Chapter 29-psych

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It has now been 1 year since Nicole's rape. Which of the following statements by Nicole would indicate that she has recovered from the trauma?

"My husband and I are having sex again and I enjoy it."

When a client tells the nurse she was raped by her date several weeks ago, the most likely reason for taking so long to report the incidence is her

feelings of guilt for somehow having caused it

Anticipatory teaching of a rape victim should include information that a common survivor problem that often develops during the long-term reorganization phase of rape trauma syndrome is

intrusive thoughts

To provide discharge treatment and support, the nurse should realize that the most common sequela(e) of acquaintance rape is the development of

symptoms of sexual distress

Nicole alternates between sobbing and being quiet and withdrawn. Which of the following illustrates best practice in giving care to a patient who has just been sexually assaulted?

Supportive: "I am going to stay with you. We can talk as long as you want to."

The nurse is meeting with a woman who was raped the previous week. The nurse's client education plan includes talking about the possibility of experiencing intrusive thoughts, increased motor activity, and fears and phobias in the next few weeks. The reason for this intervention is

that anticipatory guidance allows planning to decrease stress

Which are the following are myths surrounding rape?

Women are usually raped by a stranger. Most raped occur away from home areas such as alleys and behind buildings. Rape is usually an impulsive, spur-of-the-moment decision by the rapist. Unless the assailant is armed, most women should be able to get away and avoid the rape

Rape is best described as

an act of violence using sex as the weapon

The emergency department nurse planning care for a rape victim must realize that the emotional reaction displayed by many rape victims during the initial assessment and treatment is

fear

Care planning for the rape victim is facilitated if the nurse understands that rape trauma syndrome is actually a variant of

PTSD

A rape victim in the emergency department keeps repeating, "I don't know why he did it." Although the nurse does not necessarily give the answer at this juncture, the nurse correctly identifies the motivation for most perpetrators of rape as

a desire to dominate and humiliate

What reaction is most commonly displayed by rape victims in the immediate aftermath of the rape?

Disorganization

What statement reflects a truth about rape?

Most rapes are planned

A client who comes to the emergency department states she has just been raped. She displays a blank face and a rather calm appearance. During the assessment interview she seems unable to believe the event really happened. The nurse can assess this behavior as the client demonstrating a(an)

emotional affective response to the rape

The nurse responding to the hotline call of a rape victim advises her to go to the nearest emergency department for treatment. When the woman states, "I'll think it over while I take a shower," the nurse

explains that doing so could destroy evidence

Which statistic concerning rape is true?

most male victims do not report the crime

In the acute phase of rape trauma syndrome, nursing interventions should focus on

providing client support and safety

A sexual assault victim asks to be given "the morning-after pill" to prevent conception. The nurse does not believe in abortion. The action the nurse should take is to

report and document the request

When the nurse finishes addressing a group of college women about rape, the following comments are heard during the discussion period. Which comment calls for additional teaching by the nurse?

"So if you dress conservatively, your risk of being raped is small."

Which statement would be an appropriate long-term outcome for a rape client? The client will

integrate the rape event and resume an optimal level of functioning.

It has been 6 months since Nicole was raped, and she has undergone counseling. Which statement by Nicole would indicate that an important outcome has been met?

"I am not going to let that rapist be in control of my life. I know things will keep getting better."

A sexual assault victim tells the nurse, "I should have tried to fight him off! But I was so terrified that I could not move. I should have tried harder." A supportive response for the nurse to make would be

"The way you behaved was the right thing to do at the time"

Three weeks after a client was raped she tells the nurse, "I am going crazy. I have nightmares and wake up screaming. Then during the day all sorts of thoughts about the rape intrude into whatever I am concentrating on. I can't get anything done at work." The nurse should reply

"These are a normal response to stress and will decrease with time and therapy"

During the immediate post-rape period what verbal nursing intervention would best lower client anxiety and increase feelings of safety?

"You are safe here. I will stay with you while you have your examination"

Nicole is a 28-year-old married patient who comes to the emergency department after being raped on her way home from work. You have been with her as she cries and talks about what happened. She asks you, "What if I am pregnant?" Your response is guided by the knowledge that:

about 5% of women who are raped become pregnant as a result


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