CFN Trauma-Informed Care Strategies 5 — Questions and Answers
Question 1: A forensic nurse uses a trauma-informed lens when interpreting a patient's 'flat affect' during an exam. This presentation most likely reflects:
- Lack of credibility as a victim
- A dissociative or numbing response commonly seen in trauma survivors (Correct answer)
- Substance intoxication requiring toxicology workup
- An intellectual disability requiring modified consent procedures
Correct answer: A dissociative or numbing response commonly seen in trauma survivors
Emotional numbing and flat affect are recognized dissociative responses to overwhelming trauma, not indicators of dishonesty.
Question 2: Which of the following is a key component of a trauma-informed safety plan developed with a domestic violence patient?
- A promise from the patient to leave the abusive relationship immediately
- Identification of warning signs, safe people, emergency contacts, and exit strategies (Correct answer)
- Mandatory enrollment in a domestic violence shelter program
- A court-ordered restraining order obtained by the forensic nurse
Correct answer: Identification of warning signs, safe people, emergency contacts, and exit strategies
An effective safety plan is individualized, patient-driven, and covers practical steps for various risk scenarios.
Question 3: The concept of 'cultural humility' in trauma-informed care differs from 'cultural competence' in that it:
- Requires mastery of all cultural practices relevant to one's patient population
- Is a static body of knowledge acquired through training
- Is an ongoing, self-reflective process of acknowledging one's own cultural biases (Correct answer)
- Focuses on translating materials into multiple languages
Correct answer: Is an ongoing, self-reflective process of acknowledging one's own cultural biases
Cultural humility involves continuous self-reflection and openness to learning from patients, rather than achieving a fixed level of cultural knowledge.
Question 4: A strangulation victim denies feeling pain despite visible petechiae and hoarseness. Using a trauma-informed approach, the forensic nurse should:
- Rely solely on the patient's pain report and document no significant injury
- Recognize pain minimization as common in acute trauma and document objective findings thoroughly (Correct answer)
- Suggest the patient may be exaggerating other symptoms since she denies pain
- Defer documentation until the patient is more forthcoming
Correct answer: Recognize pain minimization as common in acute trauma and document objective findings thoroughly
Adrenaline and dissociation frequently suppress pain perception after strangulation; objective findings must be documented independent of subjective pain reports.
Question 5: When a sexual assault survivor asks the forensic nurse 'Do you believe me?', the most trauma-informed response is:
- 'I am not able to make that determination — that is for law enforcement.'
- 'It is not my role to decide what happened.'
- 'My job is to provide you with care and document your injuries thoroughly, and I am here to support you.' (Correct answer)
- 'Yes, I believe everything you told me.'
Correct answer: 'My job is to provide you with care and document your injuries thoroughly, and I am here to support you.'
This response affirms the patient's dignity and the nurse's supportive role without making forensic determinations that go beyond nursing scope.
Question 6: Which interviewing framework is specifically designed for use with trauma survivors in forensic settings and emphasizes building rapport before gathering details?
- CAGE questionnaire
- NICHD Protocol (National Institute of Child Health and Human Development) (Correct answer)
- PHQ-9 screening tool
- MMPI-2 structured interview
Correct answer: NICHD Protocol (National Institute of Child Health and Human Development)
The NICHD Protocol is an evidence-based forensic interview framework that builds rapport through narrative practice before addressing the alleged incident.
Question 7: A forensic nurse who practices 'reflective supervision' is most likely doing which of the following?
- Reviewing CCTV footage of patient interactions for quality assurance
- Engaging in structured, supported self-reflection on their clinical and emotional responses to trauma cases (Correct answer)
- Supervising nursing students during forensic examinations
- Reviewing documentation with a hospital risk management team
Correct answer: Engaging in structured, supported self-reflection on their clinical and emotional responses to trauma cases
Reflective supervision is a trauma-informed professional practice in which nurses examine their own responses to challenging cases with a trained supervisor.
CFN Trauma-Informed Care Strategies 5
A forensic nurse uses a trauma-informed lens when interpreting a patient's 'flat affect' during an exam.
This presentation most likely reflects: