Author Question: A rape victim has been diagnosed as having rape-trauma syndrome: silent reaction. The nurse who ... (Read 64 times)

kellyjaisingh

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A rape victim has been diagnosed as having rape-trauma syndrome: silent reaction.
 
  The nurse who
  will be her counselor should carefully assess for the presence of (more than one option may be
  correct)
  A. the desire to repeatedly describe the rape.
  B. the onset of phobic behaviors.
  C. a reliance on alcohol or illegal drugs.
  D. increased anxiety during the interview.
  E. a pattern of sound sleep nightly.
  F. a changed relationship with sexual partner.

Question 2

The principle on which nursing intervention should be predicated when a client's aggression quickly
  escalates is
 
  a. staff should match client's affective level, tone of voice, and so forth.
  b. immediately use physical containment measures.
  c. ask the client what will be most helpful to him or her.
  d. begin with the least restrictive measure possible.



jxjsniuniu

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Answer to Question 1

B, D, F
Rationale: Option B: Onset of phobias is common. Option D: Increased anxiety during interviews is
evidenced by blocking, long periods of silence, stuttering, or evidence of physical distress. Option F:
Abrupt changes in relationships with sexual partners is common. Option A: The usual reaction is the
inability to describe or discuss the rape. Option C: Reliance on alcohol or illegal drugs is more often
seen in rape-trauma syndrome: compound reaction. Option E: Nightmares commonly disturb sleep.

Answer to Question 2

D
Legal constraints require that staff use the least restrictive measure possible. This becomes the
guiding principle for intervention. Option A would result in greater escalation. Option B: Physical
containment is seldom the least restrictive measure. Option C: Asking the out-of-control client what
to do is rarely helpful. It may be an effective strategy during the preaggressive phase but is less
effective during escalation.



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