**** and ****-Trauma Syndrome

The nurse is preparing to teach a class about date rape to a group of college-age students. When discussing date rape drugs, which method of prevention should the nurse include in her presentation? A) Never leave a location with a friend. B) Only accept premade drinks from someone you know. C) Never leave your drink unattended. D) Only consume drinks handed to you directly by the bartender or a waitress.

Answer: C Explanation: The nurse should include several methods of prevention in her presentation, including the instruction to never leave your drink unattended. Individuals are often given date rape drugs by acquaintances, so accepting premade drinks even from an acquaintance may not be safe. Individuals should watch their drink being made by the bartender rather than trusting that all drinks coming directly from a bartender or waitress are safe. Individuals may leave a location with a friend that they explicitly trust even if they feel they have been drugged.

The nurse working in the emergency department is aware that rape victims initially exhibit which emotions? Select all that apply. A) Shock B) Disbelief C) Anger D) Self-blame E) Humiliation

Answer: A, B Explanation: Initial responses to rape generally include feelings of shock and disbelief. Anger, humiliation, and self-blame are early responses but not typically the initial response.

A rape victim is being seen in the clinic. Upon assessment it is discovered the client has contracted syphilis. Which prescription does the nurse anticipate for this client? A) Penicillin B) Ceftriaxone and azithromycin C) Tinidazole D) Doxycycline

Answer: A Explanation: Syphilis is treated with penicillin. Gonorrhea is treated with a combination of ceftriaxone and either azithromycin or doxycycline. Trichomoniasis is treated with tinidazole or metronidazole. Chlamydia is treated with doxycycline.

Which type of rape often involves the use of date rape drugs? A) Acquaintance rape B) Marital rape C) Anal rape D) Gang rape

Answer: A Explanation: The most common type of rape that uses date rape drugs is acquaintance rape, which is rape committed by an acquaintance or other familiar individual. Although the other types of rape may involve date rape drugs, this is far less common than for acquaintance rape.

The nurse is providing care for a client who was the victim of sexual abuse 8 months ago. Which ongoing, long-term treatment goals are appropriate? Select all that apply. A) The client's symptoms of anxiety and fear will decrease. B) The client will involve significant others in the treatment plan. C) The client will be able to verbalize legal rights. D) The client will establish rapport and build a trusting nurse—client relationship. E) The client will learn how to reconnect with others.

Answer: A, E Explanation: Decreasing symptoms of anxiety and fear and learning how to reconnect with others may take months or years, whereas the other treatment goals can be met in the short term (hours to days). The nurse should have involved significant others in the treatment plan, established rapport, and made the client aware of legal rights immediately after the sexual abuse occurred.

The nurse is caring for a client who has a history of being physically and sexually abused as a child, and his father abandoned the family when he was 7 years old. The nurse recognizes that this increases the client's risk of becoming a perpetrator of rape because of which type of risk factors? A) Individual B) Relationship C) Community D) Societal

Answer: B Explanation: Relationship risk factors for perpetration include a family environment characterized by physical violence and conflict; a childhood history of physical, sexual, or emotional abuse; and poor parent-child relationships, particularly with fathers. Although the client may also have individual, community, or societal risk factors as well, the factors the nurse has identified here are relationship risk factors.

A 72-year-old male client has been admitted to the emergency department after a nurse at the long-term care facility where the client lives found the client bleeding from his rectum. The client told the emergency department nurse that one of the caregivers at the facility raped him. What intervention will the nurse need to include in this client's plan of care before discharge? A) Help the client find a new long-term care facility. B) Help the client create a post-discharge safety plan. C) Help the client find a lawyer to sue the long-term care facility. D) Help the client understand the warning signs of suicide.

Answer: B Explanation: Younger and older individuals who are living with a caregiver may need help creating a post-discharge safety plan after a rape, especially if the perpetrator was the caregiver. This would be an important intervention to include in this client's plan of care. The nurse is not responsible for helping the client find a lawyer or a new long-term care facility, although the nurse may refer the client to someone who can help in these areas. The nurse should watch for warning signs of suicide and teach warning signs to family members, but helping the client understand warning signs of suicide could cause the client to avoid the warning signs if suicidal, which could cause harm to the client.

A client recovering from a rape tells the nurse that flashbacks do occur but can be managed. Which techniques should the nurse suggest to the client for managing flashbacks about the event? Select all that apply. A) Restoring personal choice B) Deep breathing C) Muscle relaxation D) Problem solving E) Guided imagery

Answer: B, C, E Explanation: Techniques that the client can use to control flashbacks include muscle relaxation, deep breathing, and guided imagery. Problem solving and restoring personal choice are techniques to support coping behaviors.

The nurse is caring for a victim of rape. Which interventions should the nurse include in the client's plan of care? Select all that apply. A) Notifying an attorney for the client B) Supporting the victim during the examination C) Identifying the individual who committed the rape D) Treating acute injuries E) Providing referrals for follow-up care

Answer: B, D, E Explanation: Priorities of nursing care include treating any acute injuries, supporting the victim during the examination, and providing referrals for follow-up care. Nursing priorities do not include identifying the individual who committed the rape or notifying an attorney for the client.

A client who was raped tells the nurse that she must not get pregnant. Which response by the nurse is appropriate? A) "The baby could always be given up for adoption." B) "You will not know for sure for at least a few more days." C) "Emergency contraception is available to prevent pregnancy." D) "Are you sure the rapist did not use a condom?"

Answer: C Explanation: Female rape victims may request information about emergency contraception if the attacker did not use a condom. The nurse should not tell the client that it will be a few more days to know for sure if she is pregnant. The nurse should not question whether the rapist used a condom. The client does not want to get pregnant. The nurse should not talk about giving a baby up for adoption at this time.

A client, who was raped and refuses to see any male healthcare providers, tells the nurse that she had an "incident" that she does not want to talk about, and wants a bed by the door. Which nursing diagnosis is appropriate for the client? A) Relocation Stress Syndrome B) Readiness for Enhanced Power C) Rape-Trauma Syndrome D) Acute Confusion

Answer: C Explanation: Rape-Trauma Syndrome can manifest itself in many ways depending on the client. Some clients, such as this one, exhibit fear, especially of individuals of the same gender as the attacker. Clients may also exhibit humiliation, shame, and distrust in others. This client is not displaying evidence of readiness for enhanced power. There is no evidence that the client is experiencing relocation stress syndrome or acute confusion.

A rape victim is being seen in the clinic. Upon assessment it is discovered the client has contracted trichomoniasis. Which prescription does the nurse anticipate for this client? A) Penicillin B) Ceftriaxone and azithromycin C) Metronidazole D) Doxycycline

Answer: C Explanation: Trichomoniasis is treated with metronidazole or tinidazole. Syphilis is treated with penicillin. Gonorrhea is treated with a combination of ceftriaxone and azithromycin. Chlamydia is treated with doxycycline.