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Jarvis: Physical Examination & Health Assessment, 6th Edition

Chapter 07: Domestic Violence Assessment


Test Bank
MULTIPLE CHOICE
1. As a mandatory reporter of elder abuse, which of these must be present before a nurse notifies

the authorities?
Statements from the victim
Statements from witnesses
Proof of abuse and/or neglect
Suspicion of elder abuse and/or neglect

A)
B)
C)
D)

ANS: D

Many health care workers are under the erroneous assumption that proof is required before
notification of suspected abuse can occur. Only a suspicion of elder abuse or neglect is necessary.
PTS: 1
DIF: Cognitive Level: Applying (Application)
REF: Page: 104
MSC: Client Needs: Safe and Effective Care Environment: Safety and Infection Control
2. During a home visit, the nurse notices that an elderly woman is caring for her bedridden

husband. The woman states that this is her duty, she does the best she can, and her children come
to help when they are in town. Her husband is unable to care for himself, and she appears thin,
weak, and exhausted. The nurse notices that several of his prescription medication bottles are
empty. This situation is best described by the term:
A) physical abuse.
B) financial neglect.
C) psychological abuse.
D) unintentional physical neglect.
ANS: D

Unintentional physical neglect may occur despite good intentions. It is the failure of the family
member or caregiver to provide basic goods or services. Physical abuse is defined as violent acts
that result or could result in injury, pain, impairment, or disease. Financial neglect is failure to
use the assets of the elderly person to provide services needed by the elderly person.
Psychological abuse is defined as behaviors that result in mental anguish.
PTS: 1
DIF: Cognitive Level: Applying (Application)
REF: Page: 104
MSC: Client Needs: Safe and Effective Care Environment: Safety and Infection Control
3. The nurse is aware that intimate partner violence (IPV) screening should occur with which

situation?
When IPV is suspected
When a woman has an unexplained injury
As a routine part of each health care encounter
When there is a known history of abuse in the family

A)
B)
C)
D)

Elsevier items and derived items 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Test Bank

7-2

ANS: C

Many nursing professional organizations have called for routine, universal screening for IPV to
assist women in getting help for the problem.
PTS: 1
DIF: Cognitive Level: Applying (Application)
REF: Pages: 105-106
MSC: Client Needs: Safe and Effective Care Environment: Safety and Infection Control
4. Which statement is best for the nurse to use when preparing to administer the Abuse Assessment

Screen?
We are required by law to ask these questions.
We need to talk about whether you feel you have been abused.
We are asking these questions because we suspect that you are being abused.
We ask the following questions because domestic violence is so common in our
society.

A)
B)
C)
D)

ANS: D

Such an introduction both alerts the woman that questions about domestic violence are coming
and makes sure that the woman knows she is not being singled out for these questions.
PTS: 1
DIF: Cognitive Level: Applying (Application)
REF: Pages: 105-106
MSC: Client Needs: Safe and Effective Care Environment: Safety and Infection Control
5. Which term refers to a wound produced by the tearing or splitting of body tissue, usually from

blunt impact over a bony surface?


Abrasion
Contusion
Laceration
Hematoma

A)
B)
C)
D)

ANS: C

The term laceration fits this definition. An abrasion is caused by rubbing of the skin or mucous
membrane. A contusion is injury to tissues without breakage of skin, and a hematoma is a
localized collection of extravasated blood.
PTS: 1
DIF: Cognitive Level: Remembering (Knowledge)
REF: Pages: 108-109
MSC: Client Needs: Safe and Effective Care Environment: Safety and Infection Control
6. During an examination, the nurse notices a patterned injury on a patients back. Which of these

would cause such an injury?


Blunt force
Friction abrasion
Stabbing from a kitchen knife
Whipping from an extension cord

A)
B)
C)
D)

ANS: D

Elsevier items and derived items 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Test Bank

7-3

A patterned injury is an injury caused by an object that leaves a distinct pattern on the skin or
organ. The other actions do not cause a patterned injury.
PTS: 1
DIF: Cognitive Level: Applying (Application)
REF: Page: 109
MSC: Client Needs: Safe and Effective Care Environment: Safety and Infection Control
7. When documenting intimate partner violence and elder abuse, the nurse should include:
A) photographic documentation of injuries.
B) a summary of the abused patients statements.
C) verbatim documentation of every statement made.
D) a general description of injuries in the progress notes.
ANS: A

Documentation of intimate partner violence and elder abuse must include detailed nonbiased
progress notes, the use of injury maps, and photographic documentation. Written documentation
needs to be verbatim, within reason. Not every statement can be documented.
PTS: 1
DIF: Cognitive Level: Applying (Application)
REF: Pages: 109-110
MSC: Client Needs: Safe and Effective Care Environment: Safety and Infection Control
8. A female patient has denied any abuse when answering the Abuse Assessment Screen, but the

nurse has noticed some other conditions that are associated with intimate partner violence.
Examples of such conditions include:
A) asthma.
B) confusion.
C) depression.
D) frequent colds.
ANS: C

Depression is one of the conditions that is particularly associated with intimate partner violence.
Abused women also have been found to have more chronic health problems, such as neurologic,
gastrointestinal, and gynecologic symptoms, and chronic pain, as well as suicidality and
posttraumatic stress disorder symptoms.
PTS: 1
DIF: Cognitive Level: Understanding (Comprehension)
REF: Pages: 104-105
MSC: Client Needs: Safe and Effective Care Environment: Safety and Infection Control
9. The nurse is using the danger assessment (DA) tool to evaluate the risk of homicide. Which of

these statements best describes its use?


