SANE Exam A 122 Questions with Verified Answers
When to evaluate a patient for N pep administration? - CORRECT ANSWER When care is sought less than 72
... [Show More] hours after a potential exposure and its non-occupational and presents with a substantial risk for HIV acquisition.
Two factors to consider when giving Npep - CORRECT ANSWER HIV testing should be done prior to administration, preferably by using rapid combined AG/AB, or antibody blood test.
2nd Factor to consider when giving NPep - CORRECT ANSWER If rapid HIV blood test results are unavailable and NPeP is otherwise indicated, meds should be initiated without delay and can be discontinued if the patient is later determined to have HIV infection already or the source is determined not to have HIV infection.
What is the course for NPep - CORRECT ANSWER 28 day course of a three drug antiretroviral regimen
What are the elements of negligence? - CORRECT ANSWER Duty, breach of duty, causation, damages
Duty - CORRECT ANSWER defined as acts or interactions required after the presumption of a relationship between the provider and the patient.
What are the three ways in which duty is established? - CORRECT ANSWER 1. When you provide direct care to a patient
2. when you observe an unattended person in need of care, 3. Observes or is aware of provider performing care in a manner that may cause harm.
Causation - CORRECT ANSWER The proximate cause causation is often the most difficult to prove. The difficulty lies in the fact of the cause of an injury often cannot be identified.
Foreseeability - CORRECT ANSWER The ability of a reasonable person to anticipate the consequence of an action, a causation concept
Res Ipsa Loquitur - CORRECT ANSWER the thing speaks for itself
4 conditions of Res Ipsa Loquitur - CORRECT ANSWER The act that caused the injury was was in the nurses control
The injury would not have but fir the nurses negligence
No negligence on the patients part contributed to the injury
Evidence of the truth as to what what happened is unavailable
Intentional torts - CORRECT ANSWER Assault, battery, false imprisonment, quasi- intentional torts
Assault - CORRECT ANSWER An act to make a person feel fearful or an apprehension about Bodily harm. It does not have to be touching it can be a funny statement
Battery - CORRECT ANSWER Unlawful or offensive touching of another without consent
False Imprisonment - CORRECT ANSWER restraining an individual or restricting an individual's freedom, against his or her will.
Quasi-intentional torts - CORRECT ANSWER invasion of privacy, defamation of character, slander,
breach of confidentiality - CORRECT ANSWER Failure to keep privileged medical information private, legal and ethical concern
Blunt force trauma - Four kinds - CORRECT ANSWER Abrasions, lacerations, contusions, and fractures
4 types of abrasions - CORRECT ANSWER Scratch ( cat as scratch)graze ( road rash) impact ( object stamps the skin removing epidermal layer, linear( pressure with movement)
contusions or bruises - CORRECT ANSWER Blood extravasates from circulating vasculature into interstitial space
SANE programs beliefs (FNS-388-389) - CORRECT ANSWER Sexual assault survivors have the right to immediate, compassionate and comprehensive medicolegal evaluation evaluation and treatment by specially trained professionals who have experience to anticipate their needs during this time of crisis.
SANE responsibilities (FNS pg 389$ - CORRECT ANSWER Ethical responsibilities to provide victims with complete information about choices so victims can make informed decisions about the care they want to receive
Assault survivors rights - CORRECT ANSWER Report to law enforcement, know what their options are and what to expect if they do, or do not decide to report.
Rights of those that do report (FNS 389) - CORRECT ANSWER Sensitive and knowledgeable support, without bias, during this difficult process
Rights of those who do not report (FNS 389) - CORRECT ANSWER Right to expert, complete healthcare.
What does providing a high standard of evidence collection do? - CORRECT ANSWER Increase the prosecution of sex offenders, and hopefully reduce Rape but it can also speed the victims recovery to a higher level of functioning and prevent secondary illness or injury
Minimum members in a SART (FNS 389) - CORRECT ANSWER SANE, LEA, Advocate, prosecutor
VAWA (Violence Against Women Act, 2005 - CORRECT ANSWER As of January 5th 2009 the sexual assault victim should be offered a sexual assault medicolegal exam and not be billed for this care.
How long fir SANE to arrive - CORRECT ANSWER Usually no more then an hour
Top priority for victim - CORRECT ANSWER Evaluate and treat any urgent or life threatening injuries, while always considering the forensic consequences of the lifesaving and stabilizing medical procedure.
If clothing is removed by ED Staff - CORRECT ANSWER Care should be taken utilizing forensic principles for handling and storage of the physical evidence
Trial by Jury ( core curr Fn pg 225) - CORRECT ANSWER Under the Canadian Charter of tights and Freedoms people accused of the MOST serious criminal offenses generally have the right to choose to be tried by a jury or by a judge alone.
