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Exam (elaborations) RNSG 2539 Final Blueprint (Spring 2019) (RNSG2539)

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RNSG 2539 Final Blueprint (RNSG2539)

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Exam (elaborations) RNSG 2539 Final Blueprint (Spring 2019) (RNSG2539)/Exam (elaborations) RNSG 2539 Final Blueprint (Spring 2019) (RNSG2539)

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rnsg 2539
final blueprint
rnsg 2539 final blueprint spring 2019

Institution
San Antonio College
Course
RNSG 2539 Final Blueprint (RNSG2539)

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2539 Study Guide
Question & Objectives Nursing Concept / Client Needs Integrative Process Bloom’s Reference
Content Area Taxonomy
1. Interpersonal Interpersonal Relations Psychosocial Communication and Application Videbeck
Relations Intimate Partner Violence Integrity Documentation Abuse &
3 Interviewing Violence –
Chapter 12

4. Interpersonal Interpersonal Relations Psychosocial Nursing Process: Application Videbeck
Relations Intimate Partner Integrity Assessment Abuse &
3 Violence Violence
Interviewing –
Chapter
12

A woman has just presented at the emergency department after being raped. The initial nursing action would be to
A) provide emotional support.
B) refer her to a rape crisis hotline.
C) encourage her to file charges immediately.
D) perform a nursing history and physical as quickly as possible.

Ans: A Feedback: In the emergency setting, the nurse is an essential part of the team in providing emotional support to
the victim. The nurse should allow the woman to proceed at her own pace and not rush her through any interview or
examination procedures. Giving back to the victim as much control as possible is important. Ways to do so include
allowing her to make decisions, when possible, about whom to call, what to do next, what she would like done, and so
on.

A nurse is working with a client who has a history of repeated abusive intimate relationships. The nurse has difficulty
understanding why a woman would repeatedly enter into relationships with abusive partners. When working with this
client, the nurse can best maintain a therapeutic relationship through which of the following approaches?
A) Keeping focused on the client's feelings about her life situation
B) Honestly asking the client why she repeats the cycles of victimization
C) Convincing the client to develop a self-rescue plan
D) Not prying into the details of the client's private life

Ans: A Feedback: Nurses may believe that a woman who stays in an abusive relationship might deserve or enjoy the
abuse or that abuse between husband and wife is private. The nurse may also feel horror or revulsion. Because clients
often watch for the nurse's reaction, containing these feelings and focusing on the client's needs are important. The
nurse must be prepared to listen to the client's story, no matter how disturbing, and support and validate the client's
feelings with comments such as “That must have been terrifying” or “Sounds like you were afraid for your life.” The nurse
must remember that he or she cannot fix or change things; the nurse's role is to listen and convey acceptance and
support for the client.

A female client comes to an urgent care clinic and says, “I’ve just been raped.” What should the nurse do?
1

, 2539 Study Guide
a. Allow the client to express whatever she wants.
b. Ask the client if staff can call a friend or family member for her.
c. Offer the client coffee, tea, or whatever she likes to drink.
d. Get the examination completed quickly to decrease trauma to the client.
e. Provide the client privacy—let her go to a room to make phone calls.
f. Stay with the client until someone else arrives to be with her.

Ans: a, b, f Feedback: see table 12.1 or Videbeck pages 200-203

****Which approach would be most appropriate when counseling a woman who is a suspected victim of violence?
A) Offer her a pamphlet about the local battered women’s shelter.
B) Call her at home to ask her some questions about her marriage.
C) Wait until she comes in a few more times to make a better assessment.
D) Ask, “Have you ever been physically hurt by your partner?”

Ans D Feedback (Ricci) Uncovering abuse in pregnant women requires a consistent and direct approach to every client
by the nurse. Multiple assessments may enhance reporting by enabling the nurse to establish trust and rapport with the
woman and identify changes in her behavior. Once abuse is discovered in a pregnant woman, interventions should
include safety assessment, emotional support, counseling, referral to community services, and ongoing prenatal care to
avoid adverse health outcomes (Hewitt, 2015).

A battered pregnant woman reports to the nurse that her husband has stopped hitting her and promises never to hurt
her again. Which of the following is an appropriate response?
A) “That’s great. I wish you both the best.”
B) “The cycle of violence often repeats itself.”
C) “He probably didn’t mean to hurt you.”
D) “You need to consider leaving him.”

Ans B

Which of the following nursing actions would be least helpful for a client who is a victim of violence?
A) Assist the client to project her anger.
B) Provide information about a safe home and crisis line.
C) Teach her about the cycle of violence.
D) Discuss her legal and personal rights.

Ans A

Which of the following statements would be most appropriate to empower victims of violence to take action?
A) “Give your partner more time to come around.”
B) “Remember—children do best in two-parent families.”
C) “Change your behavior so as not to trigger the violence.”
D) “You are a good person and you deserve better than this.”

Ans D

2

, 2539 Study Guide
*****When a nurse suspects that a client may have been abused, the first action should be to:
A) Ask the client about the injuries and if they are related to abuse.
B) Encourage the client to leave the batterer immediately.
C) Set up an appointment with a domestic violence counselor.
D) Ask the suspected abuser about the victim’s injuries.

Ans A

*****In addition to providing privacy, which of the following would be most appropriate initially in situations involving
suspected abuse?
A) Allow the client to have a good cry over the situation.
B) Tell the client, “Injuries like these don’t usually happen by accident.”
C) Call the police immediately so they can question the victim.
D) Ask the abuser to describe his side of the story first.

Ans B

When the nurse is alone with a client, the client says, “It was all my fault. The house was so messy when he got home
and I know he hates that.” Which response would be most appropriate?
A) “It is not your fault. No one deserves to be hurt. ”
B) “What else did you do to make him so angry with you?”
C) “You need to start to clean the house early in the day.”
D) “Remember, he works hard and you need to meet his needs.”

Ans A

Above all, the nurse can offer caring and support throughout. Table 12.1 summarizes techniques for working with victims
of partner violence.

Ask if you have been physically hurt
Ask questions in an empathetic & non-threatening manner, be non-judgmental.
Direct questions: Does your partner hit you? Have you ever been or are you now in an abusive relationship?
Indirect questions? We see many women with injuries or complaints like yours & often they are being abused, is that
what is happening to you?
Isolate the woman to provide privacy & to prevent potential retaliation from the abuser. The assessment can take place
anywhere that is private and away from the abuser, for example, x-ray area, ultrasound room, elevator, ladies’ room, or
laboratory.
If abuse is detected, the nurse can do the following to enhance the nurse–client relationship: Educate the woman about the
connection between the violence and her symptoms, Help the woman acknowledge what has happened to her and begin to
deal with the situation, Offer her referrals so she can get the help that will allow her to begin to heal.

Marquis:
3

, 2539 Study Guide
For intimate partner violence, begin the screening by telling the “Yes” to any of the questions strongly indicates initial
client that it is important to routinely screen all clients for disclosure of abuse. If the client answers yes, then you
intimate partner violence because it affects so many women and should do the following:
men in our society. Ask the client to fill out or help the client fill  Acknowledge the abuse and the client’s courage
out the Abuse Assessment Screen in Assessment Tool 10-2. in admitting that abuse is occurring.
 Use supportive statements such as “I’m sorry
this is happening to you. This is not your fault.
Clinical Tip You are not responsible for his behavior. You are
Sometimes no matter how carefully you prepare the client and not alone. You don’t deserve to be treated this
ask the questions she or he may not disclose abuse. way. Help is available to you.”
 Acknowledge the client’s autonomy and right to
self-determination.
 Reiterate confidentiality of disclosure.
If the client replies “no” to screening questions and is
not being abused, it is important for the client to know
that you are available if she or he ever experiences
abuse in the future.
Make statements that build trust such as:
“If your situation ever changes, please call me to talk
about it. I am happy to hear that you are not being
abused. If that should ever change, this is a safe place to
talk.”

Videbeck:
TABLE 12.1 Dos and Don’ts of Working with Victims of Partner Abuse
Don’ts Dos

Don’t tell the victim what to do. Do believe the victim.
Don’t express disgust, disbelief, or anger. Do ensure and maintain the client’s confidentiality.
Don’t disclose client communications without the Do listen, affirm, and say, “I am sorry you have been hurt.”
client’s consent. Do express, “I’m concerned for your safety.”
Don’t preach, moralize, or imply that you doubt the Do tell the victim, “You have a right to be safe and respected.”
client. Do say, “The abuse is not your fault.”
Don’t minimize the impact of violence. Do recommend a support group or an individual counseling.
Don’t express outrage with the perpetrator. Do identify community resources and encourage the client to
Don’t imply that the client is responsible for the abuse. develop a safety plan.
Don’t recommend couples’ counseling. Do offer to help the client contact a shelter, the police, or
Don’t direct the client to leave the relationship. other resources.
Don’t take charge and do everything for the client. Do accept and respect the victim’s decision.
Do encourage development of a safety plan.

Ricci:
BOX 12.2 SAFE QUESTIONS
4

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