Which aspects of assessment have priority when a nurse interviews ...

[Kthamas]

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

Question 2

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.

[Benayers]

Answer to Question 1

ANS: A, D, E
The nurse assesses the victim's level of anxiety, coping mechanisms, available support systems, signs and symptoms of emotional trauma, and signs and symptoms of physical trauma. The history of STDs or previous sexual experiences has little relevance.

Answer to Question 2

ANS: B, D
As uncomfortable as the victim may be, she should not bathe until the examination is completed. Collection of evidence is critical for prosecution of the attacker. Showering after the examination will provide comfort to the victim. The distracters will result in destruction of evidence or are untrue.