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Responding to Patients Who Have Been Sexually Abused

1. Health-care providers should provide first-line support that is gender sensitive, in response to disclosures of sexual abuse.

A. TRUE B. FALSE

2. A female, adolescent patient discloses that she was sexually abused. How should the patient's nurse proceed when obtaining the patient's medical history?

A. The patient's nurse should encourage the patient to tell her story of sexual abuse multiple times. B. The patient's nurse should be sure to ask repetitive questions regarding the reported sexual abuse. C. The patient's nurse should not use language and terminology that is appropriate to the patient's age when discussing the reported sexual abuse. D. The patient's nurse should allow the patient to respond to questions regarding sexual abuse in a manner the patient chooses to do so.

3. Which of the following statements regarding sexual abuse-related physical examinations is most accurate?

A. Health care professionals should maximize efforts to have patients undergo multiple examinations. B. Health care professionals should not make sure there is another adult present during the examination. C. Health care professionals should use appropriate visual aids and terms to explain the examination procedures. D. Health care professionals should always conduct a virginity test.

4. Which of the following statements regarding sexual abuse documentation is most accurate?

A. Health care professionals should not record verbatim statements made by patients. B. Health care professionals should record verbatim statements made by patients. C. Health care professionals should never document the child’s or adolescent’s emotional state. D. Health care professionals should document the child’s or adolescent’s emotional state only when the patient is between the ages of 4 - 16.

5. HIV post-exposure prophylaxis (PEP) should be offered, as appropriate, to children and adolescents who have been raped involving oral, vaginal or anal penetration with a penis, and who present within 72 hours of the incident.

A. TRUE B. FALSE

6. Which of the following statements is most accurate?

A. Health care professionals should offer emergency contraception to girls who have been raped involving peno-vaginal penetration and who present within 5 days of the incident. B. Health care professionals should offer emergency contraception to girls who have been raped involving peno-vaginal penetration and who present within 6 days of the incident. C. Health care professionals should offer emergency contraception to girls who have been raped involving peno-vaginal penetration and who present within 8 days of the incident. D. Health care professionals should offer emergency contraception to girls who have been raped involving peno-vaginal penetration and who present within 10 days of the incident.

7. Which of the following statements regarding vaccination of sexually abused patients is most accurate?

A. Hepatitis B vaccination with hepatitis B immunoglobulin should be offered, as per national guidance. B. Hepatitis B vaccination without hepatitis B immunoglobulin should be offered, as per national guidance. C. Hepatitis B vaccination without hepatitis B immunoglobulin should be offered only to patients between the ages of 8 - 14, as per national guidance. D. Hepatitis B vaccination, with or without hepatitis B immunoglobulin, should not be offered.

8. Psychological debriefing should be used in an attempt to reduce the risk of post-traumatic stress, anxiety or depressive symptoms.

A. TRUE B. FALSE

9. Which of the following statements most accurately describes the principle of non-discrimination?

A. This principle requires that all children and adolescents between the ages of 5 - 16 should be offered quality care, irrespective of their sex, race, ethnicity, religion, sexual orientation, gender identity, disability or socioeconomic status. B. This principle requires that all children and adolescents between the ages of 6 - 18 should be offered quality care, irrespective of their sex, race, ethnicity, religion, sexual orientation, gender identity, disability or socioeconomic status. C. This principle requires that all children and adolescents between the ages of 8 - 18 should be offered quality care, irrespective of their sex, race, ethnicity, religion, sexual orientation, gender identity, disability or socioeconomic status. D. This principle requires that all children and adolescents should be offered quality care, irrespective of their sex, race, ethnicity, religion, sexual orientation, gender identity, disability or socioeconomic status.

10. The absence of physical evidence means that sexual abuse did not occur.

A. TRUE B. FALSE

11. An adolescent patient presents to a hospital. The patient reports sexual abuse. Due to the nature of the patient's reported sexual abuse, the patient is administered HIV PEP. The patient has some questions regarding the HIV PEP. Which of the following counseling points should be included in the discussion regarding HIV PEP?

A. HIV PEP does not typically lead to side effects. B. HIV PEP should be stopped after 10 days if side effects are experienced. C. HIV PEP should be stopped after 20 days if side effects are experienced. D. The patient should be sure to complete the full 28-day regimen of HIV PEP.

12. A female, 16-year-old patient reports sexual abuse. The patient would like to receive emergency contraceptive pills. The patient does not appear to possess any contraindications to emergency contraceptive pills. Which of the following medications and corresponding doses should be administered to the patient?

A. Ulipristal acetate: single dose (one 30 mg tablet) B. Ulipristal acetate: two doses (two 30 mg tablets) C. Levonorgestrel-only: two doses (two 1.5 mg tablets) D. Levonorgestrel-only: four doses (four 1.5 mg tablets)

13. Which of the following statements is most accurate?

A. HPV vaccination should be offered to girls ages 4 - 9 years, as per national guidance. B. HPV vaccination should be offered to girls ages 6 - 9 years, as per national guidance. C. HPV vaccination should be offered to girls ages 9 - 14 years, as per national guidance. D. HPV vaccination should not be offered to girls.

14. Cognitive behavioral therapy (CBT) with a trauma focus should be considered for children and adolescents who have been sexually abused and are experiencing symptoms of PTSD.

A. TRUE B. FALSE

15. A child patient presents to a hospital. The patient has been sexually abused and is experiencing several injuries as a result of the sexual abuse. According to the Pathway of Care recommendations, what should be the first step in the patient's treatment?

A. Offer first-line support B. Treat injuries C. Take medical history D. Conduct physical examination

16. A female, adolescent patient presents to a hospital. The patient has been sexually abused within the past 5 days. The patient's sexual abuse treatment has followed the Pathway of Care recommendations. The patient has received HIV PEP and adherence counseling. According to the Pathway of Care recommendations, what should be the next step in the patient's treatment?

A. The patient should receive the Hepatitis B vaccination. B. The patient should receive STI prophylaxis. C. The patient should receive cognitive behavioral therapy. D. The patient should be offered emergency contraception.

17. Health care professionals should report consensual sexual activity between adolescents.

A. TRUE B. FALSE

18. Which of the following statements is most accurate?

A. Health care professionals should offer/continue to offer first-line support to those recently sexually abused and who experience acute traumatic stress (within the 1st month). B. Health care professionals should not offer/continue to offer first-line support to those recently sexually abused and who experience acute traumatic stress (within the 1st month). C. Health care professionals should offer/continue to offer first-line support to those recently sexually abused and who experience acute traumatic stress (within the 1st year). D. Health care professionals should only offer/continue to offer first-line support to those adolescents recently sexually abused and who experience acute traumatic stress (within the 1st year).


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