Abuse-Neglect Practice Test 2
Abuse-Neglect NCLEX Practice Test
Abuse-Neglect is a key topic within the NCLEX test plan, located under Psychosocial Integrity → Coping and Adaptation → Abuse-Neglect. This section recognizes indicators of abuse, mandates reporting, and ensures trauma-informed, compassionate nursing care. Each test contains 50 questions designed to mirror the difficulty and variety of the real exam.
This is the 2nd part of the Abuse-Neglect series. To explore all practice tests under this topic, use the “Back to Main Topic” button at the end of the page.
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Abuse-Neglect Practice Test 2
Which one of the following clients is most at risk to be a victim of elderly abuse?
- 75-year-old male with Pick's disease
- 78-year-old male with prostate cancer
- 80-year-old male with diabetes mellitus
- 65-year-old female with Alzheimer's disease
Explanation: Answer reason: Dementia increases vulnerability through impaired judgment, communication difficulties, and greater need for caregiver assistance, which can heighten caregiver stress and opportunity for neglect or abuse. Being female is also a recognized risk factor in many abuse patterns due to higher rates of vulnerability and dependence in later life. In contrast, chronic medical illnesses without cognitive impairment (e.g., diabetes, cancer) do not inherently confer the same level of vulnerability to exploitation and underreporting.
Which type of elder abuse is characterized by a failure of a caretaker to provide for basic needs (e.g., medical care, nutrition, hygiene)?
- Financial abuse
- Neglect
- Physical abuse
- Sexual abuse
Explanation: Answer reason: The stem describes omission of care rather than an act of force or coercion, which aligns with neglect. Financial exploitation involves misuse of money or property, not unmet physical needs. Physical and sexual abuse require evidence of assaultive behavior rather than inadequate provision of essentials.
The school nurse has performed an assessment on a 6-year-old child who has been sent to the office after a teacher developed concerns for his safety. Which findings will lead the nurse to investigate other signs of neglect?
- The child has a difficult time paying attention during class.
- The child always finishes his meal at lunch time and is hungry again a few hours later.
- The child is more shy than many of his classmates.
- The child is frequently absent from school and is tired when he does attend.
Explanation: Answer reason: Neglect is suggested by patterns showing unmet basic needs and lack of supervision, including poor attendance and chronic fatigue from inadequate sleep, unstable housing, or insufficient caregiving. Frequent absences can indicate failure to provide basic education/safe routine or a home environment that prevents consistent school attendance. Tiredness on days present strengthens concern for chronic deprivation rather than an isolated behavioral trait. In contrast, inattention or shyness are nonspecific and can occur with normal development or many other conditions, and hunger a few hours after lunch alone is common in children and is not a strong neglect indicator without other corroborating signs.
A school nurse notes that a child has frequent absences from school, often steals food from other children, wears clothes that are inappropriate for the weather? Which type of abuse does the nurse expect the child is experiencing?
- Emotional abuse
- Financial abuse
- Neglect
- Sexual abuse
Explanation: Answer reason: Stealing food suggests unmet nutritional needs, inappropriate clothing suggests unmet basic care for safety/temperature regulation, and frequent school absences can reflect inadequate supervision or failure to ensure education. Emotional abuse more often presents with behavioral/emotional symptoms (e.g., withdrawal, low self-esteem) rather than clear signs of unmet basic needs. Financial abuse is not the typical framework for children in this context, and sexual abuse is suggested by genital injury, STI/pregnancy, sexualized behavior, or disclosure rather than hunger and poor clothing.
When doing an admission assessment, the nurse identifies that the patient's caretaker has failed to provide them with sufficient access to food and medical care. Which type of abuse has the patient experienced?
- Emotional abuse
- False imprisonment
- Financial abuse
- Neglect
Explanation: Answer reason: The stem describes omission of essential care (insufficient access to food and medical care), which fits neglect rather than an active act of harm. Emotional abuse would involve verbal threats, humiliation, or intimidation, not deprivation of basic needs. False imprisonment requires restraining or confining the person against their will, and financial abuse centers on misusing the patient’s money or assets. Recognizing neglect is critical because it triggers safety measures, documentation, and mandatory reporting per policy and law.
A child presents to the emergency room and the nurse notes multiple injuries in various stages of healing. The nurse is aware that this finding may be consistent with what?
- Legg-Calve-Perthes disease
- Neglect
- Physical abuse
- Zollinger-Ellison syndrome
Explanation: Answer reason: This pattern is especially concerning when the history is vague, inconsistent with the child’s developmental abilities, or changes between caregivers. Neglect more commonly presents with failure to thrive, poor hygiene, missed medical care, or unsafe living conditions rather than recurrent bruises/fractures in varying ages. The nurse should prioritize safety by following facility policy for mandatory reporting and ensuring appropriate assessment and documentation.
Which behavioral characteristic describes the domestic abuser?
- Alcoholic
- Overconfident
- High tolerance for frustrations
- Low self-esteem
Explanation: Answer reason: Low self-esteem is a classic behavioral/psychosocial characteristic linked with externalizing blame and attempting to regain a sense of power through domination of a partner. Alcohol use may co-occur and worsen severity, but it is not a defining characteristic and does not explain the underlying pattern of control. High frustration tolerance is inconsistent with abuse dynamics, which more often involve poor impulse control and low frustration tolerance.
A clinic nurse interviews a parent who is suspected of abusing her child. Which of the following characteristics is the nurse LEAST likely to find in an abusing parent?
- Low self-esteem.
- Unemployment.
- Self-blame for the injury to the child.
- Single status.
Explanation: Answer reason: Abusive caregivers more commonly externalize responsibility, minimize harm, or offer implausible explanations rather than accept accountability. A pattern of denial and blaming the child or circumstances is a typical psychosocial feature noted in abuse assessments. Low self-esteem, high stress with limited supports, and socioeconomic strain (including unemployment) are recognized risk factors seen more often in abusive households. Being single can be associated with fewer supports and greater stress, but taking personal blame for the injury is comparatively least consistent with the usual abusive-parent presentation.
A parent brings a preschooler to the emergency department for treatment of a dislocated shoulder, which allegedly happened when the child fell down the stairs. Which behavior should make the nurse suspect that the child was abused?
- The child cries uncontrollably throughout the examination.
- The child pulls away from contact with the physician.
- The child doesn't cry when the shoulder is examined.
- The child doesn't make eye contact with the nurse.
Explanation: Answer reason: A key red flag for possible physical abuse is an atypical affect or pain response that is inconsistent with the severity of injury. A dislocated shoulder is typically very painful in a preschooler; lack of crying or distress during examination can indicate fear, dissociation, learned helplessness, or a blunted response after repeated trauma. In contrast, crying throughout an exam or pulling away from a provider can occur with anxiety, stranger fear, or pain and is not specific to abuse. While poor eye contact may reflect fear or shyness, it is less directly inconsistent with the expected pain response than absent distress during a painful exam.
The nurse plans care for a 4-year-old girl who has been sexually abused by her father. Play therapy is scheduled. The nurse knows that the PRIMARY goal of play therapy for a 4-year-old is which of the following?
- Provide her with the opportunity to express anger and hostility by playing with dolls.
- Promote communication because she may lack the emotional and intellectual capacity to express her perceptions verbally.
- Assess whether she is functioning at an age-appropriate developmental level.
- Reveal through direct observation of her at play what type of abuse has been experienced.
Explanation: Answer reason: Preschool children often cannot reliably verbalize traumatic experiences due to limited cognitive, language, and emotional-developmental capacity. Therapeutic play provides a developmentally appropriate medium to communicate feelings, perceptions, and needs, helping the nurse/therapist establish rapport and begin processing trauma safely. While anger expression can occur, it is not the primary goal; the broader aim is facilitating expression/communication in a form the child can manage. Using play primarily to “prove” the type of abuse is inappropriate and can be leading, and developmental assessment may be a byproduct rather than the main therapeutic purpose.
A nurse is admitting a child and observes multiple irregular bruises. Which action should the nurse take next?
- Ask parents to leave the room during the admission process
- Continue with a detailed interview and physical examination
- Notify the charge nurse and the social worker
- Promise not to tell anyone if the child reveals abuse
Explanation: Answer reason: Completing a focused history and head-to-toe exam helps identify injury patterns inconsistent with the stated mechanism and detects occult injuries needing urgent treatment. This also establishes baseline findings and preserves accurate, factual data that will support the mandated reporting process. Immediate notification of social work may follow, but it is best done after collecting critical assessment information unless the child is in immediate danger. Promising secrecy is inappropriate because nurses are mandated reporters and must not make confidentiality guarantees that cannot be kept.
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