CFN Trauma-Informed Care Strategies 4 — Questions and Answers
Question 1: Which of the following best describes 'vicarious trauma' in the context of forensic nursing?
- Physical injuries sustained during a patient altercation
- A cumulative change in the nurse's worldview resulting from repeated exposure to patient trauma (Correct answer)
- Legal liability arising from poor forensic documentation
- Emotional distress from disagreements with the care team
Correct answer: A cumulative change in the nurse's worldview resulting from repeated exposure to patient trauma
Vicarious trauma refers to the lasting shift in a clinician's beliefs, identity, and worldview caused by sustained empathic engagement with traumatized patients.
Question 2: A trauma-informed forensic nurse is preparing to collect evidence from a patient who experienced intimate partner violence. Which action best supports the patient's sense of control?
- Performing all evidence collection before obtaining a detailed history
- Asking the patient to choose the order in which the exam proceeds (Correct answer)
- Collecting evidence without narrating steps to avoid adding to distress
- Ensuring law enforcement is present to validate the process
Correct answer: Asking the patient to choose the order in which the exam proceeds
Allowing the patient to direct the order of the exam restores agency lost during the violent event.
Question 3: Which statement correctly describes the relationship between trauma and memory in forensic patients?
- Trauma always produces highly accurate, detailed memory recall
- Inconsistencies in a trauma survivor's account are typically signs of deception
- Trauma can fragment memory, causing gaps or inconsistencies that do not indicate dishonesty (Correct answer)
- Suppressed memories of trauma are always fully recovered during forensic interviews
Correct answer: Trauma can fragment memory, causing gaps or inconsistencies that do not indicate dishonesty
The neurobiology of trauma disrupts memory encoding, so fragmented or inconsistent accounts are expected and do not imply fabrication.
Question 4: When a pediatric patient refuses to answer questions during a forensic interview, the most appropriate response is to:
- Ask the parent to encourage the child to respond
- Acknowledge the child's right to remain silent and offer to continue another time (Correct answer)
- Use anatomical dolls immediately to bypass verbal responses
- Document refusal and refer to child protective services for a compelled interview
Correct answer: Acknowledge the child's right to remain silent and offer to continue another time
Respecting a child's refusal honors their autonomy and preserves trust, which may lead to future voluntary disclosure.
Question 5: A forensic nurse is screening a patient using the HITS tool. What does HITS stand for?
- Hurt, Insulted, Threatened, Screamed at (Correct answer)
- Harm, Intimidation, Terror, Shame
- Hitting, Injuring, Threatening, Stalking
- Hurt, Isolated, Threatened, Stalked
Correct answer: Hurt, Insulted, Threatened, Screamed at
HITS (Hurt, Insulted, Threatened, Screamed at) is a validated four-item domestic violence screening tool used in clinical settings.
Question 6: An elder abuse victim insists on returning home to the suspected abuser. A trauma-informed response involves:
- Contacting adult protective services without informing the patient
- Providing safety planning resources, documenting the conversation, and respecting the patient's decision-making capacity (Correct answer)
- Requiring a psychiatric hold to prevent return to the dangerous environment
- Refusing to complete the forensic exam until the patient agrees to shelter placement
Correct answer: Providing safety planning resources, documenting the conversation, and respecting the patient's decision-making capacity
Safety planning respects patient autonomy while fulfilling the nurse's duty to provide information and resources.
Question 7: Which of the following organizational practices best supports a trauma-informed forensic nursing unit?
- Scheduling back-to-back SANE exams to maximize unit efficiency
- Providing regular staff debriefs, supervision, and access to mental health support (Correct answer)
- Limiting staff discussion of cases to prevent secondary trauma
- Rotating forensic nurses to non-forensic units without preparation
Correct answer: Providing regular staff debriefs, supervision, and access to mental health support
Regular debriefs and mental health support are organizational strategies that mitigate compassion fatigue and sustain a trauma-informed workforce.
CFN Trauma-Informed Care Strategies 4
Which of the following best describes 'vicarious trauma' in the context of forensic nursing?