A client is brought to an emergency department after being ...

[ericka1]

A client is brought to an emergency department after being violently raped. Which nursing action is appropriate?
 
  A. Discourage the client from discussing the event, as this may lead to further emotional trauma.
  B. Remain nonjudgmental and actively listen to the client's description of the event.
  C. Meet the client's self-care needs by assisting with showering and perineal care.
  D. Provide cues, based on police information, to encourage further description of the event.

Question 2

In the emergency department, a raped client appears calm and exhibits a blunt affect. The client answers a nurse's questions in a monotone using single words. How should the nurse interpret this client's responses?
 
  A. The client may be lying about the incident.
  B. The client may be experiencing a silent rape reaction.
  C. The client may be demonstrating a controlled response pattern.
  D. The client may be having a compounded rape reaction.

[CAPTAINAMERICA]

Answer to Question 1

ANS: B
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 or she is safe and that it is not his or her fault. Nonjudgmental listening provides an avenue for client catharsis needed in order to begin the process of healing.

Answer to Question 2

ANS: C
This client is most likely demonstrating a controlled response pattern. In a 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.