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Olds' Maternal-Newborn Nursing and Women's Health, 10e (Davidson)
Chapter 8 Violence Against Women
1) The client has been a victim of a violent, sadistic rape. She is crying, and asks the nurse "Why
would someone do something like that?" The nurse should explain that which of the following is
the primary purpose of sadistic rape?
1. Take pleasure from the victim's struggle and pain
2. Express feelings of rage
3. Feel a sense of power or mastery
4. Relieve intolerable anxiety
Answer: 1
Explanation: 1. In sadistic rape, the assailant has an antisocial personality and delights in torture
and mutilation. In this type of rape, the victim and assailant are generally strangers, and the
assault is planned. Sadistic rapes cause the most injuries, including homicide.
Page Ref: 138
Cognitive Level: Understanding
Client Need/Sub: Psychosocial Integrity: Crisis Intervention
Standards: QSEN Competencies: I. C. 9. Recognize that patient expectations influence
outcomes in management of pain or suffering. | AACN Essentials Competencies: IX. 5. Deliver
compassionate, patient-centered, evidence-based care that respects patient and family
preferences. | NLN Competencies: Relationship-Centered Care: Appreciate the patient as a
whole person, with his or her own life story and ideas about the meaning of health or illness. |
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 8 Identify the phases of the rape trauma syndrome.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
1
Copyright © 2016 Pearson Education, Inc.
2) The nurse is teaching an in-service educational presentation about working with battered
women. The nurse should explain that it is often frustrating for nurses to work with battered
women for which reasons?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. There is little the nurse can really do to help.
2. Healthcare policies and practices are not supportive of abused women.
3. Both husband and wife must agree to therapy.
4. These women might return to the abusive situation.
5. Women often believe that they are the cause of the abuse.
Answer: 4, 5
Explanation: 4. Women often believe that escape is futile, or escape and then return when the
crisis is over.
5. Women are often convinced by the abusers that it is their own behavior that causes the abuse.
Page Ref: 131
Cognitive Level: Applying
Client Need/Sub: Psychosocial Integrity: Abuse/Neglect
Standards: QSEN Competencies: I. C. 5. Recognize personally held attitudes about working
with patients from different ethnic, cultural, and social backgrounds. | AACN Essentials
Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects
patient and family preferences. | NLN Competencies: Relationship-Centered Care: Appreciate
the patient as a whole person, with his or her own life story and ideas about the meaning of
health or illness. | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 3 Identify the phases of the cycle of violence.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
2
Copyright © 2016 Pearson Education, Inc.
3) The nurse is addressing a college class on the topic of domestic violence. Which information
would the nurse be sure to convey to her students?
1. The American Nurses Association advocates client advocacy for all nurses to help identify and
prevent violence against women.
2. The American Nurses Association has concluded that there is little nurses can do to eliminate
violence.
3. The nurse who suspects abuse should ask the doctor to deal with it, per American Nurses
Association guidelines.
4. The nurse who suspects abuse should ask the hospital's social work department to deal with it,
per American Nurses Association guidelines.
Answer: 1
Explanation: 1. This is a true statement. Nurses can follow and become involved in legislative
advocacy for issues related to domestic violence and other issues related to women's health
through participation in their local and state chapters of the American Nurses Association.
Page Ref: 136
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being and self-care management. | AACN
Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care
that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care:
Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 9 Discuss the nurse's role as patient advocate with domestic violence and
sexual assault survivors.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
3
Copyright © 2016 Pearson Education, Inc.
4) The nurse working in the emergency department of a hospital is caring for a woman whom the
nurse suspects is the victim of domestic violence. The nurse knows that which of the following
are contributing factors to domestic violence?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. Experiencing or witnessing abuse as a child
2. Strong patriarchal family traditions
3. Linking masculinity to male honor
4. Low levels of marital conflict
5. Alcohol and drug abuse cause the violence
Answer: 1, 2, 3
Explanation: 1. Children who witness or experience abuse and battering are more likely to
become batterers (men) or to be abused (women) in their own relationships.
2. Men raised in patriarchal families (those that encourage traditional gender roles) are more
likely to engage in domestic violence.
3. Cultures that link definitions of manhood to dominance, toughness, or male honor are more
likely to demonstrate violence against women.
Page Ref: 130
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs
as part of clinical interview, implementation of care plan and evaluation of care. | AACN
Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral,
psychological, spiritual, socioeconomic, and environmental assessments of health and illness
parameters in patients using developmentally and culturally appropriate approaches. | NLN
Competencies: Relationship-Centered Care: Promote and accept the patient's emotions; accept
and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 2 Identify factors that contribute to domestic violence.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
4
Copyright © 2016 Pearson Education, Inc.
5) The nurse is planning a community education presentation on battering. Which statement
about battering should the nurse include?
1. Battering occurs in a small percentage of the population.
2. Battering is mainly a lower-class, blue collar problem.
3. Battered women are at greatest risk for severe violence when they leave the batterer.
4. If the batterer stops drinking, the violence usually stops.
Answer: 3
Explanation: 3. Battered women are at greatest risk for injury or domestic homicide when they
leave the abuser.
Page Ref: 131
Cognitive Level: Understanding
Client Need/Sub: Psychosocial Integrity: Abuse/Neglect
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN
Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in their care. | NLN Competencies: Relationship-Centered Care:
Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated
Concepts: Nursing Process: Planning
Learning Outcome: 2 Identify factors that contribute to domestic violence.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
6) The nurse at a shelter is counseling a group of battered women. What will the nurse will
emphasize?
1. Battering will not stop or decrease if the woman becomes pregnant.
2. About 1 of every 5 women will experience abuse in her lifetime.
3. When these women go back to the situation after the abuser has cooled down, it will be better.
4. The battered woman can readily leave the situation.
Answer: 1
Explanation: 1. Pregnancy does not stop the abuser, and sometimes it increases the intensity of
the abuse.
Page Ref: 131
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I. B. 10. Engage patient or designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN
Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in their care. | NLN Competencies: Relationship-Centered Care:
Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated
Concepts: Nursing Process: Diagnosis
Learning Outcome: 2 Identify factors that contribute to domestic violence.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
5
Copyright © 2016 Pearson Education, Inc.
7) The nurse in the emergency department is caring for a pregnant woman who presents with
bruised breasts and abdomen. When asked how this happened, she states she fell down the stairs.
The husband stays very close to his wife and does most of the talking. Of what is the nurse
aware?
1. The client likely did fall down the stairs.
2. The husband is being attentive and trying to help her feel better.
3. The husband could have battered her and possibly caused her to fall down the stairs.
4. This client is safe to return home after her wrist is fixed.
Answer: 3
Explanation: 3. Battering may occur for the first time during pregnancy or may escalate in
intensity if the woman is already being abused. The injury is frequently aimed at the breasts,
abdomen, or vagina.
Page Ref: 131
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and
respect for the diversity of human experience. | AACN Essentials Competencies: IX. 12. Create a
safe environment that results in high quality patient outcomes. | NLN Competencies:
Relationship-Centered Care: Respect the patient's dignity, uniqueness, integrity, and self-
determination and his or her own power and self-healing processes. | Nursing/Integrated
Concepts: Nursing Process: Diagnosis
Learning Outcome: 2 Identify factors that contribute to domestic violence.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
6
Copyright © 2016 Pearson Education, Inc.
8) The nurse is interviewing a client who has admitted to being a victim of domestic violence.
What is the most typical description of how the domestic violence developed in a relationship?
1. "He changed overnight. Everything was fine, and all of a sudden he flipped out and beat me
up; he nearly killed me."
2. "It was severe from the beginning. As soon as we got married, he began hitting me and
threatening to kill me."
3. "We've both always dated other people. I thought that was understood. He was as emotionally
abusive in the beginning as he is now."
