CFN Trauma-Informed Patient Care & Assessmen 5 — Questions and Answers
Question 1: An elderly patient presents with multiple bruises in various stages of healing and appears fearful when the caregiver is present. The forensic nurse's priority is:
- Interview the patient with the caregiver present for accuracy
- Separate the patient from the caregiver and conduct a private assessment for elder abuse (Correct answer)
- Attribute the bruises to age-related skin fragility without further investigation
- Contact the caregiver to obtain the history of injury
Correct answer: Separate the patient from the caregiver and conduct a private assessment for elder abuse
Separating the patient from the potential abuser and conducting a private interview is essential to assess for elder abuse safely and accurately.
Question 2: Which of the following is an example of a trauma-informed approach to obtaining a patient's assault history?
- Asking why the patient did not resist the assault
- Using a structured narrative timeline starting with the most traumatic moment
- Allowing the patient to share their experience at their own pace without interruption (Correct answer)
- Requiring complete chronological recall before documenting
Correct answer: Allowing the patient to share their experience at their own pace without interruption
Allowing patient-led narrative at their own pace honors their autonomy and avoids imposing a linear timeline that does not match fragmented trauma memory.
Question 3: A patient who experienced childhood sexual abuse is now undergoing a forensic exam as an adult survivor. She freezes and stops responding partway through. This is most consistent with:
- Faking a reaction to strengthen a legal case
- A somatic flashback triggered by the exam re-activating childhood trauma (Correct answer)
- Drug intoxication masking her true response
- Deliberate non-compliance with the examination
Correct answer: A somatic flashback triggered by the exam re-activating childhood trauma
Somatic flashbacks occur when bodily sensations during an exam trigger physiological re-experiencing of past trauma, causing the patient to freeze or dissociate.
Question 4: Cultural humility in forensic nursing practice primarily requires the nurse to:
- Learn the specific cultural practices of every patient population in advance
- Recognize personal biases and approach each patient as the expert on their own cultural experience (Correct answer)
- Apply generalized cultural knowledge uniformly to patients from similar backgrounds
- Defer all cross-cultural assessments to social work
Correct answer: Recognize personal biases and approach each patient as the expert on their own cultural experience
Cultural humility involves ongoing self-reflection about bias and positioning the patient as the authority on their own cultural identity rather than applying stereotypes.
Question 5: A forensic nurse working with a survivor of trafficking notices she is becoming overly emotionally involved and dreams about the patient's case. This is best described as:
- Professional misconduct requiring immediate termination
- Normal compassion that improves patient outcomes
- Vicarious trauma requiring self-care, supervision, and possible debriefing (Correct answer)
- Transference that must be disclosed to the patient
Correct answer: Vicarious trauma requiring self-care, supervision, and possible debriefing
These symptoms indicate vicarious trauma; addressing it requires structured self-care, clinical supervision, and peer debriefing to sustain the nurse's wellbeing.
Question 6: Which of the following best explains why trauma survivors frequently delay reporting assault for days, weeks, or months?
- They fabricated the assault and needed time to refine their story
- Fear of disbelief, shame, self-blame, and concerns about confidentiality impede timely disclosure (Correct answer)
- They were unaware assault had occurred due to intoxication
- Medical treatment is unavailable in rural communities until symptoms worsen
Correct answer: Fear of disbelief, shame, self-blame, and concerns about confidentiality impede timely disclosure
Delayed reporting is common and results from complex psychosocial barriers including shame, fear of not being believed, and concerns about privacy or legal consequences.
Question 7: In the context of trauma-informed care, 'empowerment' as a core principle means the nurse should:
- Make clinical decisions on behalf of the patient to reduce their burden
- Focus on the patient's strengths and support their decision-making throughout the encounter (Correct answer)
- Empower the patient by ensuring they understand the legal consequences of their choices
- Transfer power to advocacy organizations to manage the patient's care
Correct answer: Focus on the patient's strengths and support their decision-making throughout the encounter
Empowerment restores agency by centering the patient's strengths and supporting informed decision-making, countering the helplessness trauma creates.
CFN Trauma-Informed Patient Care & Assessmen 5
An elderly patient presents with multiple bruises in various stages of healing and appears fearful when the caregiver is present.
The forensic nurse's priority is: