CFN Trauma-Informed Patient Care & Assessmen 3 — Questions and Answers
Question 1: A patient who experienced intimate partner violence (IPV) refuses to leave the abusive relationship. The forensic nurse's best response is:
- Discharge the patient and document refusal of services
- Call the abuser's family to intervene on the patient's behalf
- Respect the patient's autonomy, provide harm reduction information, and ensure follow-up resources (Correct answer)
- Alert law enforcement to remove the patient from the home immediately
Correct answer: Respect the patient's autonomy, provide harm reduction information, and ensure follow-up resources
Trauma-informed care respects autonomy; the nurse provides harm reduction strategies and resources while acknowledging the complexity of leaving an abusive relationship.
Question 2: Which assessment tool is validated for screening intimate partner violence in emergency and forensic nursing settings?
- PHQ-9
- AUDIT-C
- HITS (Hurt, Insult, Threaten, Scream) (Correct answer)
- GCS (Glasgow Coma Scale)
Correct answer: HITS (Hurt, Insult, Threaten, Scream)
The HITS tool is a validated, brief 4-question IPV screening instrument widely used in clinical and forensic nursing settings.
Question 3: During a forensic interview, a pediatric patient suddenly goes silent and stares blankly. The forensic nurse should recognize this as a potential sign of:
- Boredom with the interview process
- Dissociation, a protective trauma response (Correct answer)
- Deliberate non-cooperation
- Neurological emergency requiring immediate intervention
Correct answer: Dissociation, a protective trauma response
Dissociation is a common trauma response in children and adults; the nurse should gently re-orient the patient and pause the interview.
Question 4: Which of the following environmental modifications best supports a trauma-informed forensic examination suite?
- Bright overhead lighting to improve visibility for evidence collection
- Restraint equipment visibly mounted for staff efficiency
- Private, calming space with adjustable lighting and access to a support person (Correct answer)
- Open-bay design to allow rapid staff response
Correct answer: Private, calming space with adjustable lighting and access to a support person
A private, calming environment with adjustable lighting reduces patient distress and supports the trauma-informed principle of physical and emotional safety.
Question 5: A survivor of human trafficking presents for care but denies being trafficked when asked directly. The forensic nurse's best approach is:
- Accept the denial and proceed with routine care only
- Confront the patient with trafficking indicators observed during assessment
- Use indirect, trauma-informed questions and build rapport before addressing trafficking (Correct answer)
- Immediately notify law enforcement of suspected trafficking
Correct answer: Use indirect, trauma-informed questions and build rapport before addressing trafficking
Direct confrontation often causes trafficking survivors to disengage; rapport-building with indirect questioning is the trauma-informed approach that may eventually facilitate disclosure.
Question 6: The concept of 'universal precautions for trauma' in healthcare means:
- Assuming all patients have communicable diseases
- Using PPE during all forensic examinations
- Assuming any patient may have a trauma history and adjusting care accordingly (Correct answer)
- Screening only high-risk patients for traumatic exposure
Correct answer: Assuming any patient may have a trauma history and adjusting care accordingly
Universal precautions for trauma means treating every patient as a potential trauma survivor, applying trauma-informed principles regardless of known history.
Question 7: A forensic nurse is documenting injuries on a patient who experienced strangulation. Which symptom is most commonly missed due to its delayed or subtle presentation?
- Facial bruising
- Subconjunctival hemorrhage
- Petechiae and voice changes (Correct answer)
- Lacerations of the neck
Correct answer: Petechiae and voice changes
Petechiae above the clavicle and subtle voice changes are classic but often delayed signs of strangulation that may be missed in an initial assessment.
CFN Trauma-Informed Patient Care & Assessmen 3
A patient who experienced intimate partner violence (IPV) refuses to leave the abusive relationship.
The forensic nurse's best response is: