Nokea
A rape victim asks an emergency department nurse, 'Maybe I did something to cause this attack. Was it my fault?' Which response by the nurse is the most therapeutic?
- A. Pose questions about the rape, helping the patient explore why it happened.
- B. Reassure the victim that the outcome of the situation will be positive.
- C. Make decisions for the victim because of the temporary confusion.
- D. Support the victim to separate issues of vulnerability from blame.
Correct Answer: D
Rationale: The victim is not to blame for the rape, though they may have made choices that increased vulnerability. Supporting the victim to separate vulnerability from blame is therapeutic. The other options suggest nontherapeutic communication, assume outcomes, or do not address control restoration.
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Which situation constitutes consensual sex rather than rape?
- A. After coming home intoxicated from a party, a person forces the spouse to have sex. The spouse objects.
- B. A person's lover pleads to have oral sex. The person gives in but then regrets the decision.
- C. A person is beaten, robbed, and forcibly subjected to anal penetration by an assailant.
- D. A physician gives anesthesia for a procedure and has intercourse with an unconscious patient.
Correct Answer: B
Rationale: Only the scenario where the person gives in to oral sex describes consensual sex, as it involves agreement, even if later regretted. The other scenarios involve force or lack of consent.
A nurse working a rape telephone hotline should focus communication with callers toward what intervention?
- A. Arranging long-term counseling
- B. Serving as a sympathetic listener
- C. Obtaining information to relay to the local police
- D. Explaining immediate steps that a victim of rape should take
Correct Answer: D
Rationale: The counselor should provide information to help the victim decide immediate steps. Long-term counseling is addressed later, and empathy, not sympathy, is appropriate. Obtaining police information is inappropriate due to anonymity.
After assessing a victim of sexual assault, which terms could the nurse use in the documentation? (Select all that apply.)
- A. Alleged
- B. Reported
- C. Penetration
- D. Intercourse
- E. Refused
- F. Declined
Correct Answer: B,C,F
Rationale: Reported,' 'penetration,' and 'declined' are appropriate, avoiding pejorative language. 'Alleged,' 'intercourse,' and 'refused' are not recommended.
A victim of a sexual assault that occurred approximately 1 hour earlier sits in the emergency department rocking back and forth and repeatedly saying, 'I can't believe I've been raped.' This behavior is characteristic of which phase of the rape trauma syndrome?
- A. Anger phase
- B. Acute phase
- C. Outward adjustment phase
- D. Long-term reorganization phase
Correct Answer: B
Rationale: The victim's response, showing cognitive, affective, and behavioral disruptions, is typical of the acute phase. It does not reflect behaviors of the anger, outward adjustment, or long-term reorganization phases.
A rape victim tells the emergency department nurse, 'I feel so dirty. Please let me take a shower before the doctor examines me.' How should the nurse respond to the request?
- A. Arrange for the patient to shower.
- B. Explain that washing would destroy evidence.
- C. Give the patient a basin of hot water and towels.
- D. Instruct the victim to wash above the waist only.
Correct Answer: B
Rationale: The patient should not bathe until the forensic examination is complete to preserve evidence critical for court proceedings. The other options would destroy evidence or are inappropriate.