CFN Forensic Evidence Collection & Documentation 4 — Questions and Answers
Question 1: A forensic nurse is examining a child for suspected physical abuse. She notes patterned bruising on the buttocks. The best initial documentation action is:
- Report to CPS before completing documentation
- Photograph the injury with scale and label, then complete a detailed body diagram (Correct answer)
- Ask the child what happened before documenting to include their account
- Apply fluorescent dye to enhance the patterned injury before photography
Correct answer: Photograph the injury with scale and label, then complete a detailed body diagram
Photographic documentation with proper scale and labeling combined with anatomical body diagram mapping is the priority forensic documentation step before interviews or reporting.
Question 2: When documenting a patient's account of an assault for forensic purposes, the nurse should:
- Summarize the patient's account using clinical terminology
- Record the patient's exact words in quotation marks (Correct answer)
- Document only injuries that are consistent with the reported history
- Limit documentation to objective findings only to avoid bias
Correct answer: Record the patient's exact words in quotation marks
Direct quotes from the patient are documented verbatim in forensic records because they may be admissible as statements and preserve the patient's own narrative.
Question 3: A forensic nurse collects a reference buccal swab from a consenting patient. The purpose of this swab is to:
- Test for sexually transmitted infections
- Provide the patient's own DNA profile to compare against other collected specimens (Correct answer)
- Screen for alcohol and drug ingestion
- Confirm the patient's identity for the chain of custody record
Correct answer: Provide the patient's own DNA profile to compare against other collected specimens
Reference buccal swabs establish the victim's known DNA profile so laboratories can differentiate the victim's own DNA from potential perpetrator DNA in collected specimens.
Question 4: Which factor most significantly affects the reliability of injury aging (estimating when a bruise occurred) in forensic documentation?
- The patient's reported time of assault
- Variation in skin tone, depth, and individual healing response (Correct answer)
- The size and shape of the bruise
- The anatomical location of the injury
Correct answer: Variation in skin tone, depth, and individual healing response
Bruise color progression varies widely based on skin tone, depth of injury, vascular supply, and individual physiology, making precise age estimation unreliable.
Question 5: A suspected drug-facilitated sexual assault (DFSA) patient presents 10 hours after the assault. Which urine collection timing consideration is most important?
- Urine should not be collected after 6 hours as drugs will be undetectable
- Urine should be collected immediately as many drugs and metabolites remain detectable for 72–96 hours (Correct answer)
- Only blood specimens are valid for DFSA toxicology after 8 hours
- The patient should void naturally first to ensure a concentrated specimen
Correct answer: Urine should be collected immediately as many drugs and metabolites remain detectable for 72–96 hours
Many DFSA drugs and their metabolites remain detectable in urine for 72–96 hours, so immediate urine collection at presentation is critical regardless of time elapsed.
Question 6: When transferring forensic evidence to law enforcement, the forensic nurse's responsibility includes:
- Personally delivering evidence to the crime laboratory
- Signing the chain of custody form and documenting the transfer in the medical record (Correct answer)
- Sealing all specimens in a single evidence bag for transport
- Retaining a copy of all evidence swabs for nursing department records
Correct answer: Signing the chain of custody form and documenting the transfer in the medical record
The forensic nurse must document the transfer on the chain of custody form and in the medical record to maintain an unbroken evidentiary chain.
Question 7: A forensic nurse is examining abrasions on a patient's wrists. Which description in the medical record is most forensically appropriate?
- 'Wrist abrasions consistent with restraint'
- 'Linear abrasions on bilateral volar wrists, 3 cm in length, with surrounding erythema' (Correct answer)
- 'Patient shows signs of having been tied up based on wrist wounds'
- 'Bilateral wrist wounds, likely defensive in nature'
Correct answer: 'Linear abrasions on bilateral volar wrists, 3 cm in length, with surrounding erythema'
Forensic documentation requires objective description of location, orientation, size, and appearance without interpretive conclusions about mechanism or cause.
CFN Forensic Evidence Collection & Documentation 4
A forensic nurse is examining a child for suspected physical abuse.
She notes patterned bruising on the buttocks.
The best initial documentation action is: