SANE P Exam 78 Questions with Verified Answers,100% CORRECT, Exams of Nursing

Download SANE P Exam 78 Questions with Verified Answers,100% CORRECT and more Exams Nursing in PDF only on Docsity! SANE P Exam 78 Questions with Verified Answers The SANE is called to see a 4-yo patient brought to the ED by her mother with complaints of sexual abuse by a male relative. Which of the following answers best identifies an age-appropriate patient-centered approach? A. Get through the exam as quickly as possible. B. Don't explain each step of the exam process so as not to scare the chile. C. Ask a nonoffending parent/guardian to wait outside the room during the exam process. D. Limit exposure, ait times, and provide developmentally appropriate toys and distractions. - CORRECT ANSWER D a 10 yo male tells his mother that he is bleeding from his bottom. Later n the ED he discloses to his mother that his uncle has been sexually abusing him for the last five years. The SANE observes that his mother is upset. She keeps repeating, "This couldn't have happened or he would have told me sooner." Which of the following is most probable regarding the child's disclosure? A. This could not have happened since there is such a delay in the child's disclosure? B. The patient must only have disclosed because of the injuries today. C. This disclosure is consistent with a true disclosure of abuse. D. The mother is covering for the uncle and knew all along. - CORRECT ANSWER C A primary role of the pediatric SANE includes which of the following? A. Performing a forensic interview to get to important information to guide the SANE's medical examination. B. Performing an ethical, compassionate, and objective medical forensic examination. C. Performing a physical examination to confirm that sexual abuse has or has not occured. D. Performing a thorough forensic examination by analyzing clothing to find trace evidence. - CORRECT ANSWER B While performing a pediatric sexual-assault examination, the SANE notes that the 8-month-old-girl has a septate hymen, which the SANE identifies as a normal variation of the hymen. In which standard of practice is the identified? A. Assessment B. Diagnosis C. Evaluation D. Outcomes - CORRECT ANSWER B The SANE is performing an examination on a 2-year-old female with her mother present. The alleged perpetrator is the mother's boyfriend and the mother is insistent on defending him during the examination. During the exam the SANE realizes she is getting angry. The SANE later tells a coworker that she was angry with the mother for not protecting her child. Using a patient-centered care model, which standard of practice should the SANE review to improve the SANE's practice? A. Assessment B. Evaluation C. Outcomes D. Diagnosis - CORRECT ANSWER A Which of the following statements best describes a pediatric sexual assault perpetrator demonstrating the trait of cognitive distortion? A. A 27 yo Black male electrician who tells the SANE that all women are evil. B. A 30 yo Caucasian female middle school teacher who tells the SANE that many students have wanted to have sex with her. C. A 45 yo Caucasian male soccer coach who tells the SANE he sometimes hallucinates, but is well-controlled on his bipolar medication. D. A 60 yo Caucasian male pediatrician who tells the SANE he is secretly homosexual, but married. - CORRECT ANSWER B Grooming by a perpetrator can only occur if: A. Parents aren't involved with their child's day-to-day lives. B. The child is involved in sports or clubs. C. Parents do not know the perpetrator. D. The child trusts the perpetrator. - CORRECT ANSWER D the following would be considered outside the range of normal sexual behaviors in the 6 yo? A. The mother reports the child has been found touching her own genitalia while in her own bedroom. B. The mother reports the child is sitting at the dining table with the famly masurbating and cannot be redirected. C. The mother reports the child was caught on the playground at school showing another child her genitalia. D. The mother reports the child keeps trying to look at her mom and dad when they are unclothed. - CORRECT ANSWER B The SANe is called to come in for a 5 yo male who was brought in by his father with reports of possible sexual abuse by the babysitter. The father reports the child is bedwetting and screams when it is time to go to the babysitter's home. When speaking with the child, the SANE asks the child to name his body parts. The child calls his penis "stick," Buttocks "butt," and girls' genitals "privates." What is the appropriate way for the SANe to speak to the child when a genital assessment is being performed? A. "I am going to look at your privates." B. "I am going to look at your stick." C. "I am going to look at your penis." D. "I am going to look down below, we call that your penis." - CORRECT ANSWER B A SANE is called for a report of sexual assault. the mother reports her 5 yo was caught with her pants down and showing the neighbor's 6 yo child her private parts. The mother would like a medical forensic exam and reports, "She is with her dad on the weekends and ever time she comes home, she is touching herself. I found her trying to look in a mirror at her genitals. I was sexually assaulted as a child and I know it's happening to her." The SANE knows that this is: A. Common for a 6 yo and no exam is needed. B. Common for a 6 yo and exam is not necessary; the mother is experiencing PTSD and should be provided resources. C. Common for a 6 yo but the child should still have an exam. The mother should be provided resources for PTSD. D. No common for a 6 yo and this is a high-risk behavior. - CORRECT ANSWER C An 8 yo male patient arrives by ambulance with reports of anxiety and sexual abuse. The mom arrives and reports the child has had a drastic change in mood and does not leave his room except to eat. The patient's blood pressure is 70/40 mmHg, heart rate 60, respirations 28, SpO2 90% on room air. What should be the SANE's primary concern? A. Evidence collection B. Risk of suicide or attempted suicide C. Risk of self-harm and placing the patient in a locked unit D. Evidence collection and suicide - CORRECT ANSWER B A 10 yo male arrives with his mother who reports that the child said he was kidnapped and sexually assaulted. The mother does not believe the child and state, "He ran away and is making this up for attention." What is the most important education the SANE can provide to the mother of the child? A. Explaining that youa re mandatory reporter and will need to call law enforcement B. Explaining that if the child is lying, he will be charged with a crime C. Explaining that the truth will come out on forensic interview of the child. D. Explaining the connection between believing the child and reducing the psychological effects of the abuse - CORRECT ANSWER D A parent presents with the 10 yo child to the ED with concerns of a sexual assault. The parent states that the child was at the local recreational center and reported they were touched in the "private area" by another child when they were in the locker room. As the SANE begins the medical forensic history, the SANE knows that: A. The SANE will need to conduct the medial forensic history with the child alone. B. The SANE will need to conduct the medical forensic history with the parent and child together. C. The SANE will need to conduct the medical forensic history with the child alone, and then with the parent alone, and compare histories. D. The local protocol will indicate if a medical forensic history should be conducted without the parent. - CORRECT ANSWER D The SANE is gathering a history from a 4 yo child about suspected sexual abuse. The SANE in considering different techniques to use to help the child explain or describe the event. Which method should the SANE not use? A. Have the child use dolls to role-play the events. B. Ask the child to make drawings. C. Use different terminology that the child might understand. D. Ask specific questions with descriptive terms. - CORRECT ANSWER D When documenting the emotional response of child when conducting the history, what is the most appropriate description of the child? A. Child is striking out at times in anger. B. Cild is withdrawn and uncooperative with interview. C. Child is crying and traumatized. D. Child avoids eye contact and looks down when answering questions. - CORRECT ANSWER D A 7 yo child is brought to the ED with a concern of sezual abuse. The child becomes agitated during the history-taking when questions are asked and starts to strike out. What should the SANE understand about the child's behavior? A. It is a confirmation that a sexual assault occurred. B. It is a normal response and the SANE should keep asking questions as this indicates that something did happen to the child and the SANE is getting closer to an answer. C. It is a normal response and indicates that the child may need a break from questions. D. It indicates that the child may have underlying psychological issues and may need a mental health evaluation. - CORRECT ANSWER C A mother brings a 2 yo in for a sexual assault exam and reports, "She keeps toughing herself down there, saying someone hurt me." As the SANE caring for this patient, your expectation of primary sources of providing information for the even history will be: A. Law enforcement B. The child C. The advocate D. Caregivers - CORRECT ANSWER D A SANE finds a deep notch with localized bleeding at 6 o'clock on the hymen of an 8 yo female patient with Tanner Stage 1 developmental level. The patient stated C. Prone knee-chesk position D. Frog-leg - CORRECT ANSWER C What is the rate of genital findings for sexual trauma or abuse in the prepubescent population? A. At least 50% of the time in children less than 5 years of age B. Less than 5% of the time in the prepubescent population C. Greater than 75% of the time when the hymen estrogen response score is less than eight D. Between 20% and 25% of the time in the prepubescent population - CORRECT ANSWER B A 5 yo patient presents with a concern of sexual abuse. Je state his 15 yo brother put his penis in his butt. The last contact with the brother was 2 days ago. He has bathed since then. What should the pediatric SANE consider when deciding whether to collect forensic evidence? A. State and jurisdictional rule regarding forensic evidence collection. B. Forensic evidence collection is not indication; yield is very low after 24 hours. C. Forensic evidence collection is not indicated because the patient has bathed. D. Forensic evidence collection is indicated as last contact was within 120 hours. - CORRECT ANSWER A When deciding whether forensic evidence collection is indicated in the pediatric sexual assault patient, the SANE should consider all of the following except: A. Timing of the latest incident of sexual abuse/assault. B. Parental consent for forensic evidence collection. C. Medical history of sexual abuse/assault given by the child. C. Information from investigative agencies. - CORRECT ANSWER B A 10 yo female in Tanner State 1 presents 36 hours after penile penetration of her vigina by her grandfather. No vaginal bleeding is noted on exam. What should the pediatric SANE consider regarding forensic evidence collection? A. The use of a vaginal speculum to collect evidence can increase the likelihood of forensic evidence yield. B. An exam under anesthesia is indicated to utilize a vaginal speculum in order to increase the likelihood of forensic evidence yield. C. The pediatric SANE should swab the labia majora with no penetration of the vagina. D. The pediatric SANE should penetrate the vagina with swabs. - CORRECT ANSWER C Which of the following circumstances indicate when the pediatric SANE should consider testing for long-term drug exposure via analysis of a hair sample? A. A 2 yo child discovered in a known drug home with visible well-healed track marks on bilateral arms; initial urine and blood toxicology sample negative. B. A 2 yo child discovered in a known drug home with visible well-healed track marks on bilateral arms; initial urine and blood toxicology samples positive for opiates. C. A developmentally appropriate 15 yp with visible well-healed track marks on bilateral arms; initial urine and blood toxicology samples negative. D. A 12 yo runaway brought in by police with multiple injuries all over her body who will not report what happened to her. - CORRECT ANSWER A A 5 yo female resents with a concern of sexual abuse. The mother states the child returned from an overnight visit with her father a few hours ago and talked about seeing her father's penis. During the medical history the child discloses touching her father's penis and whit stuff coming out. Child denies anything happening to her body. What is the most appropriate action for the pediatric SANE related to evidence collection? A. Forensic medical care not indicated as child is not disclosing father inappropriately touching her body; sexual abuse has not occurred. B. Child needs to have a head-to-toe assessment including an anogenital exam but forensic evidence collection is not indicated. C. Forensic medical care in indicated including exam and forensic evidence collection involving but not limited to thorough swabbing of both the child's hands. D. Both hands should be swabbed for forensic evidence; no further forensic - CORRECT ANSWER C A 5 yo female resents with a concern of sexual abuse. The mother states the child returned from an overnight visit with her father a few hours ago and talked about seeing her father's penis. During the medical history the child discloses touching her father's penis and whit stuff coming out. Child denies anything happening to her body. the pediatric SANE begins the forensic evidence collection. the child had not changed clothing since her return from the father. What is the most appropriate action for the pediatric SANE related to the child's clothing? A. The pediatric SANE only collects the child's underwear for inclusion in the forensic evidence kit. B. The pediatric SANE does not collect any clothing for the inclusion in the forensic evidence kit. C. The pediatric SANE collects the child's outer clothing (pants and shirt) but not underwear for inclusion in the forensic evidence kit. D. The pediatric SANe collects - CORRECT ANSWER D Forensic evidence collection is indicated for which of the following patients? A. A 4 yo child presents to the ED with concerns of sexual abuse. The mother states that the child said to he today that Uncle Ray "kissed my privates." Last contact with Uncle Ray was 2 weeks ago. B. A 16 yo female presents to the ED with concerns of sexual assault. Patient states in medical interview that her ex-boyfriend digitally penetrated her vagina 3 days ago. C. A 2 yo patient is sent to the ED by her primary care provider due to unexplained bruising of her left arm. Mom is stating that her father is sexually abusing the child but she has not seen her father in 3 weeks. D. A 5 yo patient who comes from a visit with her father 2 weeks ago with complaints of "Daddy hurt me." - CORRECT ANSWER B A 6 yo male presents to the Ed with his father for concerns of sexual abuse. During the medical interview he discloses that his 16 yo brother put his penis in his mouth and butt last night. What is the most appropriate action for the pediatric SANE? A. Explain the forensic evidence process and purpose to father and patient. Obtain patient assent. Collect only oral and anal swabs. B. Explain the forensic evidence process and purpose to father and patient. Obtain parental consent. Obtain patient assent. Collect only oral and anal swabs. C. Explain the forensic evidence process and purpose to father and patient. Obtain assent. Collect entire forensic evidence based on the history. D. Explain the forensic evidence process and purpose to father and patient. Obtain parental consent. Obtain assent. Collect entire forensic evidence based in the history. - CORRECT ANSWER C patient's buttocks. Consent and assent are obtained for a medical forensic examination, evidence collection, photo documentation, and STI testing. During the forensic examination, the SANE observes possible biological evidence on the patient's right buttock. What are the next steps for the SANE? A. Swab the are on the right buttock of the possible biological evidence, document the finding, and photograph the swabbed area. B. Take a photograph of the possible biological evidence, swab the area, and document the finding. C. Collect a swab from the area on the right buttock of possible biological evidence after the examination is complete. D. Take a photograph before and after collecting a swab on the right buttock of the possible biological evidence and doc - CORRECT ANSWER B A 3 yo boy presents with his parents and law enforcement with a report of sexual assault. The SANE discusses options of care with the parents. After consent is obtained, the SANE performs an examination with evidence collection and photo documentation. The patient is discharged home with his parents. What is the next step for the SANE? A. Secure photographs in the evidence kit and send to the crime lib. B. Release the evidence kit with photographs to law enforcement. C. Release only the photographs to law enforcement. D. Secure and store the photographs according to the healthcare facility's policy. - CORRECT ANSWER D A 10 yo girl presents from a group home with her guardian with a report of ongoing sexual abuse by a group home staff member. The option of photo documentation is reviewed with the guardian and child. What is the most appropriate next step for the SANE? A. Allow an opportunity for the guardian to ask any questions since the guardian is the person providing consent for the patient. B. Encourage the child to cooperate with the examination and photographs and begin the examination. C. Explain photo documentation in a developmentally appropriate manner to the patient and welcome questions. D. Determine if the patient assents to photo documentation after the initiation of the physical examination. - CORRECT ANSWER C A mother presents with her 4 yo daughter with a report of sexual abuse by the patient's caregiver. The mother is offered options of care and consents to an examination with evidence collection and photo documentation. As the SANE begins to take photographs of the patient's injuries, she begins to cry and move away from the SANE. Which of the following is the most appropriate action? A. Allow the patient to explore the camera equipment and receive support from her mother. B. Explain to the mother the importance of taking the photographs as part of evidence to collect for the examination. C. Distract the child while continuing with the examination and taking of photographs. D. Discontinue taking photographs and provide only detailed written documentation of injuries seem during the examination. - CORRECT ANSWER A Photo documentation is the standard of care for which population? A. Prepubescent child B. Adolescent C. Adult D. Elderly - CORRECT ANSWER A A SANE-P is conducting a sexual assault exam on a 5 yo girl who was reportedly assaulted less than 24 hours earlier. The SANE begins the medical history by asking if anything on the patient's body hurts. The patient begins to cry and blurts out, "Mommy's friend put is pee-pee in my bottom" while pointing to her genital area. The patient continues to cry, and the SANE pauses the history. Which exception to the hearsay rule best describes the patient's statement? A. Residual and child hearsay exception B. Statements made for the purposes of diagnosis and treatment C. Excited utterance exception D. Then-existing mental, emotional, or physical condition exception - CORRECT ANSWER C A SANE-P is testifying about a sexual assault exam conducted on an 8 yo boy. The prosecuting attorney asks the SANE-P what the boy said during the medical history. The defense attorney objects on the grounds that the testimony is hearsay. After hearing arguments from both attorneys, the judge overrules the objection. Which of the following is legal rationale for why the SANE can repeat in court what the boy told her? A. Medical hearsay exception B. Then-existing mental, emotional, or physical condition exception C. Excited utterance exception D. Residual and child hearsay exception - CORRECT ANSWER A In conducting an exam on a young child, the SANE-P can increase the likelihood that the child's statements will satisfy the diagnosis and treatment hearsay exception by doing which of the following? A. Making sure the patient knows the SANE-P is a nurse, needs to know what happened, and will do a chick-up to make sure the patient is OK B. Documenting all questions asked in the medical history and summarizing the patient's responses C. Documenting any developmentally unusual sexual knowledge in the child displays to discusses D. Documenting that the child made consistent statements in the forensic interview and medical history - CORRECT ANSWER A A SANE is called to the ED to see a 6 yo male and his younger female sibling for concerns of sexual abuse. The children have been brought to the hospital by their grandmother, who watches them during the day. The 6 yo tells the SANE, "My mom kisses my pee-pee and it hurts." The grandmother confirms to the SANE that her grandson told her the same thing and the boy's mom is coming to pick up the children in 3 hours. What is the best course of action for the SANE to make a mandated report? A. Interview the attending physician and nurse to ensure the child gave a consistent history to them before reporting the abuse. B. Contact local law enforcement or CPS to report that the patient and his siblings are potentially in imminent danger and express the need for an immediate response. C. Complete a full sexual assault evaluation with evidence collection before making the mandated report. D. Have the patient forensically inte - CORRECT ANSWER B Which option best describes the requirements for making a mandated report of suspected child abuse and neglect? What was the ACE Study? - CORRECT ANSWER Examined medical, social, and economic consequences of adverse childhood events. What is ACE used for? - CORRECT ANSWER Can determine the likelihood of the 10 most common causes of death in the US. What is Trauma Informed Care? - CORRECT ANSWER • engage people with history of trauma • recognize presence of trauma • recognize of reasons affects life What is a key point of Trauma Informed Care? - CORRECT ANSWER Do Not Inflict More Trauma What are the NCA Standards? - CORRECT ANSWER • A Multi-Disciplinary Team • Cultural Competency • Legally Sound Forensic Interviewing • Victim Support and Advocacy • Medical Evaluation and Treatment • Trauma Focused Mental Health Treatment • Case Review • Child Focused Setting • Designated Legal Entity Responsible for Team What are 3 types of children's reactions to trauma? - CORRECT ANSWER • Physical • Mental • Behavioral What is the criteria for PTSD? - CORRECT ANSWER • exposure to trauma with emotional response • persistent re-experiencing of event • president avoiding and numbing • persistent increased arousal • significant distress or impairment • duration > or = 1 mo What are the elements of Trauma Focused Cognitive Behavioral Therapy (TFCBT)? - CORRECT ANSWER • Psycho-Education • Skills Building • Trauma Narritive What is Commission? - CORRECT ANSWER Harm, threat of harm, or potential harm What are Acts of Commision? - CORRECT ANSWER • Physical Abuse • Sexual Abuse • Emotional Abuse What is Ommission? - CORRECT ANSWER Failure to provide basic physical, emotional, or educational need. What are Acts of Omission? - CORRECT ANSWER • Failure to provide • Physical Neglect • Emotional Neglect • Medical/Dental Neglect • Educational Neglect • Inadequate Supervision • Exposure to violent environment Types of Child Sexual Exploitation - CORRECT ANSWER • child Sexual abuse images • intrafamilial • cyber-enticement • child Sexual tourism • commercial/ domestic sex trafficking • technology self exploitation What are perpetrator risk factors? - CORRECT ANSWER • history of IPV • Transient caregivers • like education level • low income - doesn't increase chance of child sexual abuse