Types of testimony - CORRECT ANSWER Fact witness,
Expert witness
fact witness - CORRECT ANSWER nurse who has knowledge of the actual incident prompting a legal case; bases testimony on firsthand knowledge of the incident, not on assumptions
Fact witness might be asked to provide information about what? - CORRECT ANSWER Healthcare procedures, treatments, vital signs, and the standards and protocols that he or she used when caring for the patient
Expert Witness Testimony - CORRECT ANSWER "Evidence about a scientific, technical, professional, or other specialized issue given by a person qualified to testify because of familiarity with the subject or special training in the field"
voir dire ( to speak the truth) - CORRECT ANSWER a preliminary examination of a witness. Questions asked about occupation, education, licensing, experience, and other details provided by the experts CV.
Why do elderly women experience physiological changes - CORRECT ANSWER Decreased estrogen
What changes occur in elderly women due to decreased estrogen - CORRECT ANSWER Altered Vaginal wall-thinning and shape, increased vaginal dryness which creates pain and bleeding during during intercourse and may increase the rate of vaginal or bladder infection.
Elders skin changes - CORRECT ANSWER Thin, loose, and transparent
Elder sexual assault victims have greater ( blank) injury then younger individuals - CORRECT ANSWER Skin and mucous membranes injury
Standards of forensic nursing practice - CORRECT ANSWER 1. Assessment, 2. diagnosis, 3. outcomes identified, 4. planning, 5. implementation , 5a coordination of care, 5b health teaching and health coordination, 6. Evaluation, 7. Ethics
Assessment - CORRECT ANSWER Collects personal data and information relative to the patients health, death or the situation, includes diagnostic tests and procedures that are relevant to the patients current status and forensic nursing practice.
diagnosis - CORRECT ANSWER The forensic nurse analyzes assessment data to determine actual or potential diagnosis, problems and issues
SAFER - CORRECT ANSWER Sexual Assault Forensic Evidence Reporting Act- part of the reauthorization of the VAWA.
Why was SAFER created? - CORRECT ANSWER To develop practices appropriate for the accurate, timely and effective collection and processing of DNA evidence. Outline parameters for identifying and prioritizing sexual assault kits (SAKS) to be tested; time periods for testing, processes for communication etc
victim-centered approach - CORRECT ANSWER Systemic focus on the needs and concerns of the victims to ensure COMPASSION and SENSITIVE DELIVERY of services in a NON- JUDGMENTAL MANNER.
Trauma-informed approach - CORRECT ANSWER Considers the impact of trauma and victim safety considerations. This approach includes integrating provisions for prioritizing and protecting victims rights
Training that should be included in this approach - CORRECT ANSWER The neurobiology of trauma. Trauma does not affect the accuracy of the memory but it may affect the organization of the traumatic memory.
What helps consolidate the memory after a traumatic event? - CORRECT ANSWER Sleep
System based advocates - CORRECT ANSWER Employed by LE or by prosecutors office
Community based advocate - CORRECT ANSWER Employees or trained volunteers with a nongovernmental community organization
Who/what should drive the medical forensic encounter? - CORRECT ANSWER The victim not the SAK. Accommodating individual wishes and needs takes priority
Use if SANES to collect evidence - CORRECT ANSWER Contribute to a higher conviction rate
Sample Collection - CORRECT ANSWER ASAP, regardless of post-Assault activities (showering, douching, swimming etc.)
timeframe - CORRECT ANSWER As soon as possible and up to five days ( or longer) emerging research indicates that there may be potential to extend timeframe to 9 days ( national best practices for sexual assault kits 2017)
What do the terms delayed, deferred and postponed imply when it comes to reporting sexual assault - SART TOOL KIT - CORRECT ANSWER That a victim actively inhibited a sexual assault case
The majority of sexual assault cases are reported how long after the assault - CORRECT ANSWER Years
The medical forensic exam- - CORRECT ANSWER One piece of evidence collection in a SA investigation, the results of which alone do not prove or disprove sexual assault
What should a SART protocol address- - CORRECT ANSWER Importance of believing a victim
Trauma informed response
How to handle a report of SA outside of the timeframe of evidence collection
The steps to investigate reports outside the window
Clear guidelines regarding the timeframe for referring victims
When and how to make referrals to other SART members
App referrals for victims to all other service providers
Assistance with transportation for the victim, if needed, to medical, advocacy, or other needed services
Reporting Via Technology - CORRECT ANSWER Websites that allow victims to store info with time stamps and numerous apps - use of these are new and their impact is not yet known
Text to 911- is available in some communities
Who can commit IPV - CORRECT ANSWER Spouses, current or former romantic partners, pimps, traffickers or gang members
How many women in US have been raped by an intimate partner - CORRECT ANSWER 1 in 10 and 17% have experienced some form if IPV abuse
IPV and LGBTQ - CORRECT ANSWER LGBTQ experience IPV at an equal or higher rate then heterosexuals
Bisexual women - CORRECT ANSWER Experience higher rate of lifetime IPV then heterosexuals (22.1 vs 9.1)
Black men who have sex with men - CORRECT ANSWER 22.3 % report being pressured or forced into sexual activity with an IP at some point t in their lives
What is reproductive coercion - CORRECT ANSWER behavior related to reproductive health that is used to maintain power and control in a relationship
And interfere with contraception
What should be worn during the collection of evidence? - CORRECT ANSWER Masks and gloves
Nurses should LE the SAK no longer then days after collection - CORRECT ANSWER Three
LE should give the SAK kit to the crime lab no longer the days after collection - CORRECT ANSWER Seven
chain of custody - CORRECT ANSWER Is Written documentation that identifies all persons who maintained the handling of evidence throughout the collection, packaging, transfer, storage and destruction.
Chain of custody helps to demonstrate evidence was..... - CORRECT ANSWER Handled properly to preserve its integrity and avoid contamination or loss.
What is CODIS? - CORRECT ANSWER Combined DNA Index System (NDIS) and is the generic term used to describe the FBI's program of support for criminal justice DNA databases as well as the software used to run these databases.
acid phosphatase - CORRECT ANSWER An enzyme found in high concentration in semen
acroposthitis - CORRECT ANSWER Inflammation of the prepuce
adnexa - CORRECT ANSWER The Fallopian tubes, ligaments, and ovaries in the female reproductive system
anal fissure - CORRECT ANSWER A small tear in the lining of the anus.
Anal laxity - CORRECT ANSWER Dilation of the anus resulting in decrease in the muscle tone of the anal sphincter
fossa navicularis - CORRECT ANSWER A depression between the posterior margin of the vaginal opening and the fourchette. May not be noted separately in post menarchal patients and instead combined under the label posterior fourchette, as it becomes more difficult the two after estrogen is present
Median Raphe - CORRECT ANSWER Midline external fusion of skin from posterior fourchette to the anus
vestibule - CORRECT ANSWER Almond shaped space between the lines of attachment of the labia Minora
The national protocol focuses on - CORRECT ANSWER Exams of females who have experienced the onset of menarche and males who have reached pubert
definition of forensic nursing - CORRECT ANSWER specialized nursing care that focuses on patient populations affected by violence and trauma—across the lifespan and in diverse practice settings. Forensic nursing includes education, prevention, and detection and treatment of the effects of violence in individuals, families, communities, and populations.
Standard 1. Assessment - CORRECT ANSWER The forensic nurse collects pertinent data and information relative to the patient's health, death, or the situation.
Standard 2. Diagnosis - CORRECT ANSWER The forensic nurse analyzes the assessment data to determine actual or potential diagnoses, problems, and issues
Standard 3. Outcomes Identification - CORRECT ANSWER The forensic nurse identifies expected outcomes for a plan individualized to the patient or the situation
Standard 4. Planning - CORRECT ANSWER The forensic nurse develops a plan that prescribes strategies to attain expected, measurable outcomes.
Standard 5. Implementation - CORRECT ANSWER The forensic nurse implements the identified plan
Standard 5A. Coordination of Care - CORRECT ANSWER The forensic nurse coordinates care delivery.
Standard 5B. Health Teaching and Health Promotion - CORRECT ANSWER The forensic nurse employs strategies to promote health and a safe environment
Standard 6. Evaluation - CORRECT ANSWER The forensic nurse evaluates progress toward attainment of goals and outcomes.
Standards of Professional Performance for Forensic Nurses - CORRECT ANSWER describe a competent level of behavior in the professional role, including activities related to ethics, culturally congruent practice, communication, collaboration, leadership, education, evidence-based practice and research, quality of practice, professional practice evaluation, resource utilization, and environmental health.
Standard 7. Ethics - CORRECT ANSWER The forensic nurse practices ethically
Standard 8. Culturally Congruent Practice - CORRECT ANSWER The forensic nurse practices in a manner that is congruent with cultural diversity and inclusion principles.
Standard 9. Communication - CORRECT ANSWER The forensic nurse communicates effectively in all areas of practice.
Standard 10. Collaboration - CORRECT ANSWER The forensic nurse collaborates with patient, family, and other key stakeholders in the conduct of nursing practice.
Standard 11. Leadership - CORRECT ANSWER The forensic nurse leads within the professional practice setting and the profession.
Standard 12. Education - CORRECT ANSWER The forensic nurse seeks knowledge and competence that reflects current nursing practice and promotes futuristic thinking
Standard 13. Evidence-Based Practice and Research - CORRECT ANSWER The forensic nurse integrates evidence and research findings into practice.
Standard 14. Quality of Practice - CORRECT ANSWER The forensic nurse contributes to quality nursing practice.
Standard 15. Professional Practice Evaluation - CORRECT ANSWER The forensic nurse evaluates one's own and others' nursing practice
Standard 16. Resource Utilization - CORRECT ANSWER The forensic nurse utilizes appropriate resources to plan, provide, and sustain evidence-based nursing services that are safe, effective, and fiscally responsible.
Standard 17. Environmental Health - CORRECT ANSWER The forensic nurse practices in an environmentally safe and healthy manner.
The forensic nurse death investigator (FNDI) stages - CORRECT ANSWER 1. Investigation of the death; 2. Investigation of the decedent's family and/or survivors; and 3. Effects on the community
FNDI role includesactions such as - CORRECT ANSWER assessing the scene at a death, planning for additional sample collection, implementing referrals when caring for survivors, and evaluating all actions taken during an investigation
The major pathogens causing urethral discharge are - CORRECT ANSWER Neisseria gonorrhoeae(N. gonorrhoeae) and Chlamydia trachomatis (C. trachomatis
A spontaneous complaint of abnormal vaginal discharge - CORRECT ANSWER most commonly a result of a vaginal infection
T. vaginalis, C. albicansand bacterial vaginosis (BV) are the most common cause of what? - CORRECT ANSWER Vaginal infections
cervical infections are caused by - CORRECT ANSWER gonorrhoeae and C. trachomatis
Patients taking metronidazole should be cautioned to avoid what? - CORRECT ANSWER Alcohol
Acquired syphilis is divided into early and late syphilis - CORRECT ANSWER Early syphilis comprises the primary, secondary and early latent stages.
Late syphilis refers to late - CORRECT ANSWER late latent syphilis, gummatous, neurological and cardiovascular syphilis.
Primary syphilis is characterised by - CORRECT ANSWER an ulcer or chancre at the site of infection or inoculation.
Secondary syphilis manifestations include - CORRECT ANSWER skin rash, condylomata lata, mucocutaneous lesions and generalised lymphadenopathy.
latent syphilis has no - CORRECT ANSWER clinical manifestations
What is early latent syphilis? - CORRECT ANSWER infection of less than two years duration.
what is late latent syphilis - CORRECT ANSWER An infection of more than two years duration without clinical evidence of treponemal infection
What does Symptomatic trichomoniasis presents with? - CORRECT ANSWER an offensive vaginal discharge and vulval itching in women, and urethritis in men.
three theoretical frameworks were chosen by The International Association of Forensic Nurses Education Guidelines Task Force upon which to base the Sexual Assault Nurse Examiner (SANE) Education Guidelines they are - CORRECT ANSWER Sister Callista Roy's Adaptation Model of Nursing, Dr. Patricia Benner's From Novice to Expert Theory, and Joanne Duffy's Quality Caring Model.
ROY'S ADAPTATION MODEL OF NURSING - CORRECT ANSWER the individual is a "bio-psycho- social being in constant interaction with a changing environment" Viewing people as individuals and in groups, such as communities and families, is a major component of the model. SANE educational courses identify the patient as an individual and as part of a family or community system, which is affected by all forms of violence.
BENNER'S FROM NOVICE TO EXPERT THEORY - CORRECT ANSWER Benner's theory proposes an approach to the learning process that highlights the importance of clinical experience as an extension of practical knowledge. Experience is a prerequisite for expertise. Benner uses the theory to describe how nurses progress through five levels: novice, advanced beginner, competent, proficient, and expert
DUFFY'S QUALITY CARING MODEL - CORRECT ANSWER offers a framework to support the interventions and actions of the caring relationship that exists between the SANE and the patient, family, and community. A number of nursing theorists contributed to the creation of the Quality Caring Model—most notably, Watson, who spoke about caring as the essence of nursing (1979, 1985). Later, Duffy noted, "The relationship, therefore, becomes the base that the nurse and the patient use to share information, thoughts, feelings, and concerns. As this relationship is forged, caring is developed and quality outcomes are achieved" [Show Less]