Chapter 22 Sexual Violence
The nurse is assessing a client with rape-trauma syndrome. The client killed the perpetrator in an attempt to save herself. The client tells the nurse, "I am a murderer. I killed that man. I should have tried to run away. Why did I have to kill the man?" What should be the response given by the nurse to the client?
1 "Please calm down and start thinking logically." Correct2 "You have done the right thing to save your life." 3 "I don't think that law enforcement would take actions against you." 4 "Running away would have been a better solution to save yourself." The rape victim killed the perpetrator in an attempt to save herself. Therefore, the nurse should reassure the client by saying that the client did the right thing to save her life. This will reduce the feelings of guilt and self-blame. The nurse should listen when the client tries to explain her feelings. Asking the client to calm down and start thinking logically would not reassure the client. The nurse should not say that law enforcement would not take actions against the client or suggest she should have run away instead, because these statements are both judgmental and could increase the client's feelings of guilt.Test-Taking Tip: Once you have decided on an answer, look at the stem again. Does your choice answer the question that was asked? If the question stem asks "why," be sure the response you have chosen is a reason. If the question stem is singular, then be sure the option is singular, and the same for plural stems and plural responses. Many times, checking to make sure that the choice makes sense in relation to the stem will reveal the correct answer.
Anticipatory teaching of a rape victim should include information concerning which common survivor problem that often develops during the long-term phase of rape-trauma syndrome?
1 Denial of the event 2 Headaches and fatigue 3 Shock and numbness 4 Intrusive thoughts 4 Just as in posttraumatic stress disorder, intrusive thoughts haunt the rape victim in the weeks and months following the trauma. Knowing this is a common occurrence is reassuring to the client, who often is frightened by the symptom. Denial of the event, headaches and fatigue, or shock and numbness are not associated with the long-term phase of rape-trauma syndrome.
A sexual assault victim arrives at the emergency department (ED). During the immediate post-rape period, what verbal nursing intervention would best lower client anxiety and increase feelings of safety?
Correct1 "You are safe here. I will stay with you while you have your examination." 2 "I know you feel confused. We will make all the necessary decisions for you." 3 "Please tell me as much about the details of the rape as you can remember." 4 "When you leave you will be given follow-up appointments for pregnancy and sexually transmitted disease screening." People who have been sexually assaulted often go to the ED to find emotional support, help in regaining a sense of control, and reassurance regarding their safety. A sexual assault victim who arrives at the ED should not be left alone. The presence of the nurse is reassuring, especially when the client is experiencing disorganization and the environment is confusing. The nurse should not tell the client that staff will make decisions for him or her, immediately ask for details of the assault, or overwhelm the client with details about pregnancy and disease follow-up screenings.
An emergency department (ED) nurse talks with a newly admitted victim of rape. Which communication should the nurse first offer to this client?
Correct1 "You are safe now. I will stay with you in this private room." 2 "Would you like for your family member to stay with you during the exam?" 3 "You made a good decision to come to the hospital after you were raped." 4 "What questions do you have about your sexual assault forensic examination?" A sexual assault victim who arrives at the ED needs compassionate supportive care and should not be left alone. People who go to the ED after a sexual assault are frequently seeking reassurances of their safety, so the first priority is to communicate to the client that the client is safe and will not be left alone. Asking if the client wants the family member to stay, reinforcing the client's decision to come to the hospital, and asking if the client has any questions are all appropriate responses once the client has been made to feel safe.
Which statements accurately describe the effects of child sexual abuse on the adult client? Select all that apply.
Correct1 Child sexual violence results in higher rates of suicide. Correct2 Childhood sexual abuse results in higher rates of mental health issues. Correct3 Untreated child sexual violence may result in drug and alcohol abuse. Correct4 Sexually abused children may suffer from posttraumatic stress disorder. 5 Children who are sexually assaulted do not usually remember being sexually assaulted. The effects of child sexual abuse can last a lifetime. Children who are victims of sexual violence have higher rates of suicide, mental health issues, drug and alcohol abuse, and may suffer from posttraumatic stress disorders. Although it is possible, it is not common for children who were sexually assaulted to not remember being sexually assaulted.Test-Taking Tip: Avoid looking for an answer pattern or code. There may be times when four or five consecutive questions have the same letter or number for the correct answer.
Which are indicators of recovery in a client diagnosed with rape-trauma syndrome? Select all that apply.
Correct1 Expressions of hope 2 Feelings of revenge Correct3 Feelings of empowerment Correct4 Healing of physical injuries Correct5 Evidence of comfort in relationships A rape victim, if treated successfully, may show expressions of hope and be optimistic about the future. The client may feel empowered and confident. The healing of physical injuries sustained during the traumatic event also indicates effective recovery. The client may again start showing interest in relationships and have comfortable and enjoyable sex. Ineffective healing may be manifested by feelings of revenge and anger towards the rapist.
Which statement would indicate an appropriate long-term outcome for a rape client?
Correct1 Integrate the rape event and resume an optimal level of functioning. 2 Identify and develop coping skills necessary to reduce level of anxiety. 3 Blame the rapist rather than blame him- or herself for the situation. 4 Repress feelings of shame, embarrassment, and self-blame. The ideal long-term goal of treatment for rape-trauma syndrome is that the client will return to the usual precrisis level of functioning. Developing coping skills is part of the recovery process that will help the client achieve this long-term goal. Blame and repression are not components of therapeutic goals.
