The nurse understands that which factors are central to the dynamic of intimate partner violence?

Emotional injury and learned helplessness.

Poor communication and social isolation.

Power and control.

Erratic relationships and vulnerability.

Answer and Explanation

The Correct Answer is C

Choice A Reason:

Emotional injury and learned helplessness. While emotional injury and learned helplessness are significant consequences of intimate partner violence (IPV), they are not the central factors driving the dynamic of IPV. Learned helplessness refers to a state where the victim feels powerless to change their situation due to repeated exposure to traumatic events. Emotional injury is a result of the abuse but not a driving factor.

Choice B Reason:

Poor communication and social isolation. Poor communication and social isolation can exacerbate the situation but are not the primary factors central to the dynamic of IPV. Social isolation is often a tactic used by abusers to control their victims, but it is a consequence rather than a cause. Poor communication can contribute to misunderstandings and conflicts but is not the root cause of IPV.

Choice C Reason:

Power and control. This statement is correct. The central dynamic of intimate partner violence is the abuser’s desire to exert power and control over their partner. This need for dominance manifests through various abusive behaviors, including physical, emotional, psychological, and financial abuse. The Power and Control Wheel, a tool developed by the Domestic Abuse Intervention Project, illustrates how different abusive tactics are used to maintain control over the victim.

Choice D Reason:

Erratic relationships and vulnerability. Erratic relationships and vulnerability are characteristics often seen in IPV situations but are not central to the dynamic. Vulnerability can make individuals more susceptible to abuse, and erratic relationships can be a symptom of the abuse, but they do not drive the abusive behavior5.

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Correct Answer is D

Explanation

d. Interview the client alone and assess for abuse

Explanation of Choices

Choice A Reason: Provide the Daughter and Client with Nutritional Counseling

While nutritional counseling is important, especially given the client’s malnourished state, it is not the immediate priority in this scenario. The client’s reluctance to speak and the daughter’s interruptions suggest that there may be underlying issues that need to be addressed first. Nutritional counseling can be provided later, once the immediate concerns have been resolved.

Choice B Reason: Request a Psychiatric Evaluation for the Client

Requesting a psychiatric evaluation may be necessary if there are signs of mental health issues, but it is not the first step in this situation. The priority is to ensure the client’s safety and well-being by addressing any immediate concerns, such as potential abuse. A psychiatric evaluation can be considered after the initial assessment and intervention.

Choice C Reason: Take the History from the Daughter Because of the Client’s Confusion

Taking the history from the daughter might seem practical due to the client’s confusion, but it is not the best approach in this case. The daughter’s constant interruptions and the client’s reluctance to speak raise concerns about the reliability of the information provided by the daughter. It is crucial to gather information directly from the client whenever possible to ensure an accurate assessment.

Choice D Reason: Interview the Client Alone and Assess for Abuse

Interviewing the client alone and assessing for abuse is the most appropriate intervention. The client’s reluctance to speak and the daughter’s interruptions could indicate that the client is being controlled or intimidated. Conducting a private interview allows the client to speak freely and provides an opportunity to identify any signs of abuse or neglect. Ensuring the client’s safety and addressing any immediate risks is the top priority.

A. Food is rapidly ingested without proper chewing B. Poor dental and oral hygiene leads to dental caries C. Purging causes the depletion of dietary calcium D. Emesis from purging corrodes the tooth enamel

Correct Answer is D

Explanation

d. Emesis from purging corrodes the tooth enamel

Explanation of Choices

Choice A Reason: Food is Rapidly Ingested Without Proper Chewing

While individuals with bulimia nervosa may engage in rapid eating during binge episodes, this behavior alone does not directly cause dental deterioration. Rapid ingestion of food can lead to other gastrointestinal issues, but it is not the primary cause of dental problems seen in bulimia nervosa. The main dental issues arise from the purging behavior that follows binge eating.

Choice B Reason: Poor Dental and Oral Hygiene Leads to Dental Caries

Poor dental and oral hygiene can indeed lead to dental caries (cavities), but this is not the primary issue in bulimia nervosa. The dental deterioration observed in bulimia nervosa is more specifically related to the effects of repeated vomiting, which introduces stomach acid into the mouth. While maintaining good oral hygiene is important, it does not fully address the unique dental challenges posed by bulimia.

Choice C Reason: Purging Causes the Depletion of Dietary Calcium

Purging can lead to various nutritional deficiencies, including calcium, but the depletion of dietary calcium is not the main cause of dental deterioration in bulimia nervosa. The primary issue is the direct effect of stomach acid on the teeth. Calcium depletion can contribute to overall bone health issues, but it is not the specific cause of the dental erosion seen in bulimia.

Choice D Reason: Emesis from Purging Corrodes the Tooth Enamel

Emesis (vomiting) from purging is the primary cause of dental deterioration in bulimia nervosa. When individuals with bulimia vomit, stomach acid comes into contact with the teeth, leading to enamel erosion. This acid is highly corrosive and can wear away the protective enamel layer, resulting in increased tooth sensitivity, cavities, and other dental issues. This repeated exposure to stomach acid is the most significant factor in the dental deterioration observed in bulimia nervosa.

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The nurse understands that which factors are central to the dynamic of intimate partner violence?

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Correct Answer is D

Explanation

The nurse observes dental deterioration when assessing a client diagnosed with Bulimia Nervosa. Which best explains this assessment finding?

Correct Answer is D

Explanation

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