CFN Victim Assessment and Documentation 4 — Questions and Answers
Question 1: A forensic nurse completes a sexual assault examination and finds no anogenital injuries. The most appropriate documentation would state:
- No injuries found; sexual assault did not occur
- Examination findings are inconsistent with reported assault
- No acute anogenital injuries identified; absence of injury does not exclude sexual assault (Correct answer)
- Patient declined examination; findings inconclusive
Correct answer: No acute anogenital injuries identified; absence of injury does not exclude sexual assault
Research shows the majority of sexual assault victims have no anogenital injuries, so absence of injury must be explicitly documented without implying non-occurrence.
Question 2: Which toxicological specimen has the longest window of detection for drug-facilitated sexual assault (DFSA) substances?
- Urine collected within 4 hours of assault
- Blood collected within 12 hours of assault
- Hair sample collected 4–6 weeks post-assault (Correct answer)
- Saliva collected immediately after assault
Correct answer: Hair sample collected 4–6 weeks post-assault
Hair analysis can detect drug-facilitated assault substances weeks to months after ingestion, far exceeding the detection windows of urine or blood.
Question 3: During a forensic assessment, a patient discloses suicidal ideation. The forensic nurse's priority action is to:
- Complete the evidence collection before addressing the mental health concern
- Immediately address safety, initiate appropriate mental health referral, and document the disclosure (Correct answer)
- Contact law enforcement to take custody of the patient
- Delay the forensic exam until the patient's psychiatric status is resolved
Correct answer: Immediately address safety, initiate appropriate mental health referral, and document the disclosure
Patient safety takes priority; suicidal ideation requires immediate assessment, appropriate intervention, and documentation concurrent with forensic care.
Question 4: What is the primary purpose of the FERN (Forensic Evidence Recovery Nurse) protocol in sexual assault cases?
- To authorize forensic nurses to prescribe controlled substances for trauma patients
- To standardize evidence collection procedures, ensuring completeness and legal admissibility (Correct answer)
- To allow forensic nurses to determine prosecutorial merit of a case
- To replace the role of emergency physicians in sexual assault examinations
Correct answer: To standardize evidence collection procedures, ensuring completeness and legal admissibility
FERN and similar standardized protocols ensure consistent, thorough evidence collection that withstands legal scrutiny.
Question 5: A victim reports being assaulted 6 days ago but is presenting for the first time. The forensic nurse should:
- Inform the patient that evidence collection is no longer possible or useful
- Conduct a thorough assessment, document delayed healing injuries, and collect available evidence (Correct answer)
- Refer the patient only to counseling since the forensic window has passed
- Limit the examination to STI screening and pregnancy testing only
Correct answer: Conduct a thorough assessment, document delayed healing injuries, and collect available evidence
Delayed presentations can still yield documentation of resolving injuries and, in some cases, biological evidence, making a full assessment essential.
Question 6: Which of the following accurately describes a 'laceration' versus an 'abrasion' in forensic injury documentation?
- A laceration is a superficial scraping of skin; an abrasion involves full-thickness skin disruption
- A laceration is a tear through tissue caused by blunt force; an abrasion is a superficial scrape from friction (Correct answer)
- Both terms are interchangeable and describe the same wound mechanism
- A laceration is caused by sharp force; an abrasion is caused by blunt force with skin penetration
Correct answer: A laceration is a tear through tissue caused by blunt force; an abrasion is a superficial scrape from friction
Precise terminology is critical: lacerations are blunt-force tears with irregular margins, while abrasions are superficial wounds caused by friction or scraping.
Question 7: A forensic nurse is assessing a human trafficking victim. Which behavioral indicator is most consistent with trafficking victimization?
- Patient is accompanied by a friend who allows her to answer questions independently
- Patient is unable to speak without a companion present, lacks ID, and appears coached (Correct answer)
- Patient voluntarily provides her home address and contact information
- Patient reports a single episode of coerced labor with an identified employer
Correct answer: Patient is unable to speak without a companion present, lacks ID, and appears coached
Lack of independent communication, absence of identification, and scripted or monitored responses are hallmark indicators of trafficking control.
CFN Victim Assessment and Documentation 4
A forensic nurse completes a sexual assault examination and finds no anogenital injuries.
The most appropriate documentation would state: