CFN - Certified Forensic Nurse Violence and Abuse Patterns Questions and Answers — Questions and Answers
Question 1: A forensic nurse is assessing a patient who reports a history of intimate partner violence. The patient states, "Things will be fine for a while, he's so sorry and buys me gifts. But then I feel like I'm walking on eggshells, and eventually, he explodes over something small." This pattern is best described by which of the following theories?
- The Power and Control Wheel
- The Cycle of Violence (Correct answer)
- Learned Helplessness Theory
- Trauma Bonding Theory
Correct answer: The Cycle of Violence
The patient's description of a repeating pattern of a calm/honeymoon phase, a tension-building phase, and an acute battering or explosion phase directly aligns with Dr. Lenore Walker's Cycle of Violence theory, first described in 1979.
Question 2: A forensic nurse is examining a 4-month-old infant and notes multiple bruises on the torso, neck, and ears. The caregiver states the infant rolled off the changing table. Which of the following findings would be most inconsistent with this explanation and highly suspicious for non-accidental trauma?
- A single bruise on the forehead
- Bruises on the shins and knees
- Multiple bruises in different stages of healing on soft tissue areas (Correct answer)
- A linear bruise on the cheek
Correct answer: Multiple bruises in different stages of healing on soft tissue areas
Bruises in various stages of healing suggest injuries occurred at different times, which is a significant indicator of repeated physical abuse. Furthermore, bruises on soft tissue areas like the torso, neck, and ears are less common in accidental injuries for a non-mobile infant and are highly concerning for inflicted trauma.
Question 3: During the 'honeymoon phase' of the Cycle of Violence, which of the following perpetrator behaviors is most characteristic?
- Increasingly isolating the victim from family and friends.
- Making threats and exhibiting minor aggressive acts.
- Expressing remorse, apologizing, and promising the abuse will not happen again. (Correct answer)
- Blaming the victim for provoking the violent episode.
Correct answer: Expressing remorse, apologizing, and promising the abuse will not happen again.
The honeymoon phase, or remorseful/reconciliation phase, is characterized by the abuser's attempts to make up for the violence. This often includes apologies, promises to change, gift-giving, and affectionate behavior, which can give the victim false hope and make it difficult to leave the relationship.
Question 4: A patient discloses that their partner controls all their finances, tracks their movements with GPS, dictates what they wear, and has isolated them from their family. While there is no physical violence, the patient feels constantly monitored and fearful. This pattern of abuse is best defined as:
- Situational Couple Violence
- Physical Abuse
- Coercive Control (Correct answer)
- Emotional Abuse
Correct answer: Coercive Control
Coercive control is a strategic pattern of behavior designed to make a person dependent by isolating them, exploiting them, and depriving them of independence and control over their own lives. The scenario describes key tactics of coercive control, such as financial abuse, isolation, and monitoring, which are used to establish and maintain power.
Question 5: Which of the following describes the 'tension-building' phase in Walker's Cycle of Violence?
- The abuser is apologetic and loving, promising to change.
- The victim experiences a sense of relief that the violence is over.
- A major act of physical or sexual violence occurs.
- The victim may feel like they are 'walking on eggshells' as the abuser becomes more irritable and critical. (Correct answer)
Correct answer: The victim may feel like they are 'walking on eggshells' as the abuser becomes more irritable and critical.
The tension-building phase is characterized by escalating tension, increased criticism and verbal abuse from the perpetrator, and minor abusive incidents. The victim often tries to placate the abuser to prevent an explosion, leading to the feeling of 'walking on eggshells.'
Question 6: A forensic nurse is assessing an elderly patient brought in by a family member for untreated pressure ulcers and malnutrition. The patient appears withdrawn and the family member is dismissive of the concerns. The nurse should be alert to which specific pattern of elder abuse?
- Financial Exploitation
- Physical Abuse
- Sexual Abuse
- Neglect (Correct answer)
Correct answer: Neglect
The presentation of untreated medical conditions like severe pressure ulcers, coupled with malnutrition and the caregiver's dismissive attitude, are classic red flags for neglect. Neglect is the failure of a caregiver to provide the necessary care for an elder, resulting in harm or risk of harm.
