is associated with substance abuse, it is not the singular cause. The statement
that the family violence predominantly occurs in lower socioeconomic levels is false. Abuse often
occurs during pregnancy; about 23% of all pregnant women seeking prenatal care are victims of
abuse.

 
The interventions common to treatment plans for survivors include which of the
following? Select all that apply. *
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Identify areas of control.
 
Establish trust and rapport.
 
Encourage the client to pursue legal action.
Remove the client from home.
Support the client in the decisions he/she makes.
 
 
Mrs. Salas was admitted to the emergency department of SHC Medical Center with a
fractured arm. She explains to the nurse that her injury resulted when she provoked
her drunken husband. Mr. Salas. who then pushed her. Which of the following best
describes the nurse's understanding of the wife's explanation? *
1/1
Mrs. Salas' explanation is evidence that the woman may be an abuser as well as a victim.
Mrs. Salas' explanation is an atypical reaction of an abused woman.
Mrs. Salas' explanation is a typical response of a victim accepting blame for the abuser.
 
Mrs. Salas' explanation is appropriate acceptance of her responsibility.

 
Sheila tells the community nurse that her boyfriend has been abusive and she is afraid
of him. but she doesn't want to leave. The client asks the nurse for assistance. Which
nursing interventions are appropriate in this situation? Select all that apply. *
0/1
Tell Sheila that she should leave because things will not improve.
Reinforce concern for Sheila’s safety and her right to be free of abuse.
 
Help Sheila to develop a plan to ensure safety. including phone numbers for emergency help.
Help Sheila to get her boyfriend into an appropriate treatment program.
Communicate acceptance. avoiding any implication that Sheila is at fault for not leaving.
Help Sheila to explore available options. including shelters and legal protection.
Feedback
These are all appropriate nursing interventions for the victim of domestic violence. The client is not
responsible for seeking help for the abuser. and encouraging her to do so may reinforce the client’s
feeling responsible for the abuse. Advising the client must decide for herself whether to leave. and
the nurse must respect any decision the client makes. Making the decision for the client will erode
her self-esteem and reinforce her sense of powerlessness.

 
Mariefer is studying about abuse for the upcoming exam. For her to fully instill the
topic. she should know that the priority nursing intervention for a child or elder victim
of abuse is: *
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Teach appropriate coping skills.
Assess the scope of the abuse problem.
Implement measures to ensure the victim’s safety.
 
Analyze family dynamics.

CRISIS MANAGEMENT
12 of 21 points
 
Sexual intercourse with a consenting minor is termed as: *
1/1
Planned rape
Opportunistic rape
Statutory rape
 
Date Rape

 
Six months ago, a woman had a prophylactic double mastectomy because of a family
history of breast cancer. One week ago, this woman learned her husband was
involved in an extramarital affair. The woman tearfully says, “What else can happen?”
If the woman’s immediate family is unable to provide sufficient support, which of the
following should the nurse do? *
1/1
Tell the patient, “You are a strong person. You can get through this crisis”
Suggest hospitalization for a short period
Foster insight by relating the present situation to earlier situations involving loss
Ask what other relatives or friends are available for support
 
 
A woman says, “I can’t take anymore. Last year my husband had an affair, and now
we do not communicate. Three months ago, I found a lump in my breast. Yesterday
my daughter said she’s quitting college and moving in with her boyfriend.” Which issue
should the nurse focus on during crisis intervention? *
1/1
The effects of the husband’s extramarital affair
The possible mastectomy
Coping with the reaction to the daughter’s events
 
The disordered family communication

 
A patient being seen in the clinic for superficial cuts on both wrists is pacing and
sobbing. After a few minutes, the patient is calmer. The nurse attempts to determine
the patient’s perception of the precipitating event by saying which of the following? *
1/1
“Tell me why you were crying.”
“How did your wrists get injured?”
“What was happening just before you started to feel this way
 
“How can I help you feel more comfortable?”
 
Six months ago, a woman had a prophylactic double mastectomy because of a family
history of breast cancer. One week ago, this woman learned her husband was
involved in an extramarital affair. The woman tearfully says to the nurse, “What else
can happen?” What type of crisis is this person experiencing? *
1/1
Maturational
Adventitious
Recurring
Situational
 
 
A patient who is visiting the crisis clinic for the first time asks, “How long will I be
coming here?” The nurse’s reply should consider that the usual duration of crisis
intervention is how long? *
0/1
4 to 6 weeks
1 to 2 weeks
 
3 to 4 weeks
6 to 8 weeks
Feedback
The disorganization associated with crisis is so distressing that it usually cannot be tolerated for
more than 4 to 6 weeks. If it is not resolved by that time, the individual usually adopts dysfunctional
behaviors that reduce anxiety without solving the problem. Crisis intervention can shorten the
duration

 
A patient comes to the crisis clinic after an unexpected job termination. The patient
paces around the room sobbing, cringes when approached, and responds to
questions with only shrugs or monosyllables. Choose the nurse’s best initial comment
to this patient. *
1/1
“Let’s set some guidelines and goals for your visit here.”
“I see you are feeling upset. I’m going to stay and talk with you to help you feel better.”
 
“Everything is going to be all right. You are here at the clinic, and the staff will keep you safe.”
“You need to try to stop crying and pacing so we can talk about your problems.”

 
A patient comes to the crisis center saying, “I’m in a terrible situation. I don’t know
what to do.” The triage nurse can initially assume that the patient is which of the
following? *
0/1
Misperceiving reality
Potentially homicidal
 
Suicidal
Anxious and fearful
Feedback
Individuals in crisis are universally anxious. They are often frightened and may be mildly confused.
Perceptions are often narrowed with anxiety.

 
Which of the following is a correct assumption regarding the concept of crisis? *
1/1
the stressful event that precipitates crisis is seldom identifiable.
crises are chronic situations that recur many times during an individuals's life.
crises occur only in individuals with psychopathology.
a crisis situation contains the potential for psychological growth or deterioration.
 
 
A student falsely accused a college professor of sexual intimidation. The professor
tells the nurse, “I cannot teach nor do any research. My mind is totally preoccupied
with these false accusations.” What is the priority nursing diagnosis? *
1/1
Ineffective denial related to threats to professional identity
Ineffective role performance related to distress from false accusations
 
Deficient knowledge related to sexual harassment protocols
Impaired social interaction related to loss of teaching abilities

 
During the initial interview at the crisis center, a patient says, “I’ve been served with
divorce papers. I’m so upset and anxious that I can’t think clearly.” Which comment
should the nurse use to assess personal coping skills? *
0/1
“Can you describe your role in the marital relationship?”
 
“In the past, how have you handled difficult or stressful situations?”
“Tell me more about how it feels to be anxious and upset.”
“What would you like us to do to help you feel more relaxed?”

 
A woman said, “I can’t take it anymore! Last year my husband had an affair, and now
we don’t communicate. Three months ago, I found a lump in my breast. Yesterday my
daughter said she’s quitting college.” What is the nurse’s priority assessment? *
1/1
Whether the husband is still engaged in an extramarital affair
Clarify what the patient means by “I can’t take it anymore.”
 
The patient’s feelings about the possibility of having a mastectomy
Identify measures useful to help improve the couple’s communication.

 
Which communication technique will the nurse use more in crisis intervention than in
traditional counselling? *
···/1
Role modeling
Giving direction
Information giving
 
Empathic listening

 
Which situation demonstrates use of primary care related to crisis intervention? *
0/1
Implementation of suicide precautions for a depressed patient
Assessing coping strategies used by a patient who attempted suicide
 
Referring a patient with schizophrenia to a partial hospitalization program
Teaching stress reduction techniques to a first-year college student
Feedback
Primary care-related crisis intervention promotes mental health and reduces mental illness. The
incorrect options are examples of secondary or tertiary care.

 
An adult has cared for a debilitated parent for 10 years. The parent’s condition
recently declined, and the health care provider recommended placement in a nursing
home. The adult says, “I’ve always been able to care for my parents. Nursing home
placement goes against everything I believe.” Successful resolution of this person’s
crisis will most closely relate to which of the following? *
Reliance on assistance from role models within the person’s culture
Resolving the feelings associated with the threat to the person’s self-concept
 
Mobilization of automatic relief behaviors by the person
Ability of the person to identify situational supports in the community

 
While conducting the initial interview with a patient in crisis, the nurse should do which
of the following? *
0/1
Be forthright about time limits of the interview
Let the patient know the nurse controls the interview
 
Listen carefully and summarize often
Convey a sense of urgency to the patient
Feedback
Severe anxiety narrows perceptions and concentration. The nurse should listen carefully and
summarize what the patient is saying to ensure correct meaning. Conveying urgency will increase
the patient’s anxiety. Letting the patient know who controls the interview or stating that time is limited
is nontherapeutic.

 
An adolescent comes to the crisis clinic and reports sexual abuse by an uncle. The
adolescent told both parents about the uncle’s behavior, but the parents did not
believe the adolescent. What type of crisis exists? *
1/1
Adventitious
 
Organic
Maturational
Situational

 
An adult seeks counselling after the spouse was murdered. The adult angrily says, “I
hate the beast that did this. It has ruined my life. During the trial, I don’t know what I’ll
do if the jury doesn’t return a guilty verdict.” What is the nurse’s highest priority
response? *
1/1
“Would you like to talk to a psychiatrist about some medication to help you cope during the trial?”
Are you having thoughts of hurting yourself or others?”
 
“What resources do you need to help you cope with this situation?”
“Do you have enough support from your family and friends?”
 
A victim of spousal violence comes to the crisis center seeking help. Which of the
following crisis intervention strategy will be the nurse’s focus? *
0/1
Providing legal assistance
Supporting emotional security and reestablishing equilibrium
Long-term resolution of issues precipitating the crisis
 
Promoting growth of the individual
Feedback
Strategies of crisis intervention address the immediate cause of the crisis and restoration of
emotional security and equilibrium. The goal is to return the individual to the pre-crisis level of
function. Crisis intervention is, by definition, short term. The correct response is the most global
answer. Promoting growth is a focus of long-term therapy. Providing legal assistance might or might
not be applicable.

 
Sexual relationship between people classed as being too closely related to marry each
other. WRITE IN CAPITAL LETTER. *
1/1

INCEST
 
 
After celebrating the fortieth birthday, an individual becomes concerned with the loss
of youthful appearance. What type of crisis has occurred?
···/1
Reactive
Situational
Maturational
Adventitious
 
 
Which scenario is an example of an adventitious crisis? *
0/1
The death of a child from sudden infant death syndrome
A riot at a rock concert
Being fired from a job because of company downsizing
 
Retirement of a 55-year-old person
This form was created inside of Sacred Heart College.

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