4. "I don't know when it started, really. It was gradual. First, just yelling, blaming, and shoving.
Then the beatings started; and now they're more frequent."
Answer: 4
Explanation: 4. Typically, these forms of abuse begin slowly and subtly after some form of
commitment, such as engagement, onset of a sexual relationship, marriage, pregnancy, or first
childbirth.
Page Ref: 130
Cognitive Level: Understanding
Client Need/Sub: Psychosocial Integrity: Abuse/Neglect
Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs
as part of clinical interview, implementation of care plan, and evaluation of care. | AACN
Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral,
psychological, spiritual socioeconomic, and environmental assessments of health and illness
parameters in patients, using developmentally and culturally appropriate approaches. | NLN
Competencies: Relationship-Centered Care: Promote and accept the patient's emotions; accept
and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 2 Identify factors that contribute to domestic violence.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
7
Copyright © 2016 Pearson Education, Inc.
9) The nurse working in the emergency department is admitting a woman who has been battered
for a second time, and recognizes that the woman is again in the cycle of violence. The nurse
knows that which of the following are characteristics of the phases of the cycle of violence?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. Batterer demonstrates power and control
2. Active battering from some event
3. A loving, contrite period
4. Defeat and admission of guilt by the victim
5. Blame and punishment for inferiority
Answer: 1, 2, 3
Explanation: 1. In the tension-building phase in the cycle of violence, the batterer demonstrates
power and control.
2. The acute battering incident is typically triggered by some external event or internal state of
the batterer.
3. The tranquil phase in the cycle of violence is also sometimes called the honeymoon period.
This phase may be characterized by extremely loving, kind, and contrite behaviors by the
batterer.
Page Ref: 131
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs
as part of clinical interview, implementation of care plan and evaluation of care. | AACN
Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral,
psychological, spiritual, socioeconomic, and environmental assessments of health and illness
parameters in patients, using developmentally, and culturally appropriate approaches. | NLN
Competencies: Relationship-Centered Care: Promote and accept the patient's emotions, accept
and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 3 Identify the phases of the cycle of violence.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
8
Copyright © 2016 Pearson Education, Inc.
10) The nurse working in the emergency department knows that many batterers have feelings of
ambivalence. In what way might this be evident?
1. The abuser alternates episodes of unmerciful beatings with periods of remorse and loving
attention.
2. The abuser has alternating periods of sadness and happiness.
3. The abuser has alternating periods of maturity and immaturity.
4. The abuser alternates letting the person he abuses be independent and then dependent.
Answer: 1
Explanation: 1. Extremes in behavior and overreacting are typical patterns.
Page Ref: 131
Cognitive Level: Analyzing
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I. C. 4. Seek learning opportunities with patients who
represent all aspects of human diversity. | AACN Essentials Competencies: I. 5. Apply
knowledge of social and cultural factors to the care of diverse populations. | NLN Competencies:
Relationship-Centered Care: Demonstrate self-awareness, self-care, self-growth; be open and
non-judgmental. | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 4 Summarize the characteristics of batterers and perpetrators of sexual
assault.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
9
Copyright © 2016 Pearson Education, Inc.
11) A nurse in the emergency department recognizes in the husband of a client one of which of
the following common characteristics of batterers?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. Emotionally immature
2. Tend to express their overwhelming feelings of inadequacy through violence
3. Feelings of insecurity and inferiority
4. A lack of respect in the community
5. Limited jealousy or possessiveness
Answer: 1, 2, 3
Explanation: 1. Batterers tend to be emotionally immature.
2. Because they tend to be emotionally immature and aggressive, batterers have a tendency to
express their overwhelming feelings of inadequacy through violence.
3. Batterers are insecure, and feel inferior, often feeling that they are undeserving of their
partner.
Page Ref: 131
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I. C. 5. Recognize personally held attitudes about working
with patients from different ethnic, cultural, and social backgrounds. | AACN Essentials
Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care that respects
patient and family preferences. | NLN Competencies: Relationship-Centered Care: Demonstrate
self-awareness, self-care, self-growth; be open and non-judgmental. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 4 Summarize the characteristics of batterers and perpetrators of sexual
assault.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
10
Copyright © 2016 Pearson Education, Inc.
12) The nurse is presenting a session on intimate partner violence. Which statement by a client
indicates a need for further education?
1. "My daughter is not to blame for the violence in her marriage."
2. "Everyone experiences anger and hitting in a relationship."
3. "Abusers can be either husbands or boyfriends or girlfriends."
4. "The 'honeymoon period' follows an episode of violence."
Answer: 2
Explanation: 2. Violence is not a normal part of intimate relationships. Domestic violence, also
called intimate partner violence (IPV), is defined as a pattern of coercive behaviors and methods
used to gain and maintain power and control by one individual over another in an adult intimate
relationship. This statement indicates that the client has likely been a victim of domestic
violence.
Page Ref: 129
Cognitive Level: Applying
Client Need/Sub: Psychosocial Integrity: Abuse/Neglect
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN
Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental
stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster
patient engagement in their care. | NLN Competencies: Relationship-Centered Care:
Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated
Concepts: Nursing Process: Evaluation
Learning Outcome: 1 Describe the factors that contribute to the occurrence of domestic violence
and sexual assault.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
11
Copyright © 2016 Pearson Education, Inc.
13) When a woman seeks care for an injury, the nurse should be alert to which clues of abuse?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. Defensive injuries
2. Immediate reporting of symptoms or seeking care for injuries
3. Lack of eye contact
4. Providing too much detailed information about the injury
5. Vague complaints without accompanying pathology
Answer: 1, 3, 5
Explanation: 1. Defensive injuries may be a sign of abuse.
3. Lack of eye contact may be a sign of abuse.
5. Vague complaints without accompanying pathology may be a sign of abuse.
Page Ref: 133, 134
Cognitive Level: Applying
Client Need/Sub: Psychosocial Integrity: Abuse/Neglect
Standards: QSEN Competencies: I. C. 1. Value seeing health care situations "through patients'
eyes." | AACN Essentials Competencies: IX. 5. Deliver compassionate, patient-centered,
evidence-based care that respects patient and family preferences. | NLN Competencies:
Relationship-Centered Care: Promote and accept the patient's emotions; accept and respond to
distress in patient and self; facilitate hope, trust, and faith. | Nursing/Integrated Concepts:
Nursing Process: Implementation
Learning Outcome: 6 Specify physical and psychologic signs that may indicate a woman is in an
abusive relationship.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
14) A woman who has been abused for a number of years asks the nurse for assistance in leaving
the relationship. What response by the nurse is most appropriate?
1. Comment that she should have left long ago.
2. Remind the client that that fault was not likely all attributable to her abuser.
3. Encourage her to be sure with her decision, as her abuser will be difficult to deal with.
4. Assist the client to develop a safety plan.
Answer: 4
Explanation: 4. The nurse should provide women who have been abused with information that
empowers them in decision making and provide critical assistance in safety planning for women
and their children.
Page Ref: 135
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I. B. 15. Communicate care provided and needed at each
transition in care. | AACN Essentials Competencies: IX. 12. Create a safe environment that
results in high quality patient outcomes. | NLN Competencies: Relationship-Centered Care:
Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated
Concepts: Nursing Process: Implementation
Learning Outcome: 5 Delineate the role of the nurse in caring for women who have experienced
partner abuse.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
12
Copyright © 2016 Pearson Education, Inc.
15) A woman with multiple bruises on her face and arms is seen in the emergency department.
Her significant other is with her. When asked about her injuries, the woman states, "I ran into a
door." Which action by the nurse is of highest priority?
1. Take the woman's vital signs.
2. Document the location of the bruises.
3. Assess for additional bruising.
4. Interview the woman in private.
Answer: 4
Explanation: 4. Screening for women experiencing domestic violence must be done privately,
with only yourself and the client present, in a safe and quiet place.
