Chapter 29: Sexual Assault
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? A. "I don't walk home anymore because I am terrified it may happen again." B. "I am sleeping better but still only get about 5 hours of sleep at night because of bad dreams about the rape." C. "I realize that I was partly to blame for the rape because of walking in an unsafe neighborhood." D. "My husband and I are having sex again and I enjoy it."
D
Rape is best described as A. an act of violence using sex as the weapon. B. assault by a stranger on an unsuspecting victim. C. sexual desire satisfied inappropriately. D. an act prompted by early childhood neglect.
A
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 A. fear. B. eagerness. C. suspicion. D. disinterest.
A
Which statement would be an appropriate long-term outcome for a rape client? The client will A. integrate the rape event and resume an optimal level of functioning. B. identify and develop coping skills necessary to reduce level of anxiety. C. blame the rapist rather than blame herself for the situation. D. repress feelings of shame, embarrassment, and self-blame.
A
In the legal system, what is a patient of sexual assault known as? 1 Patient 2 Victim 3 Survivor 4 Client
2
Care planning for the rape victim is facilitated if the nurse understands that rape trauma syndrome is actually a variant of A. posttraumatic stress disorder. B. a maturational crisis. C. a dissociative disorder. D. generalized anxiety disorder.
A
A nurse is performing an assessment of a patient who was sexually assaulted. The patient reports being unconscious 10 minutes after having a cool drink. The nurse anticipates that the patient was given flunitrazepam (Rohypnol) with the drink. Which symptom does the nurse find in the patient? 1 Muscle relaxation 2 Tachycardia 3 Anxiety 4 Tremors
1
A patient who was sexually assaulted was treated effectively and discharged. What appropriate action should the nurse follow while discharging the patient? 1 The nurse should give printed follow-up instructions to the patient. 2 The nurse should avoid calling the patient after the discharge. 3 The nurse should instruct the patient to follow up every 6 months. 4 The nurse should refrain from taking contact information from the patient.
1
A rape victim is discharged home after initial treatment. Which method of giving follow-up instructions is most appropriate? 1 Provide written instructions 2 Provide oral instructions 3 Provide instruction to the family 4 Provide instruction to friends
1
Statistics about sexual violence in the United States: 1 Are unreliable because rape is underreported 2 Show more men than women are victimized by rape 3 Show that white women are the most common racial group victimized by rape 4 Show male rape victims
1
A nurse is performing a physical assessment of a female patient who was sexually abused. Which steps does the nurse follow while performing the assessment? 1 The nurse inquires about the date of the patient's last menstrual cycle. 2 The nurse avoids inquiring about sexually transmitted diseases of the patient. 3 The nurse encourages the patient to participate in all the decisions of the assessment. 4 The nurse explains the examination procedure to the patient. 5 The nurse avoids
1,3,4
A woman seeks outpatient therapy two weeks after being raped. She complains of insomnia, decreased appetite, episodes of panic, and feeling vulnerable when she is away from home. What are the most appropriate nursing interventions for the plan of care? Select all that apply. 1 Continue to monitor this patient for depression, posttraumatic stress disorder, and suicidal thinking. 2 Ask the patient, "Why did you wait two weeks to report the rape?" 3 Refer the patient to a support group for victims of rape. 4 Use active listening to validate the patient's feelings. 5 Teach the patient stress management techniques.
1,3,4,5
A patient says to the nurse, "A man in the neighborhood always makes obscene gestures at me. He had also tried to touch me once. I was so scared, I just ran away." What should the nurse document in the patient's case report? 1 "The patient has rape-trauma syndrome." 2 "The patient is a victim of a date rape." 3 "The patient is a victim of attempted rape." 4 "The patient is a victim of acquaintance rape."
3
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 A. "Becoming mentally ill is a frightening thought for you?" B. "These are a normal response to stress and will decrease with time and therapy." C. "You are right to be concerned. I can give you a referral for treatment." D. "Would it help if you took some time off from work and stayed home?"
B
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 A. embarrassment about having a physical examination. B. feelings of guilt for somehow having caused it. C. initial fear that no one would believe her. D. worry over contracting a sexually transmitted disease.
B
Which statement reflects a truth about rape? A. Some women want to be raped. B. Rapists are oversexed. C. Most rapes are planned. D. Most women are raped by strangers.
C
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 A. "Try not to think about it. Put it out of your mind." B. "We each behave in characteristic ways in a crisis. That was your way." C. "Do you think others will think badly of you for not trying to fight?" D. "The way you behaved was the right thing to do at the time."
D
An emergency department nurse assesses a woman who reports being raped in the parking lot at a local shopping mall. The woman's clothes are torn and bloody. What should the nurse do with the woman's clothing? 1 Preserve the clothing in accordance with agency policy. 2 Place the clothing in a plastic bag for return to the woman. 3 Place the clothing in the facility's contaminated waste disposal. 4 Ask the woman, "What would you like for me to do with your clothing?"
1
The nurse is caring for a patient with posttraumatic stress disorder (PTSD) who is also a rape victim. The patient wakes up suddenly from sleep and cries out loudly. This takes place about 2-3 times every night. What should the nurse document in the patient's case file? 1 The patient has frequent reexperiences of the assault. 2 The patient avoids expressing emotions related to the assault. 3 The patient has reduced concentration and has difficulty sleeping. 4 The patient becomes aggressive occasionally without any reason.
1
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? A. "I keep having nightmares about the rape and I can't sleep at night." B. "My husband has been very supportive during this whole thing." C. "I am not going to let that rapist be in control of my life. I know things will keep getting better." D. "I am not pressing charges because I want this whole thing to be over with so I can move on."
C
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? A. Sympathetic: "I'm so sorry for what you have been through." B. Reassuring: "Don't worry. It's hard now, but everything will be alright." C. Supportive: "I am going to stay with you. We can talk as long as you want to." D. Assertive: "Let's talk about new coping skills you can use."
C
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 A. denial of the event. B. headaches and fatigue. C. shock and numbness. D. intrusive thoughts.
D
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 A. refer the woman for social services counseling. B. report and document the request. C. ask the supervising nurse to reassign the client. D. ask the client to reevaluate her request after 24 hours.
B
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 A. to help the client redevelop a sense of control over herself. B. that anticipatory guidance allows planning to decrease stress. C. that talking about feelings reduces their intensity. D. that self-destructive behaviors develop out of negative feelings.
B
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) A. defense mechanism that involves lying about the rape. B. behavioral reaction to the rape. C. emotional affective response to the rape. D. somatic reaction to stress from the rape.
C
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. anxiety relief. B. an overwhelming sexual desire. C. a desire to dominate and humiliate. D. a wish to be apprehended and punished.
C
Which intervention is appropriate when caring for a sexual assault victim who is being examined initially? Select all that apply. 1 Assisting the patient with preexamination bathing or showering. 2 Obtaining consent for the rape protocol to be implemented. 3 Providing detailed explanations concerning the procedures. 4 Staying with the patient until family members arrive. 5 Performing a physical assessment to identify bruises and lacerations.
2,3,4,5
A nurse is caring for a patient who was sexually assaulted. The nurse reports to the primary health care provider that the patient has the symptoms of hyperarousal. Which symptom is the nurse referring to in the patient? 1 The patient has repeated frightening thoughts and dreams. 2 The patient avoids remembering the events of being sexually assaulted. 3 The patient has insomnia and reduced concentration. 4 The patient has depression and feelings of guilt and numbness.
3
An adolescent brings a friend to the emergency department. The adolescent says to the triage nurse, "My friend was raped. Somebody gave her some Special K." The friend is confused, dazed, and drooling. What is the nurse's priority action? 1 Contact the friend's parent or legal guardian. 2 Assess whether the friend is experiencing pain. 3 Assess the friend's airway and breathing pattern. 4 Obtain a Sexual Assault Evidence Collection Kit (SAECK).
3
The nurse cares for a 42-year-old woman who was raped the preceding night. The woman is considering morning-after medication to avoid pregnancy resulting from the rape. The nurse does not believe in abortion. Which action by the nurse is most appropriate? 1 Ask the woman, "Are you currently experiencing menopause?" 2 Encourage the woman to take more time to consider the options. 3 Provide the woman with information about morning-after medication. 4 Explain to the woman that pregnancy occurs in less than 5% of rape situations.
