Chapter 29: Sexual Assault

Chapter 29: Sexual Assault

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The nurse at a university health center leads a dialogue with female freshmen about rape and sexual assault. One student says, “If I avoid strangers or situations where I am alone outside at night, I’ll be safe from sexual attacks.”  Choose the nurse’s best response.

ANS:  D

Females know their offenders in almost 70% of all violent crimes committed against them, including rape. The nurse should share this information along with encouraging discussion of safety measures. The distracters fail to provide adequate information or encourage discussion.

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 553-554 | Page 560 (Nursing Care Plan 29-1)

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Psychosocial Integrity

2. A woman was found confused and disoriented after being abducted and raped at gunpoint by an unknown assailant. The emergency department nurse makes these observations about the woman: talking rapidly in disjointed phrases, unable to concentrate, indecisive when asked to make simple decisions. What is the woman’s level of anxiety?

ANS:  D

Acute anxiety results from the personal threat to the victim’s safety and security. In this case, the patient’s symptoms of rapid, dissociated speech, inability to concentrate, and indecisiveness indicate severe anxiety. Weak is not a level of anxiety. Mild and moderate levels of anxiety would allow the patient to function at a higher level.

PTS:   1                    DIF:    Cognitive Level: Understand (Comprehension)

REF:   Page 560 (Nursing Care Plan 29-1) + learning from Chapter 15

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Psychosocial Integrity

3. After an abduction and rape at gunpoint by an unknown assailant, which assessment finding best indicates that a patient is in the acute phase of the rape-trauma syndrome?

ANS:  B

Reactions of the acute phase of the rape-trauma syndrome are shock, emotional numbness, confusion, disbelief, restlessness, and agitated motor activity. Flashbacks, dreams, fears, and phobias are seen in the long-term reorganization phase of the rape-trauma syndrome. Decreased motor activity by itself is not indicative of any particular phase.

PTS:   1                    DIF:    Cognitive Level: Understand (Comprehension)

REF:   Page 554 | Page 558 (Table 29-2) | Page 560 (Nursing Care Plan 29-1)

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Psychosocial Integrity

4. A nurse interviews a patient abducted and raped at gunpoint by an unknown assailant. The patient says, “I can’t talk about it. Nothing happened. I have to forget.” What is the patient’s present coping strategy?

ANS:  D

The patient’s statements reflect use of denial, an ego defense mechanism. This mechanism may be used unconsciously to protect the person from the emotionally overwhelming reality of the rape. The patient’s statements do not reflect somatization, compensation, or projection.

PTS:   1                    DIF:    Cognitive Level: Understand (Comprehension)

REF:   Page 558 (Table 29 – 2) + learning from Chapter 15

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Psychosocial Integrity

5. An emergency department nurse prepares to assist with evidence collection for a sexual assault victim. Prior to photographs and pelvic examination, what documentation is important?

ANS:  B

Patients have the right to refuse legal and medical examination. Consent forms are required to proceed with these steps.

PTS:   1                    DIF:    Cognitive Level: Understand (Comprehension)

REF:   Page 557-558 (Box 29-1) | Page 560 (Nursing Care Plan 29-1)

TOP:   Nursing Process: Implementation     MSC:  Client Needs: Safe, Effective Care Environment