Chapter 29 Sexual Assault-ALL

Which statement best illustrated support in giving care to patient who has been sexually assaulted?

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

It has been 6 months since a woman was raped which statements by the client would indicate that counseling has helped her to achieve an important long-term outcome?

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

Which of the following statements by a woman who was sexuallly assaulted a year ago would indicated that she has recovered from a trauma?

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

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." '

A sexual assault survivor tells the nruse, "I should have tried to fight him off! But I was so terrified that I could not move. I should have tried harder." Which response should the nurse make to reassure the client?

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

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

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

Perpetrators of sexual assault are often incarcerated but frequently do not undergo therapy. Samuel, convicted of rape and sentenced to 15 years in prison, has requested to see a therapist. The psychiatric nurse practitioner is surprised to learn of the request as many perpetrators: a. Boast of their assault history b. Feel regret and remorse c. Do not acknowledge the need for change d. Are unable to recognize rape as a crime

c. Do not acknowledge the need for change

Ron is a victim of assault and has revealed to his family and friends the fact that he was raped. The family reacts with horror and disgust, and the nurse caring for Ron recognizes: a. Ron's family is being judgmental. b. Ron's family should leave the hospital. c. Ron's family will also need support. d. Dysfunctional family dynamics.

c. Ron's family will also need support.

Physical ________________ of a child includes refusal of or delay in seeking health care, abandonment, expulsion from the home or refusal to allow a runaway to return home, and inadequate supervision.

ANS: neglect Rationale: Physical neglect of a child includes refusal of or delay in seeking health care, abandonment, expulsion from the home or refusal to allow a runaway to return home, and inadequate supervision. Children are vulnerable and relatively powerless, and the effects of maltreatment are infinitely deep and long lasting.

Who is the act of rape is best described?

An act of violence using sex as a weapon'

To provide dischage treatmen and support, the nurse should relize that the most common outcome of acquaintance rape is which psychosocial dysfunction?

Sexual distress '

A 28 y/o married client who is seeking treatment after being raped tearfullly asks the nuse, "What if I am pregnant?"

The nurse's response should be gilded by what knowledge. Pregnancy prevention is offered in the emergency deparment '

Which fo the following are myths surround rape?

Unless the assailant is armedm most women should be able to get awaya and avoid the rape. Most rapes occur wayw form home areas such as alleys and behind building. Rape is ually an impulsice, spur-of-the moment decision by the rapist. Document rapse cases include wome from 8-70 years old. Women are usually rpaed by a stranger. '

Considering the guilt that women feel after being sexually assaulted, which nursing assessment question has priority? a. "Do you want the police to be called?" b. "Did you recognize the person who assaulted you?" c. "Do you have someone you trust that can stay with you?" d. "Do you have any thoughts about harming yourself?"

d. "Do you have any thoughts about harming yourself?"

The stress of being raped often results in suffering similar to people who have witnessed a murder or had a physiological reaction to trauma, resulting in: a. Posttraumatic stress disorder b. Anxiety c. Depression d. All of the above

d. All of the above

A college student was sexually assaulted when out on a date. After several weeks of crisis intervention therapy, which client statement should indicate to a nurse that the student is handling this situation in a healthy manner? 1. "I know that it was not my fault." 2. "My boyfriend has trouble controlling his sexual urges." 3. "If I don't put myself in a dating situation, I won't be at risk." 4. "Next time I will think twice about wearing a sexy dress."

ANS: 1 Rationale: The client who realizes that sexual assault was not her fault is handling the situation in a healthy manner. The nurse should provide nonjudgmental listening and communicate statements that instill trust and validate self-worth.

A kindergarten student is frequently violent toward other children. A school nurse notices bruises and burns on the child's face and arms. What other symptom should indicate to the nurse that the child may have been physically abused? 1. The child shrinks at the approach of adults. 2. The child begs or steals food or money. 3. The child is frequently absent from school. 4. The child is delayed in physical and emotional development.

ANS: 1 Rationale: The nurse should determine that a child who shrinks at the approach of adults in addition to having bruises and burns may be a victim of abuse. Maltreatment is considered, whether or not the adult intended to harm the child.

A nurse works at rape telephone hotline. Communication with potential victims should focus on A. explaining immediate steps victims should take. B. providing callers with a sympathetic listener. C. obtaining information for law enforcement. D. arranging counseling.

A

A rape victim says to the nurse, "I always try to be so careful. I know I should not have walked to my car alone. Was this attack my fault?" Which communication by the nurse is most therapeutic? A. Support the victim to separate issues of vulnerability from blame. B. Emphasize the importance of using a buddy system in public places. C. Reassure the victim that the outcome of the situation will be positive. D. Pose questions about the rape and help the patient explore why it happened.

A

A victim of a sexual assault who sits in the emergency department is rocking back and forth and repeatedly saying, "I can't believe I've been raped." This behavior is characteristic of which stage of rape-trauma syndrome? A. The acute phase reaction B. The long-term phase C. A delayed reaction D. The angry stage

A

A victim of a violent rape was treated in the emergency department. As discharge preparation begins, the victim says softly, "I will never be the same again. I can't face my friends. There is no reason to go on." Select the nurse's most appropriate response. A. "Are you thinking of harming yourself?" B. "It will take time, but you will feel the same as before the attack." C. "Your friends will understand when you explain it was not your fault." D. "You will be able to find meaning from this experience as time goes on."

A

A patient was abducted and raped at gunpoint by an unknown assailant. Which nursing interventions are appropriate while caring for the patient in the emergency department? (Select all that apply.) A. Allow the patient to talk at a comfortable pace. B. Place the patient in a private room with a caregiver. C. Pose questions in nonjudgmental, empathetic ways. D. Invite the patient's family members to the examination room. C. Put an arm around the patient to demonstrate support and compassion.

A,B,C

An emergency department nurse prepares to assist with examination of a sexual assault victim. What equipment will be needed to collect and document forensic evidence? (Select all that apply.) A. Camera B. Body map C. DNA swabs D. Pulse oximeter E. Sphygmomanometer

A,B,C

When an emergency department nurse teaches a victim of rape-trauma syndrome about reactions that may occur during the long-term phase, which symptoms should be included? (Select all that apply.) a.Development of fears and phobias B. Decreased motor activity C. Feelings of numbness D. Flashbacks, dreams E. Syncopal episodes

A,C,D

Which scenarios describe completed rape? (Select all that apply.) A. A husband forces vaginal sex when he comes home intoxicated from a party. The wife objects. B. A woman's lover pleads with her to have oral sex. She gives in but later regrets the decision. C. A person is beaten, robbed, and forcibly subjected to anal penetration by an assailant. D. A dentist gives anesthesia for a procedure and then has intercourse with the unconscious patient. E. A perpetrator grabs a potential victim, tears off most of her clothing, and fondles her breasts before she escapes.

A,C,D

Which aspects of assessment have priority when a nurse interviews a rape victim in an acute setting? (Select all that apply.) A. Coping mechanisms, the patient is using B. The patient's previous sexual experiences C. The patient's history of sexually transmitted diseases D. Signs and symptoms of emotional and physical trauma E. Adequacy and availability of the patient's support system

A,D,E

Which assessment data should a school nurse recognize as a sign of physical neglect? 1. The child is often absent from school and seems apathetic and tired. 2. The child is very insecure and has poor self-esteem. 3. The child has multiple bruises on various body parts. 4. The child has sophisticated knowledge of sexual behaviors.

ANS: 1 Rationale: The nurse should recognize that a child who is often absent from school and seems apathetic and tired may be a victim of neglect. Other indicators of neglect are stealing food or money, lacking medical or dental care, being consistently dirty, lacking sufficient clothing, or stating that there is no one home to provide care.

A nursing instructor is developing a lesson plan to teach about domestic violence. Which information should be included? 1. Power and control are central to the dynamic of domestic violence. 2. Poor communication and social isolation are central to the dynamic of domestic violence. 3. Erratic relationships and vulnerability are central to the dynamic of domestic violence. 4. Emotional injury and learned helplessness are central to the dynamic of domestic violence.

ANS: 1 Rationale: The nursing instructor should include the concept that power and control are central to the dynamic of domestic violence. Battering is defined as a pattern of coercive control founded on physical and/or sexual violence or threat of violence. The typical abuser is very possessive and perceives the victim as a possession.

Which of the following nursing diagnoses are typically appropriate for an adult survivor of incest? (Select all that apply.) 1. Low self-esteem 2. Powerlessness 3. Disturbed personal identity 4. Knowledge deficit 5. Non-adherence

ANS: 1, 2 Rationale: An adult survivor of incest would most likely have low self-esteem and a sense of powerlessness. Adult survivors of incest are at risk for developing post-traumatic stress disorder, sexual dysfunction, somatization disorders, compulsive sexual behavior disorders, depression, anxiety, eating disorders, and substance abuse disorders.

A nursing instructor is teaching about intimate partner violence. Which of the following student statements indicate that learning has occurred? (Select all that apply.) 1. "Intimate partner violence is a pattern of abusive behavior that is used by an intimate partner." 2. "Intimate partner violence is used to gain power and control over the other intimate partner." 3. "Fifty-one percent of victims of intimate violence are women." 4. "Women ages 25 to 34 experience the highest per capita rates of intimate violence." 5. "Victims are typically young married women who are dependent housewives."

ANS: 1, 2, 4 Rationale: Intimate partner violence is a pattern of abusive behavior that is used by an intimate partner. It is used to gain power and control over the other intimate partner. Women ages 25 to 34 experience the highest per capita rates of intimate violence. Eighty-five percent of victims of intimate violence are women. Battered women represent all age, racial, religious, cultural, educational, and socioeconomic groups. They may be married or single, housewives or business executives.

In planning care for a woman who presents as a survivor of domestic abuse, a nurse should be aware of which of the following data? (Select all that apply.) 1. It often takes several attempts before a woman leaves an abusive situation. 2. Substance abuse is a common factor in abusive relationships. 3. Until children reach school age, they are usually not affected by abuse between their parents. 4. Women in abusive relationships usually feel isolated and unsupported. 5. Economic factors rarely play a role in the decision to stay.

ANS: 1, 2, 4 Rationale: When planning care for a woman who is a survivor of domestic abuse, the nurse should be aware that it often takes several attempts before a woman leaves an abusive situation, that substance abuse is a common factor in abusive relationships, and that women in abusive relationships usually feel isolated and unsupported. Children can be affected by domestic violence from infancy, and economic factors often play a role in the victim's decision to stay.

A client is brought to an emergency department after being violently raped. Which nursing action is appropriate? 1. Discourage the client from discussing the rape, because this may lead to further emotional trauma. 2. Remain nonjudgmental while actively listening to the client's description of the violent rape event. 3. Meet the client's self-care needs by assisting with showering and perineal care. 4. Probe for further, detailed description of the rape event.

ANS: 2 Rationale: The most appropriate nursing action is to remain nonjudgmental and actively listen to the client's description of the event. It is important to also communicate to the victim that he/she is safe and that it is not his/her fault. Nonjudgmental listening provides an avenue for catharsis, which contributes to the healing process.

A client diagnosed with an eating disorder experiences insomnia, nightmares, and panic attacks that occur before bedtime. She has never married or dated, and she lives alone. She states to a nurse, "My father has recently moved back to town." What should the nurse suspect? 1. Possible major depressive disorder 2. Possible history of childhood incest 3. Possible histrionic personality disorder 4. Possible history of childhood physical abuse

ANS: 2 Rationale: The nurse should suspect that this client may have a history of childhood incest. Adult survivors of incest are at risk for developing post-traumatic stress disorder, sexual dysfunction, somatization disorders, compulsive sexual behavior disorders, depression, anxiety, eating disorders, and substance abuse disorders.

When questioned about bruises, a woman states, "It was an accident. My husband just had a bad day at work. He's being so gentle now and even brought me flowers. He's going to get a new job, so it won't happen again." This client is in which phase of the cycle of battering? 1. Phase I: The tension-building phase 2. Phase II: The acute battering incident phase 3. Phase III: The honeymoon phase 4. Phase IV: The resolution and reorganization phase

ANS: 3 Rationale: The client is in the honeymoon phase of the cycle of battering. In this phase, the batterer becomes extremely loving, kind, and contrite. Promises are often made that the abuse will not happen again.

A woman comes to an emergency department with a broken nose and multiple bruises after being beaten by her husband. She states, "The beatings have been getting worse, and I'm afraid, next time, he will kill me." Which is the appropriate nursing response? 1. "Leopards don't change their spots, and neither will he." 2. "There are things you can do to prevent him from losing control." 3. "Let's talk about your options so that you don't have to go home." 4. "Why don't we call the police so that they can confront your husband with his behavior?"

ANS: 3 Rationale: The most appropriate response by the nurse is to talk with the client about options so that the client does not have to return to the abusive environment. It is essential that clients make decisions on their own without the nurse being the "rescuer." Imposing judgments and giving advice is nontherapeutic.

A client asks, "Why does a rapist use a weapon during the act of rape?" Which is the most appropriate nursing response? 1. "To decrease the victimizer's insecurity." 2. "To inflict physical harm with the weapon." 3. "To terrorize and subdue the victim." 4. "To mirror learned family behavior patterns related to weapons."

ANS: 3 Rationale: The nurse should explain that a rapist uses weapons to terrorize and subdue the victim. Rape is the expression of power and dominance by means of sexual violence. Rape can occur over a broad spectrum of experience, from violent attack to insistence on sexual intercourse by an acquaintance or spouse.

A survivor of rape presents in an emergency department crying, pacing, and cursing her attacker. A nurse should recognize these client actions as which behavioral defense? 1. Controlled response pattern 2. Compounded rape reaction 3. Expressed response pattern 4. Silent rape reaction

ANS: 3 Rationale: The nurse should recognize that this client is exhibiting an expressed response pattern. In the expressed response pattern, feelings of fear, anger, and anxiety are expressed through crying, sobbing, smiling, restlessness, and tension. In the controlled response pattern, the client's feelings are masked or hidden, and a calm, composed, or subdued affect is seen.

A raped client answers a nurse's questions in a monotone voice with single words, appears calm, and exhibits a blunt affect. How should the nurse interpret this client's responses? 1. The client may be lying about the incident. 2. The client may be experiencing a silent rape reaction. 3. The client may be demonstrating a controlled response pattern. 4. The client may be having a compounded rape reaction.

ANS: 3 Rationale: This client is most likely demonstrating a controlled response pattern. In the controlled response pattern, the client's feelings are masked or hidden, and a calm, composed, or subdued affect is seen. In the expressed response pattern, feelings of fear, anger, and anxiety are expressed through crying sobbing, smiling, restlessness, and tension.

Which information should the nurse in an employee assistance program provide to an employee who exhibits symptoms of domestic physical abuse? 1. Have ready access to a gun and learn how to use it. 2. Research lawyers that can aid in divorce proceedings. 3. File charges of assault and battery. 4. Have ready access to the number of a safe house for battered women.

ANS: 4 Rationale: The nurse should provide information about the accessibility of safe houses for battered women when working with a client who has symptoms of domestic physical abuse. Many women feel powerless within the abusive relationship and may be staying in the abusive relationship out of fear.

A woman presents with a history of physical and emotional abuse in her intimate relationships. What should this information lead a nurse to suspect? 1. The woman may be exhibiting a controlled response pattern. 2. The woman may have a history of childhood neglect. 3. The woman may be exhibiting codependent characteristics. 4. The woman may be a victim of incest.

ANS: 4 Rationale: The nurse should suspect that this client may be a victim of incest. Many women who are battered have low self-esteem and have feelings of guilt, anger, fear, and shame. Women in abusive relationships often grew up in an abusive home.

A client who is in a severely abusive relationship is admitted to a psychiatric inpatient unit. The client fears for her life. A staff nurse asks, "Why doesn't she just leave him?" Which is the nursing supervisor's most appropriate response? 1. "These clients don't know life any other way, and change is not an option until they have improved insight." 2. "These clients have limited cognitive skills and few vocational abilities to be able to make it on their own." 3. "These clients often have a lack of financial independence to support themselves and their children, and most have religious beliefs prohibiting divorce and separation." 4. "These clients are paralyzed into inaction by a combination of physical threats and a sense of powerlessness."

ANS: 4 Rationale: The nursing supervisor is accurate when stating that clients who are in abuse relationships are paralyzed into inaction by a combination of physical threats and a sense of powerlessness. Women often choose to stay with an abusive partner: for the children, for financial reasons, for fear of retaliation, for lack of a support network, for religious reasons, or because of hopefulness.

A nurse in the emergency department assesses an unresponsive victim of rape. The victim's friend reports, "That guy gave her salty water before he raped her." Which question is most important for the nurse to ask of the victim's friend? a. "Does the victim have any kidney disease?" b. "Has the victim consumed any alcohol?" c. "What time was she given salty water?" d. "Did you witness the rape?"

ANS: B Salty water is a slang/street name for GHB (-hydroxy-butyric acid), a Schedule III central nervous system depressant associated with rape. Use of alcohol would produce an increased risk for respiratory depression. GHB has a duration of 1 to 12 hours, but the duration is less important than the potential for respiratory depression. Seeking evidence is less important than the victim's physiologic stability.

Order the description of the progressive phases of Walker's model of the "cycle of battering?" ________ This phase is the most violent and the shortest, usually lasting up to 24 hours. ________ In this phase, the man's tolerance for frustration is declining. ________ In this phase, the batterer becomes extremely loving, kind, and contrite.

ANS: The correct order is 2, 1, 3 Rationale: In her classic studies of battered women and their relationships, Walker identified a cycle of predictable behaviors that are repeated over time. The behaviors can be divided into three distinct phases that vary in time and intensity both within the same relationship and among different couples. 1. Tension building phase. In this phase, the man's tolerance for frustration is declining. 2. Acute battering incident phase. This phase is the most violent and the shortest, usually lasting up to 24 hours. 3. Honeymoon phase. In this phase, the batterer becomes extremely loving, kind, and contrite.

A pattern of coercive control founded on and supported by physical and/or sexual violence or threat of violence of an intimate partner is termed ______________________.

ANS: battering Rationale: Battering is a pattern of behavior used to establish power and control over another person with whom an intimate relationship is or has been shared through fear and intimidation, often including the threat or use of violence. Battering happens when one person believes they are entitled to control another.

Which signs and symptoms are associated with acute stress disorder and often observed in patients who have been sexually assaulted? Select all that apply. a. Outbursts of anger b. Depression c. Auditory hallucinations d. Flashbacks e. Amnesia for the event

a, b, d, e; a. Outbursts of anger b. Depression d. Flashbacks e. Amnesia for the event

A nurse interviews a 17-year-old male victim of sexual assault. The victim is reluctant to talk about the experience. Which comment should the nurse offer to this victim? A. "Male victims of sexual assault are usually better equipped than women to deal with the emotional pain that occurs." B. "Male victims of sexual assault often experience physical injuries and are assaulted by more than one person." C. "Do you have any male friends who have also been victims of sexual assault?" D. "Why do you think you became a victim of sexual assault?"

B

A nurse interviews a patient abducted and raped at gunpoint by an unknown assailant. The patient says, "I shouldn't have been there alone. I knew it was a dangerous area." What is the patient's present coping strategy? a. Projection b. Self-blame c. Suppression d. Rationalization

B

A victim of a sexual assault comes to the hospital for treatment but abruptly decides to decline treatment and leaves the facility. While respecting the person's rights, the nurse should A. say, "You may not leave until you receive prophylactic treatment for sexually transmitted diseases." B. provide written information about physical and emotional reactions the person may experience. C. explain the need and importance of infectious disease and pregnancy tests. D. give verbal information about legal resources in the community.

B

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? A. Decreased motor activity B. Confusion and disbelief C. Flashbacks and dreams D. Fears and phobias

B

An unconscious teenager is treated in the emergency department. The teenager's friends suspect the teenager was drugged and raped at a party. Priority action by the nurse should focus on A. preserving rape evidence. B. maintaining physiological stability. C. determining what drugs were ingested. D. obtaining a description of the rape from a friend.

B Because the patient is unconscious, the risk for airway obstruction is present. The nurse's priority will focus on maintaining physiological stability. The distracters are of lower priority than preserving physiological functioning.

A rape victim tells the emergency nurse, "I feel so dirty. Help me take a shower before I get examined." The nurse should (Select all that apply.) A. arrange for the victim to shower. B. explain that bathing destroys evidence. C. give the victim a basin of water and towels. D. offer the victim a shower after evidence is collected. E. explain that bathing facilities are not available in the emergency department.

B,D

A rape victim visited a rape crisis counselor weekly for 8 weeks. At the end of this counseling period, which comment by the victim best demonstrates that reorganization was successful and the victim is now in recovery? A. "I have a rash on my buttocks. It itches all the time." B. "Now I know what I did that triggered the attack on me." C. "I'm sleeping better although I still have an occasional nightmare." D. "I have lost 8 pounds since the attack, but I needed to lose some weight."

C

A nurse cares for a rape victim who was given a drink that contained flunitrazepam by an assailant. Which intervention has priority? Monitoring for A. coma. B. seizures. C. hypotonia. D. respiratory depression.

D

A rape victim tells the nurse, "I should not have been out on the street alone." Select the nurse's most therapeutic response. A. "Rape can happen anywhere." B. "Blaming yourself increases your anxiety and discomfort." C. "You are right. You should not have been alone on the street at night." D. "You feel as though this would not have happened if you had not been alone."

D

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? a. Weak b. Mild c. Moderate d. Severe

D

Before a victim of sexual assault is discharged from the emergency department, the nurse should A. notify the victim's family to provide emotional support. B. offer to stay with the patient until stability is regained. C. advise the patient to try not to think about the assault. D. provide referral information verbally and in writing.

D

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. A. "Your plan is not adequate. You could still be raped or sexually assaulted." B. "I am glad you have this excellent safety plan. Would others like to comment?" C. "It's better to walk with someone or call security when you enter or leave a building." D. "Sexual assaults are more often perpetrated by acquaintances. Let's discuss ways to prevent that."

D

The nursing diagnosis Rape-trauma syndrome applies to a rape victim in the emergency department. Select the most appropriate outcome to achieve before discharging the patient. A. The memory of the rape will be less vivid and less frightening. B. The patient is able to describe feelings of safety and relaxation. C. Symptoms of pain, discomfort, and anxiety are no longer present. d. The patient agrees to a follow-up appointment with a rape victim advocate.

D

The emergency department nurse planning care for a rape survivor msut realize that the emotional reaction displayed by many rape victimd during the initial assessment and treatment is which emotion?

Fear'

Which statemen would be an appropriate long-term outcome for a rape client?

Integrate of the rape event and resumption of an optimal level of functioning. '

Anticipatory teaching of rape vicitim should include information that a common survivior problem?

Intrusive thoughts '

Which statement reflexts truth about raped?

Most rapes are planned '

Care planing for the rape victim is facilitated if the nurse understands that rape trauma symdorme is acually a variant in which psychiatric disorder?

Posttraumatic stress disorder (PTSD) '

A sexual assult victim asks to be given "the morning after pill" to prevent constipation. The nurse does not believe in abortion. What action the nurse should take?

Report and document the request '

You are working at a telephone hotline center when Abby, a rape victim, calls. Abby states she is afraid to go to the hospital. What is your best response? a. "I'm here to listen, and we can talk about your feelings." b. "You don't need to go to the hospital if you don't want to." c. "If you don't go to the hospital, we can't collect evidence to help convict your rapist." d. "Why are you afraid to seek medical attention?"

a. "I'm here to listen, and we can talk about your feelings."

Which racial identification places a woman at the greatest risk of being sexually assaulted in her lifetime? a. Multiracial b. American Indian c. Black non-Hispanic d. Caucasian

a. Multiracial

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? a. The patients vital signs b. consent signed by the patient c. Supervision and credentials of the examiner d. Storage location of the patient's personal effects

b

Which statement made by a sexually assaulted patient strongly suggests the drug gamma-hydroxybutyrate acid (GHB) was involved in the attack? a. "I remember everything that happened, but felt too tired to fight back." b. "The drink I was given had a salty taste to it." c. "They tell me I was unconscious for 24 hours." d. "I heard that I was fighting the nursing staff and saying that they were trying to kill me."

b. "The drink I was given had a salty taste to it."

Which statement is an accurate depiction of sexual assault? a. Rape is a sexual act. b. Most rapes occur in the home. c. Rape is usually an impulsive act. d. Women are usually raped by strangers.

b. Most rapes occur in the home.

A young woman named Carly was raped behind the restaurant where she works after closing shift. Six months have passed and Carly has not been able to return to work, refuses to go out to eat, and feels that she has less value as a woman now that she has been raped. Carly's clinical presentation suggests: a. Re-experiencing b. Hyperarousal c. Avoidance d. Physical effects

c. Avoidance