3
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? 1 "It makes sense that rape is a crime of violence, not a crime of sex." 2 "Who would have guessed that most rape victims know the rapist?" 3 "So if you dress conservatively, your risk of being raped is small." 4 "I always thought rapes happened at night, but now I know that isn't true."
3
During the immediate post-rape period what verbal nursing intervention would best lower client anxiety and increase feelings of safety? A. "You are safe here. I will stay with you while you have your examination." B. "I know you feel confused. We will make all the necessary decisions for you." C. "Please tell me as much about the details of the rape as you can remember." D. "When you leave you will be given followup appointments for pregnancy and sexually transmitted disease screening."
A
To provide discharge treatment and support, the nurse should realize that the most common sequela(e) of acquaintance rape is the development of A. symptoms of sexual distress. B. anxiety and fear of men. C. a paranoid psychosis. D. an eating disorder.
A
What reaction is most commonly displayed by rape victims in the immediate aftermath of the rape? A. Disorganization B. Philosophical acceptance C. Total withdrawal from reality D. Display of seductive actions
A
Which statistic concerning rape is true? A. Most male rape victims do not report the crime. B. Male rape is perpetrated by homosexual men. C. The peak incidence of rape occurs in the 25 to 29 age group. D. Most rapes occur after abductions.
A
A nurse is performing the clinical assessment of a patient who was sexually abused during a date. What appropriate actions does the nurse take during assessment? 1 The nurse considers only the verbal statements made by the patient. 2 The nurse asks, "Why didn't you try to escape from the situation?" 3 The nurse avoids interacting with the patient's friends. 4 The nurse assesses the usefulness of the patient's social support system.
4
A nurse is teaching a group of nursing students about sexual assault. Which information should the nurse include in the teaching? 1 Only females are raped. 2 Rape is a sexual act. 3 Most of the rapists are oversexed. 4 Fifty percent of all rapes occur in the home.
4
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? A. "It makes sense that rape is a crime of violence, not a crime of sex." B. "Who would have guessed that most rape victims know the rapist?" C. "So if you dress conservatively, your risk of being raped is small." D. "I always thought rapes happened at night, but now I know that isn't true."
C
Which information is considered a part of the general nursing assessment of a victim who has experienced a physical assault? Select all that apply. 1 The value of existing physical evidence 2 Indications of emotional trauma 3 Indications of physical trauma 4 Coping mechanisms 5 Level of anxiety
2,3,4,5
In the acute phase of rape trauma syndrome, nursing interventions should focus on A. teaching stress management techniques to the client. B. helping the client's family clarify feelings. C. providing client support and safety. D. ensuring case management.
C
The nurse is assessing a patient who has been sexually abused. Following the assessment, the nurse finds that the patient has a positive coping mechanism. What response by the patient led the nurse to conclude this? 1 "I need to go to a place where God will be beside me." 2 "I am glad that I survived and can live for my children." 3 "I don't feel like going out of my room nowadays." 4 "I feel it is better that we do not discuss the incident."
2
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 A. questions her regarding the circumstances of the rape. B. advises her not to take too long before seeking treatment. C. explains that doing so could destroy evidence. D. asks if she may call a police woman to accompany her to the hospital.
C
Which of the following are myths surrounding rape? (select all that apply): A. Women are usually raped by a stranger. Correct B. Women do not "ask" to be raped by their behavior or dress. C. Most rapes occur away from home areas such as alleys and behind buildings. D. Documented rape cases include women from 8 to 70 years old. E. Rape is an expression of aggression and anger. F. Rape is usually an impulsive, spurofthemoment decision by the rapist. G. Unless the assailant is armed, most women should be able to get away and avoid the rape
A,C,D,F,G
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: A. the risk of pregnancy after rape is high, up to 50%. B. about 5% of women who are raped become pregnant as a result. C. reproductive functions shut down during a violent attack, and as a result pregnancy does not occur. D. Nicole may be worried about how her spouse will accept the baby.
B