Page Ref: 132
Cognitive Level: Analyzing
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V. B. 2. Demonstrate effective use of strategies to reduce risk
of harm to self or others. | AACN Essentials Competencies: IX. 12. Create a safe environment
that results in high quality patient outcomes. | NLN Competencies: Quality and Safety:
Communicate effectively with different individuals (team members, other care providers,
patients, families, etc.) so as to minimize risks associated with handoffs among providers and
across transitions in care. | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 5 Delineate the role of the nurse in caring for women who have experienced
partner abuse.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
13
Copyright © 2016 Pearson Education, Inc.
16) A woman has come to the emergency department with multiple bruises over her body and a
small laceration over her upper lip. She says she fell down the stairs while doing her housework.
Which observation would most likely cause the nurse to suspect that she has been a victim of
battering?
1. The client is hesitant to provide details about how the injuries occurred.
2. The client was accompanied to the emergency department by her mother instead of her
partner.
3. The client has sought care quickly after the incident.
4. The client does not seem to be in pain.
Answer: 1
Explanation: 1. Hesitation to provide detailed information about the injury and how it occurred
is a common sign of abuse.
Page Ref: 133
Cognitive Level: Applying
Client Need/Sub: Psychosocial Integrity: Abuse/Neglect
Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs
as part of clinical interview, implementation of care plan and evaluation of care. | AACN
Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral,
psychological, spiritual, socioeconomic, and environmental assessments of health and illness
parameters in patients, using developmentally and culturally appropriate approaches. | NLN
Competencies: Context and Environment: Read and interpret data; apply health
promotion/disease prevention strategies; apply health policy; conduct population-based
transcultural health assessments and interventions. | Nursing/Integrated Concepts: Nursing
Process: Assessment
Learning Outcome: 6 Specify physical and psychologic signs that may indicate a woman is in an
abusive relationship.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
14
Copyright © 2016 Pearson Education, Inc.
17) The client with limited English language skills has a black eye, and bruises across her face
and arms. The client's husband has been acting as an interpreter for her, and answers all of the
questions the nurse asks, often without talking to his wife first. The nurse suspects the client has
been a victim of domestic abuse. What should the nurse do next?
1. Ask the husband whether he has beaten his wife.
2. Ask the husband to have a female friend come in with his wife.
3. Provide written materials in English for the client to read at home.
4. Ask the husband to step out of the room, and obtain an interpreter.
Answer: 4
Explanation: 4. Screening for women experiencing domestic violence must be done privately.
An interpreter should also be provided as necessary.
Page Ref: 132, 140
Cognitive Level: Applying
Client Need/Sub: Psychosocial Integrity: Abuse/Neglect
Standards: QSEN Competencies: V. B. 2. Demonstrate effective use of strategies to reduce risk
of harm to self or others. | AACN Essentials Competencies: IX. 12. Create a safe environment
that results in high quality patient outcomes. | NLN Competencies: Quality and Safety:
Communicate effectively with different individuals (team members, other care providers,
patients, families, etc.) so as to minimize risks associated with handoffs among providers and
across transitions in care. | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5 Delineate the role of the nurse in caring for women who have experienced
partner abuse.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
18) A woman is seen in the prenatal clinic. The nurse notices that the woman has a swollen eye
and a bruise on her cheek. Which statement is most appropriate for the nurse to make?
1. "You must leave your partner before you are injured again."
2. "It is important that you refrain from doing things that anger your partner."
3. "Women who are abused often have injuries like yours."
4. "I am required by law to notify the police department of your injuries."
Answer: 3
Explanation: 3. This is an appropriate statement to make.
Page Ref: 134
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being and self-care management. | AACN
Essentials Competencies: IX. 5. Deliver compassionate, patient-centered, evidence-based care
that respects patient and family preferences. | NLN Competencies: Relationship-Centered Care:
Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated
Concepts: Nursing Process: Assessment
Learning Outcome: 6 Specify physical and psychologic signs that may indicate a woman is in an
abusive relationship.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
15
Copyright © 2016 Pearson Education, Inc.
19) A home health nurse is making a home visit to a new mother who is diabetic and requires
some follow-up to make sure her baby is doing well and that her diabetes is in control while she
is breastfeeding. The client meets her at the door, crying, with bruises on her face and legs. The
nurse knows the client has been in a questionable relationship. What is the first responsibility of
the nurse for this client at this time?
1. Assist in getting the client and her baby to a safe situation.
2. Check her blood sugar and make sure it is within normal limits.
3. Ask her how she is doing with the breastfeeding.
4. Check the baby's heart rate and other vital signs.
Answer: 1
Explanation: 1. Providing the abused woman with information that empowers her in decision
making and providing critical assistance in safety planning for her and her baby is the nurse's
first responsibility.
Page Ref: 135
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V. B. 2. Demonstrate effective use of strategies to reduce risk
of harm to self or others. | AACN Essentials Competencies: IX. 12. Create a safe environment
that results in high quality patient outcomes. | NLN Competencies: Quality and safety:
Encourage patients and families to communicate their observations and concerns regarding
safety. | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 6 Specify physical and psychologic signs that may indicate a woman is in an
abusive relationship.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
16
Copyright © 2016 Pearson Education, Inc.
20) The nurse suspects that a pregnant client might be experiencing abuse when the client does
which of the following?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. Gives an inappropriate explanation for the injuries
2. Hesitates in providing detailed information about the injury
3. Makes eye contact with the nurse while answering questions
4. Allows her partner to answer the nurse's questions
5. Frequently calls to change appointment times
Answer: 1, 2, 4, 5
Explanation: 1. Whenever a client gives an inappropriate explanation for injuries, such as being
accident prone, the nurse should suspect abuse.
2. Clients experiencing abuse often hesitate in providing detailed information about an injury and
how it occurred.
4. The client experiencing abuse may show signs of increased anxiety in the presence of the
possible batterer, who frequently does most of the talking or hovers around the woman.
5. If a client has injuries sustained from abuse, she will often delay reporting of symptoms or
seeking care for injuries.
Page Ref: 133, 134
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs
as part of clinical interview, implementation of care plan, and evaluation of care. | AACN
Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral,
psychological, spiritual, socioeconomic, and environmental assessments of health and illness
parameters in patients, using developmentally and culturally appropriate approaches. | NLN
Competencies: Quality and safety: Promote communication and open reporting as a priority in
health care. | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 6 Specify physical and psychologic signs that may indicate a woman is in an
abusive relationship.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
17
Copyright © 2016 Pearson Education, Inc.
21) If a woman returns to an abusive situation, the nurse should encourage her to develop an exit,
or safety, plan for herself and her children, if she has any. What should the plan include?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.
1. Identify friends and family who know about the situation and will help her.
2. Call the police if violence begins.
3. Pack a change of clothes for herself and the children.
4. Have a plan for where she will go.
5. Have a planned escape route.
Answer: 1, 3, 4, 5
Explanation: 1. She should identify friends and family who know about the situation and will
help her. Ask that she establish a code word for danger with those family and friends.
3. She should pack a change of clothes for herself and the children, including toilet articles and
an extra set of car and house keys stored away from her house with a friend or neighbor.
4. She should have a plan for where she will go, regardless of the day or time.
5. She should have a planned escape route and emergency telephone numbers she can call.
Page Ref: 135
Cognitive Level: Understanding
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V. B. 2. Demonstrate effective use of strategies to reduce risk
of harm to self or others. | AACN Essentials Competencies: IX. 12. Create a safe environment
that results in high quality patient outcomes. | NLN Competencies: Relationship-Centered Care:
Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated
Concepts: Nursing Process: Planning
Learning Outcome: 7 Describe the needs that women with abusive partners and their children
may have beyond the healthcare setting.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
18
Copyright © 2016 Pearson Education, Inc.
22) The nurse is caring for an abused mother in the postpartum department. The client is afraid to
go home, but has no money to do anything else. What can the nurse do to assist this individual
and her baby?
1. Work with community services to have the client and her baby go to a safe place, complete
paperwork to obtain financial assistance, and obtain some temporary assistance.
2. Explain that she will have to go home at this time, but provide her with paperwork to complete
to obtain assistance.
3. Offer to have her partner come in and attend a counseling session with her.
4. Suggest that once she gets home, she should pursue getting a restraining order against her
abuser.
Answer: 1
Explanation: 1. Nurses and medical personnel need to be alert to symptoms of battering,
recognize these cues, and encourage women to seek assistance from community agencies. The
most innovative and effective domestic violence programs in hospitals and urgent care facilities
work collaboratively with domestic violence service agencies, develop a comprehensive
community referral network, and work with multidisciplinary intervention teams.
Page Ref: 135
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V. B. 2. Demonstrate effective use of strategies to reduce risk
of harm to self or others. | AACN Essentials Competencies: IX. 12. Create a safe environment
that results in high quality patient outcomes. | NLN Competencies: Quality and safety:
Encourage patients and families to communicate their observations and concerns regarding
safety. | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 7 Describe the needs that women with abusive partners and their children
may have beyond the healthcare setting.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
19
Copyright © 2016 Pearson Education, Inc.
23) When evaluating the care given a battered woman, the nurse analyzes care plan components
to determine which of the following?
Note: Credit will be given only if all correct and no incorrect choices are selected.
Select all that apply.
1. Compassionate, respectful care was delivered.
2. The woman has the necessary information to make decisions.
3. Medical records are deliberately vague.
4. Psychological care was given in the hospital.
5. The woman identifies culturally appropriate resources.
Answer: 1, 2, 5
Explanation: 1. One expected outcome of nursing care is that the woman receives
compassionate, respectful, and individualized medical attention.
2. One expected outcome of nursing care is that the woman has the information she needs to
make a decision about her future based on thoughtful consideration of alternatives.
5. Two expected outcomes of nursing care are that the woman is able to identify culturally
appropriate community resources available to her and develops strategies for keeping herself, her
children, and her family as safe as possible.
Page Ref: 136, 137
Cognitive Level: Applying
Client Need/Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I. B. 10. Engage patients or designated surrogates in active
partnerships that promote health, safety and well-being, and self-care management. | AACN
Essentials Competencies: IX. 12. Create a safe environment that results in high quality patient
outcomes. | NLN Competencies: Relationship-Centered Care: Communicate information
effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process:
Evaluation
Learning Outcome: 5 Delineate the role of the nurse in caring for women who have experienced
partner abuse.
MNL LO: 6.1.3 Determine strategies to assist the victim of domestic violence.
20
Copyright © 2016 Pearson Education, Inc.
Another random document with
no related content on Scribd:
Dirk’s stem huilde van onmacht en drift, maar Kees
verstond niet.
—Hoho! hou jai d’r moar stiekem deuse kant hee! dan
komp ’r t’ met juustighait in!
—Effe hooger je vork Kees! ikke kèn d’r soo nie bai!
Als was z’n oog met ’n zuur gif volgedrupt zoo vrat en
brandde [227]’t kopzweet hem ’t oogenwit in.—Rood
geflakker vlamde ’r voòr ’m. Toch strompelde ie, half
blind naar ’t voorkrat, met Ouë Gerrit achter ’m aan.
Uit ’n hoek grabbelde Kees ’n end touw op. Met
nijdigen ruk sjorde ie ’t voorbint los en kronkelknoopte
’r ’n stuk aan vast. Op één oog voelde ie zich blind, en
pijn schroeide er in, als was ’t z’n kop uitgerukt. Toch
vond ie ’t malligheid te jammeren.
—Kloar!