Question: An employee has recently been absent from work on several occasions. Each time, this employee returns to work wearing dark glasses. Facial and body bruises are apparent. During the occupational health nurse’s interview, the employee says, “My partner beat me, but it was because there are problems at work.” What should the nurse’s next action be?

Answer Options:
a. Notify the police.
b. Refer the employee to a shelter.
c. Notify the adult protective agency.
d. Document injuries with a body map.

Answer: d. Document injuries with a body map

Question: A patient tells the nurse, “My husband is abusive only when he drinks too much. His family was like that when he was growing up. He always apologizes and regrets hurting me.” What risk factor was most predictive for the husband to become abusive?

Answer Options:
a. History of family violence
b. Loss of employment
c. Abuse of alcohol
d. Poverty

Answer: a. History of family violence

Question: An adult tells the nurse, “My partner abuses me only when drinking. The drinking has increased lately, but I always get an apology afterward and a box of candy. I’ve considered leaving but haven’t been able to bring myself to actually do it.” Which phase in the cycle of violence prevents the patient from leaving?

Answer Options:
a. Tension building
b. Acute battering
c. Honeymoon
d. Recovery

Answer: c. Honeymoon

Question: After treatment for a detached retina, a victim of intimate partner violence says, “My partner only abuses me when intoxicated. I’ve considered leaving, but I was brought up to believe you stay together, no matter what happens. I always get an apology, and I can tell my partner feels bad after hitting me.” Which nursing diagnosis applies?

Answer Options:
a. Social isolation, related to lack of community support system
b. Risk for injury, related to partner’s physical abuse when intoxicated
c. Deficient knowledge, related to resources for escape from the abusive relationship
d. Disabled family coping, related to uneven distribution of power within a relationship

Answer: b. Risk for injury, related to partner’s physical abuse when intoxicated

Question: A victim of physical abuse by an intimate partner is treated for a broken wrist. The patient has considered leaving but says, “You stay together, no matter what happens.” Which outcome should be met before the patient leaves the emergency department? The patient will:

Answer Options:
a. Limit contact with the abuser by obtaining a restraining (protective) order.
b. Name two community resources that can be contacted.
c. Demonstrate insight into the abusive relationship.
d. Facilitate counseling for the abuser.

Answer: b. Name two community resources that can be contacted.

Question: An older adult diagnosed with dementia lives with family and attends an adult day care center. A nurse at the center notices the adult has a disheveled appearance, a strong odor of urine, and bruises on the limbs and back. What type of abuse might be occurring?

Answer Options:
a. Psychological
b. Financial
c. Physical
d. Sexual

Answer: c. Physical

Question: An older adult diagnosed with Alzheimer’s disease lives with family. During the week, the person attends a day care center while the family is at work. In the evenings, members of the family provide care. Which factor makes this patient most vulnerable to abuse?

Answer Options:
a. Dementia
b. Living in a rural area
c. Being part of a busy family
d. Being home only in the evening

Answer: a. Dementia

Question: An older adult, diagnosed with Alzheimer’s disease, lives with family and has multiple bruises. The home health nurse talks with the older adult’s daughter, who becomes defensive and says, “My mother often wanders at night. Last night she fell down the stairs.” Which nursing diagnosis has priority?

Answer Options:
a. Risk for injury, related to cognitive impairment and lack of caregiver supervision
b. Noncompliance, related to confusion and disorientation as evidenced by lack of cooperation
c. Impaired verbal communication, related to brain impairment as evidenced by the confusion
d. Insomnia, related to cognitive impairment as evidenced by wandering at night

Answer: a. Risk for injury, related to cognitive impairment and lack of caregiver supervision

Question: An older adult diagnosed with dementia lives with family and attends day care. After observing poor hygiene, the nurse at the center talks with the patient’s adult child. This caregiver becomes defensive and says, “It takes all my time and energy to care for my mother. She’s awake all night. I never get any sleep.” Which nursing intervention has priority?

Answer Options:
a. Teach the caregiver more about the effects of dementia.
b. Secure additional resources for the mother’s evening and night care
c. Support the caregiver to grieve the loss of the mother’s ability to function.
d. Teach the family how to give physical care more effectively and efficiently.

Answer: b. Secure additional resources for the mother’s evening and night care

Question: A patient has a history of physical violence against family members when frustrated and then experiences periods of remorse after each outburst. The patient attends anger management classes. Which finding indicates success in this plan of care?

Answer Options:
a. The patient expresses frustration verbally instead of physically.
b. The patient explains the rationale for behaviors to the victim.
c. The patient identifies three personal strengths.
d. The patient agrees to seek counseling.

Answer: a. The patient expresses frustration verbally instead of physically.

Question: Which referral is most appropriate for a woman who is severely beaten by her husband, has no relatives or friends in the community, is afraid to return home, and has limited financial resources?

Answer Options:
a. Support group
b. Law enforcement
c. Women’s shelter
d. Vocational counseling

Answer: c. Women’s shelter

Question: Which family scenario presents the greatest risk for family violence?

Answer Options:
a. An unemployed husband with low self-esteem, a wife who loses her job, and a developmentally delayed 3-year-old child
b. A husband who finds employment 2 weeks after losing his previous job, a wife with stable employment, and a child diagnosed with attention deficit disorder
c. A single mother with an executive position, a gifted and talented child, and a widowed grandmother living in the home to provide child care
d. A single homosexual male parent and an adolescent son who has just begun dating

Answer: a. An unemployed husband with low self-esteem, a wife who loses her job, and a developmentally delayed 3-year-old child

Question: A 10-year-old child cares for siblings while the parents work because the family cannot afford a babysitter. This child says, “My father doesn’t like me. He calls me stupid all the time.” The mother says the father is easily frustrated and has trouble disciplining the children. The community health nurse should consider which resources to stabilize the home situation? (Select all that apply.)

Answer Options:
a. Parental sessions to teach child-rearing practices
b. Anger management counseling for the father
c. Continuing home visits to provide support

Answer: a. Parental sessions to teach child-rearing practices
b. Anger management counseling for the father
c. Continuing home visits to provide support

Question: A 10-year-old child cares for siblings while the parents work because the family cannot afford a babysitter. This child says, “My father doesn’t like me. He calls me stupid all the time.” The mother says the father is easily frustrated and has trouble disciplining the children. The community health nurse should consider which resources to stabilize the home situation? (Select all that apply.)

Answer Options:
a. Parental sessions to teach child-rearing practices
b. Anger management counseling for the father
c. Continuing home visits to provide support
d. Safety plan for the wife and children
e. Foster placement of the children in foster care

Answer: a. Parental sessions to teach child-rearing practices
b. Anger management counseling for the father
c. Continuing home visits to provide support

Question: A nurse assists a victim of intimate partner violence to create a plan for escape if it becomes necessary. The plan should include which components? (Select all that apply.)

Answer Options:
a. Keep a cell phone fully charged.
b. Hide money with which to buy new clothes.
c. Have the telephone number for the nearest shelter.
d. Take enough toys to amuse the children for 2 days.
e. Secure a supply of current medications for self and children.
f. Determine a code word to signal children that it is time to leave.
g. Assemble birth certificates, Social Security cards, and licenses.

Answer: a. Keep a cell phone fully charged.
c. Have the telephone number for the nearest shelter.
e. Secure a supply of current medications for self and children.
f. Determine a code word to signal children that it is time to leave.
g. Assemble birth certificates, Social Security cards, and licenses.