A sexual assault nurse examiner (SANE) is a caring for a client who experienced sexual assault. Which of the following actions should the nurse take?
Request the police to gather evidence of the incident.
Require the client to call the police.
Provide legal testimony on behalf of the client.
Protect the client from further harm.
The Correct Answer is D
D. In the immediate aftermath of a sexual assault, the primary focus of the SANE nurse is to ensure the safety and well-being of the client. This includes providing a safe and supportive environment for the client, assessing and treating any physical injuries, addressing immediate medical needs, and offering emotional support and crisis intervention.
A, B, and C involve aspects of legal procedures and involvement of law enforcement, but they may not be appropriate or feasible for every client in every situation. Additionally, the decision to involve law enforcement or pursue legal action should be made in collaboration with the client and should prioritize their safety, autonomy, and well-being.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
C. Vulnerable populations, such as those with low socioeconomic status, the elderly, racial and ethnic minorities, and individuals with certain health conditions, may experience higher levels of health risks due to various factors such as limited access to healthcare, environmental exposures, social determinants of health, and underlying health disparities.
A. Although variability of response to stressors is important it is not the primary concern
B. Although older individuals are vulnerable to risk factors, the nurse should include all vulnerable groups.
D. While resilience can mitigate the impact of risk factors on health outcomes, it is not a determinant of health risk itself.
Correct Answer is D
Explanation
D. Tardive dyskinesia (TD) is a side effect of long-term use of first-generation antipsychotic medications, such as those commonly used to treat schizophrenia. It is characterized by involuntary, repetitive movements of the face, tongue, lips, and other parts of the body.
A. Impaired ability to regulate body temperature is more commonly associated with conditions such as heatstroke or certain neurological disorders affecting the hypothalamus, and it typically presents with symptoms such as fever or hypothermia.
B. Extrapyramidal symptoms encompass a range of movement disorders caused by dysfunction of the extrapyramidal system, which includes the basal ganglia.
C. Neuroleptic malignant syndrome (NMS) is a rare but potentially life-threatening side effect of antipsychotic medications, characterized by fever, altered mental status, muscle rigidity, and autonomic dysfunction.
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