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A patient in an abusive relationship is hospitalized with abdominal and head trauma caused by their partner. The partner sends flowers to the patient and pizzas for all the staff. Via video chat, the partner tearfully begs the patient to forgive them and not press charges. The partner states, “I just want you, me, and the kids to be together. You know you do too.” What conclusions can the nurse make about this scenario? (Select All That Apply)

The patient’s partner’s act of sending flowers is an example of undoing.

The patient and partner are in the honeymoon phase of intimate partner violence.

The patient has a submissive personality and depression.

Since the injuries have caused hospitalization, the patient will end the relationship.

The partner may be trying to manipulate the staff by buying pizza.

Answer and Explanation

Correct Answer : A,B,E

The correct answer is a, b, and e.

Choice A Reason:

The patient’s partner’s act of sending flowers is an example of undoing. Undoing is a defense mechanism where a person tries to cancel out or remove an unhealthy, destructive, or otherwise threatening thought or action by engaging in contrary behavior. In this case, the partner is attempting to make amends for the abuse by sending flowers, which is a common tactic used by abusers to mitigate their guilt and manipulate the victim into forgiving them.

Choice B Reason:

The patient and partner are in the honeymoon phase of intimate partner violence. The cycle of abuse in intimate partner violence typically includes a honeymoon phase, where the abuser may apologize, show remorse, and promise to change. This phase often involves gestures of affection and kindness, such as sending flowers or gifts, to win back the victim’s trust and prevent them from leaving.

Choice C Reason:

The patient has a submissive personality and depression. While it is possible that the patient may have a submissive personality and depression, this conclusion cannot be definitively made based on the given scenario alone. Submissive personality traits and depression are complex and require thorough psychological evaluation to diagnose accurately.

Choice D Reason:

Since the injuries have caused hospitalization, the patient will end the relationship. This conclusion is not necessarily accurate. Victims of intimate partner violence often face significant psychological, emotional, and practical barriers to leaving an abusive relationship, even after severe incidents that result in hospitalization. The decision to leave an abusive relationship is influenced by various factors, including fear, financial dependence, emotional attachment, and lack of support.

Choice E Reason:

The partner may be trying to manipulate the staff by buying pizza. Manipulative behavior is common in abusive relationships. By buying pizza for the staff, the partner may be attempting to create a favorable impression and gain sympathy, which can influence the staff’s perception of the situation and potentially affect their support for the patient.

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Correct Answer is C

Explanation

Choice A Reason: My boyfriend is too passionate for me

This statement indicates that the client is still placing some blame on their boyfriend’s behavior rather than recognizing the assault as a violation of their autonomy and consent. It suggests that the client may not fully understand that the responsibility for the assault lies with the perpetrator, not with their boyfriend’s level of passion. This mindset can hinder the healing process and indicates that the client may still be struggling with self-blame.

Choice B Reason: Next time I won’t wear such a sexy dress

This statement reflects a common misconception that the victim’s clothing or behavior can provoke sexual assault. It indicates that the client is still internalizing blame for the assault, believing that their attire was a contributing factor. This belief can be detrimental to recovery, as it perpetuates the myth that victims are responsible for the actions of their assailants.

Choice C Reason: I know it was not my fault

This statement is a strong indicator of progress in therapy. Recognizing that the assault was not their fault shows that the client is beginning to understand that the responsibility lies solely with the perpetrator. This realization is crucial for healing, as it helps to alleviate feelings of guilt and self-blame, allowing the client to move forward in their recovery.

Choice D Reason: I’ll just go on double dates from now on

This statement suggests that the client is still trying to find ways to prevent future assaults by changing their behavior rather than recognizing that the fault lies with the perpetrator. While taking precautions can be a part of feeling safe, it should not be based on the belief that the client could have prevented the assault by altering their actions.

A. Promoting activities that encourage self-reflection. B. Conveying an accepting attitude. C. Identifying community resources. D. Providing positive feedback.

Correct Answer is B

Explanation

Choice A Reason:

Promoting activities that encourage self-reflection. While promoting self-reflection is important in the therapeutic process, it is not the most essential aspect initially for establishing a trusting nurse-patient relationship. Self-reflection activities are more effective once a foundation of trust has been established.

Choice B Reason:

Conveying an accepting attitude. This statement is correct. Conveying an accepting attitude is crucial in the initial stages of establishing a trusting nurse-patient relationship. Patients with borderline personality disorder often feel judged and misunderstood. An accepting attitude helps to create a safe and supportive environment, which is essential for building trust and encouraging open communication.

Choice C Reason:

Identifying community resources. Identifying community resources is important for long-term support and management of borderline personality disorder, but it is not the most essential aspect initially for establishing trust. This step is more relevant once the therapeutic relationship has been established and the patient is ready to engage with external support systems.

Choice D Reason:

Providing positive feedback. Providing positive feedback is beneficial in reinforcing positive behaviors and encouraging progress. However, it is not the most essential aspect initially for establishing trust. Positive feedback is more effective when the patient already feels understood and supported by the nurse.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A college student experienced a sexual assault when out on a date. After several weeks of crisis intervention therapy, which statement by the client would indicate to the nurse that the student is making progress?

Correct Answer is C

Explanation

The nurse is planning a psycho-education group for clients diagnosed with borderline personality disorder. The nurse understands that which aspect of group intervention is most essential initially to establish a trusting nurse-patient relationship?

Correct Answer is B

Explanation

Several children come to the Emergency Department for treatment. The situation that would cause the nurse to have the highest suspicion of child abuse would be:

The nurse is scheduled to interview a client with histrionic personality disorder. The nurse can anticipate that the assessment findings will include the following. The client:

An individual with a history of antisocial personality disorder was arrested for driving under the influence of alcohol and causing a serious car accident. Which comment on this behavior would be expected?

A nurse is providing care for a client who is malnourished and appears exhausted. What data would cause the nurse to suspect the client is a victim of human trafficking? The client:

The nurse is observing a family member administer eye drops to the patient as part of medication teaching. Which action(s) indicate the family member is performing the skill correctly? (SELECT ALL THAT APPLY)

A client diagnosed with bipolar disorder is experiencing a severe depressive episode. Which client behavior would alert the nurse to the highest priority intervention? The client:

The nurse has recently set limits for a client with borderline personality disorder. The client yells at the nurse, “You used to care about me. I thought you were wonderful. Now I can see that I was mistaken. You are hateful.” This outburst can be assessed as: