CFN Violence and Abuse Patterns 2 — Questions and Answers
Question 1: Which injury pattern is most consistent with defensive wounds in an assault victim?
- Bruising on the shins and knees
- Lacerations on the ulnar forearm and dorsal hands (Correct answer)
- Burns on the plantar feet
- Contusions on the lower back
Correct answer: Lacerations on the ulnar forearm and dorsal hands
Defensive wounds typically appear on the ulnar forearm and dorsal hands as victims raise their arms to block blows.
Question 2: The 'cycle of violence' model developed by Lenore Walker describes which sequence of phases?
- Explosion, remorse, escalation, honeymoon
- Tension building, acute explosion, reconciliation/honeymoon, calm (Correct answer)
- Calm, tension, explosion, separation
- Honeymoon, tension, abuse, recovery
Correct answer: Tension building, acute explosion, reconciliation/honeymoon, calm
Walker's cycle includes tension building, acute explosion, reconciliation/honeymoon, and calm phases.
Question 3: In child physical abuse, which fracture type is most specifically associated with non-accidental trauma in infants?
- Greenstick fracture of the radius
- Transverse fracture of the tibia
- Classic metaphyseal lesion (bucket-handle fracture) (Correct answer)
- Clavicle fracture
Correct answer: Classic metaphyseal lesion (bucket-handle fracture)
Classic metaphyseal lesions (bucket-handle or corner fractures) result from shearing forces and are highly specific for non-accidental trauma in infants.
Question 4: An elder patient presents with pressure injuries in multiple stages on the sacrum, heels, and occiput simultaneously. What abuse concern does this raise?
- Self-inflicted injury
- Neglect by caregiver (Correct answer)
- Financial exploitation
- Psychological abuse
Correct answer: Neglect by caregiver
Multiple simultaneous pressure injuries in different stages suggest prolonged immobility without repositioning, indicating caregiver neglect.
Question 5: During an intimate partner violence (IPV) screening, a patient minimizes injuries and defends the partner. The forensic nurse's best response is to:
- Challenge the patient's denial directly
- Document findings and provide safety information without judgment (Correct answer)
- Contact the partner for collateral history
- Discharge the patient since no abuse is confirmed
Correct answer: Document findings and provide safety information without judgment
Non-judgmental documentation and providing safety resources respect patient autonomy while fulfilling the forensic nurse's duty.
Question 6: Which pattern of bruising is pathognomonic of human bite marks versus animal bites?
- Circular or ovoid pattern with arch-shaped marks from both upper and lower arches (Correct answer)
- Linear scratch marks with ragged edges
- Crescent-shaped single arch marks only
- Deep puncture wounds in a linear pattern
Correct answer: Circular or ovoid pattern with arch-shaped marks from both upper and lower arches
Human bite marks produce an elliptical or circular pattern with two opposing arch-shaped bruising areas from upper and lower dental arches.
Question 7: Strangulation in intimate partner violence is significant because it predicts which outcome?
- Increased risk of future minor injuries only
- Sevenfold increase in risk of homicide by that partner (Correct answer)
- Lower likelihood of repeat violence
- Primarily psychological rather than physical harm
Correct answer: Sevenfold increase in risk of homicide by that partner
Strangulation is a significant predictor of lethality; victims are approximately seven times more likely to be killed by their partner.
CFN Violence and Abuse Patterns 2
Which injury pattern is most consistent with defensive wounds in an assault victim?