The DA tool is to be administered by law enforcement personnel.
The DA tool should be used in every assessment of suspected abuse.
The number of yes answers indicates the womans understanding of her situation.
The higher the number of yes answers, the more serious the danger of the womans
situation.

A)
B)
C)
D)

Elsevier items and derived items 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Test Bank

7-4

ANS: D

There are no predetermined cutoff scores on the DA. The more yes answers there are, the more
serious the danger of the womans situation. The use of this tool is not limited to law
enforcement personnel, and not required in every case of suspected abuse.
PTS: 1
DIF: Cognitive Level: Applying (Application)
REF: Pages: 111-112
MSC: Client Needs: Safe and Effective Care Environment: Safety and Infection Control
10. The nurse is assessing bruising on an injured patient. Which color indicates a new bruise that is

less than 2 hours old?


Red
Purple-blue
Greenish-brown
Brownish-yellow

A)
B)
C)
D)

ANS: A

A new bruise is usually red and will often develop a purple or purple-blue appearance 12 to 36
hours after blunt-force trauma. The color of bruises (and ecchymoses) generally progresses from
purple-blue to bluish-green to greenish-brown to brownish-yellow before fading away.
PTS: 1
DIF: Cognitive Level: Understanding (Comprehension)
REF: Page: 108
MSC: Client Needs: Safe and Effective Care Environment: Safety and Infection Control
11. During a home visit, the nurse notices that an elderly woman has very little food in her cabinets

or refrigerator and that most of her prescription bottles are empty. She says that she has enough
money, but her nephew has her checkbook and he takes care of everything. She says, Oh, my
nephew will get around to getting groceries and my medicine when he can. Hes very busy. This
is an example of:
A) financial abuse.
B) financial neglect.
C) psychological neglect.
D) physical abuse.
ANS: B

Financial neglect is failure to use the assets of the elderly person to provide services needed by
the elderly person. Financial abuse is intentional misuse of the elderly persons financial or
material resources without the informed consent of the person; there is no evidence of intent in
this example.
PTS: 1
DIF: Cognitive Level: Applying (Application)
REF: Page: 104
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
12. The nurse suspects abuse when a 10-year-old child is taken to the urgent care center for a leg

injury. The best way to document the history and physical findings is to:
A) write what the childs caregiver tells the nurse.

Elsevier items and derived items 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Test Bank

7-5

B) use the words the child has given to describe how the injury occurred.
C) write what the nurse observes during the conversation.
D) rely on photographs of the injuries.
ANS: B

When documenting the history and physical findings of child abuse and neglect, use the words
the child has given to describe how his or her injury occurred. Remember that the abuser may be
accompanying the child.
PTS: 1
DIF: Cognitive Level: Applying (Application)
REF: Pages: 111-112
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
13. During an interview, a woman has answered yes to two of the Abuse Assessment Screen

questions. What should the nurse say next?


I need to report this abuse to the authorities.
Tell me about this abuse in your relationship.
So you were abused?
Do you know what caused this abuse?

A)
B)
C)
D)

ANS: B

If a woman answers yes to any of the Abuse Assessment Screen questions, then the nurse
should ask questions designed to assess how recent and how serious the abuse was. Asking the
woman an open-ended question, such as tell me about this abuse in your relationship is a good
way to start.
PTS: 1
DIF: Cognitive Level: Analyzing (Analysis)
REF: Pages: 106-107
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
14. The nurse is examining a 3-year-old child who was brought to the emergency room after a fall.

Which bruise, if found, would be of most concern?


A bruise on the knee
A bruise on the elbow
Bruising on the abdomen
A bruise on the shin

A)
B)
C)
D)

ANS: C

Studies have shown that children who were walking often had bruises over the bony
prominences of the front of their bodies. Other studies have found that bruising in atypical
places such as the buttocks, hands, feet and abdomen was exceedingly rare and should arouse
concern.
PTS: 1
DIF: Cognitive Level: Analyzing (Analysis)
REF: Page: 109
MSC: Client Needs: Safe and Effective Care Environment: Management of Care

MULTIPLE RESPONSE

Elsevier items and derived items 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Test Bank

7-6

1. The nurse is assessing an elderly woman and suspects abuse. Which questions are appropriate for

screening for abuse? Select all that apply.


Has anyone ever physically hurt you?
Are you being abused?
Are you alone a lot?
Are you afraid of anybody at home or anyone who enters your home?
Has anyone ever failed to help you take care of yourself when you needed help?

A)
B)
C)
D)
E)

ANS: A, C, D, E

Directly asking Are you being abused? is not appropriate for a screening question for abuse
because the woman could easily say no and no further information would be obtained. The
other questions are among the questions recommended by the American Medical Association
when screening for elder abuse.
PTS: 1
DIF: Cognitive Level: Analyzing (Analysis)
REF: Page: 107
MSC: Client Needs: Safe and Effective Care Environment: Management of Care

Elsevier items and derived items 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.