SANE-A Certification Exam 156 Questions with Verified Answers,100% CORRECT

SANE-A Certification Exam 156 Questions with Verified Answers Name of scope of practice for FNE - CORRECT ANSWER Forensic Nursing Scope and Standards of Practice FNE theoretical framework - CORRECT ANSWER Quality-Caring model Standards of FNE practice - CORRECT ANSWER A.D.O.P.I.E FNE standards of prof. Performance - CORRECT ANSWER 6 principles of trauma-informed care - CORRECT ANSWER Safety, trustworthiness/transparency, peer support, collaboration & mutuality, empowerment and choice, cultural/historical/gender issues Core members of a SART - CORRECT ANSWER LEO, SANE, advocates, prosecutors Outcome of using CACs - CORRECT ANSWER Increase prosecution rates, improves child FI, increased referrals for mental health, increased nonoffending caregivers' satisfaction PTSD Criteria - CORRECT ANSWER assault, intrusive symptoms (1), cognitive/mood alterations (2), arousal/reactivity alterations, duration functional significance, symptoms not due to other occurrences Suicide is 2nd leading cause of death in what age range? - CORRECT ANSWER 10-34 years old Which gender is at higher risk for suicide? - CORRECT ANSWER Males Which part of the Brain is responsible for memory? - CORRECT ANSWER Hippocampus Which part of the brain is responsible for executive function? - CORRECT ANSWER Cerebral cortex (mental processes) Things to obtain during medical/assault history - CORRECT ANSWER Capacity definition (informed consent) - CORRECT ANSWER Ability to use and understand information to make a decision Competency definition (informed consent) - CORRECT ANSWER Typically when a legal determination is made that a patient is unable to provide consent for themself Informed Assent definition - CORRECT ANSWER Patient's expressed willingness to participate in a procedure or treatment What range of Psychosocial stages (Erikson ) apply to adolescent/adult patients? - CORRECT ANSWER Psychosocial stages 5-8 How can a SANE help deescalate a crisis with a patient? - CORRECT ANSWER Addressing health needs providing appropriate resources/referrals Developing initial plan that will assist w safety What are the different types of blunt force injury? - CORRECT ANSWER Erythema, bruise/contusion, ecchymosis, petechiae, abrasion, laceration, avulsion, bite What is erythema? - CORRECT ANSWER redness due to capillary dilation Will blanch with pressure & may resolve quickly What is a bruise/contusion? - CORRECT ANSWER Blunt force injury that produces diffuse extravasation of blood w/o rupture of skin Doesn't blanch with pressure/may be Indurated (hard) What variabilities are there with bruises? - CORRECT ANSWER Appearance, pain, color, timing What is ecchymosis? - CORRECT ANSWER Extravasated blood into tissue, not necessarily from blunt force trauma. Gravity takes blood to area beyond original impact of trauma What is this a picture of? - CORRECT ANSWER Ecchymosis Definition of petechiae - CORRECT ANSWER Rupture of thin-walled vessels above point of pressure from events such as: strangulation, prolonged vomiting, severe coughing Definition of abrasion - CORRECT ANSWER Removal of some or all of the first layer of epidermis as result of friction or compression Definition of laceration - CORRECT ANSWER Tear in soon when stretching off fibers is exceeded due to impact of blunt force trauma Appearance: - ragged edges that may be bruised, abraded, or inverted - bridging of connective tissues, hair, blood vessels, or nerves may be visible across wound What is this a picture of? - CORRECT ANSWER Petechiae Definition of avulsion - CORRECT ANSWER Skin is torn away by shearing or blunt force trauma Normally deeper than it is wide What immunization needs to be addressed when dealing with a bite wound that has broken the skin? - CORRECT ANSWER Rabies and tetanus What type of injury is a sharp force injury? - CORRECT ANSWER Incision/cut Definition of incision/cut - CORRECT ANSWER When a sharp object comes against the skin w/ sufficient force to divide the skin What are the 2 types of penetrating injuries? - CORRECT ANSWER Stab & gunshot Definition of penetrating injury - CORRECT ANSWER Wound that causes disruption of body surface that extends into underlying tissue or into a body cavity Patterned injury vs pattern of injury - CORRECT ANSWER Patterned: distinctive pattern that is consistent with/suggestive of object Pattern of: group of injuries occur together In what 4 ways can immediate death occur as a result of strangulation? - CORRECT ANSWER 1. cardiac arrhythmia by pressure on carotid artery 2. pressure obstruction on carotid=no blood to brain 3. pressure on jugular veins= back up of blood in brain 4. pressure obstruction of larynx= no airflow unconsciousness from strang. can occur in as little as how many seconds? - CORRECT ANSWER 10 seconds What are the two broad forms of AFSA/DFSA? - CORRECT ANSWER Proactive & opportunistic proactive AFSA/DFSA vs opportunistic AFSA/DFSA - CORRECT ANSWER Proactive: unknowing or forced to ingest incapacitating substance Opportunistic: taken advantage of after incapacitated by self-ingestion predominate drug used in substance-facilitated assault - CORRECT ANSWER alcohol Tanner stages - CORRECT ANSWER Pectinate/ dentate line - CORRECT ANSWER Line between rectum and anal canal—can be seen with anal dilation Tool used to assist in accentuating minor epithelial trauma - CORRECT ANSWER Toluidine blue Name the varying types of hymens - CORRECT ANSWER Annular, crescentic, septate, cribiform, imperforate, microperferate What is a fimbriated hymen? - CORRECT ANSWER Hymen with multiple projection-like appearances along the edge creating a "ruffled" appearance Definition of ectropion cervix - CORRECT ANSWER Circumferential erythema around cervical os —caused by exposed columnar epithelium from cervical canal Are vestibular papillae (can be found during genital exam) a normal variant or abnormal finding? - CORRECT ANSWER Normal variant Vestibular papillae - CORRECT ANSWER Small, soft, flesh-colored tubular papillae that appear in grouped clusters of vestibule Most common in adolescents Due to change in hormones Lichen sclerosis - CORRECT ANSWER chronic, progressive, inflammatory skin condition found in the anogenital region—patchy white skin intense vulvar itching, dysuria, pain w/ BM high-potency topical corticosteroids for tx Molluscum contagiosum - CORRECT ANSWER Common viral skin infection 1-5mm papules-smooth, firm, dome-shaped, waxy, central umbilication Transmission can be sexual/non-sexual Lichen sclerosis is usually seen in what 2 populations? - CORRECT ANSWER Elderly and prepubescent What is the common term for suction ecchymoses? - CORRECT ANSWER Hickeys Besides genitalia, what other body part can the "clock" be used to document injury? - CORRECT ANSWER Breasts How can you differentiate anal bruise vs venous engorgement? - CORRECT ANSWER Change position —have pt lay on side or in prone knee-chest position to see if discoloration disappears Area of vagina most likely to have injury post-sexual assault - CORRECT ANSWER Posterior fourchette How many types of Female genital mutilation (FGM) are there? - CORRECT ANSWER 4 FGM TYPE I - CORRECT ANSWER Clitoridectomy—removal/ partial removal of clitoral glans & prepuce FGM TYPE II - CORRECT ANSWER Excision—partial/total removal of clitoral glans & labia minora—-with or without excision of labia majora FGM TYPE III - CORRECT ANSWER Infibulation—narrowing of vag opening w creation of covering seal by cutting and opposing labia minora or labia majora w or w/o excision of clitoral prepuce & glans FGM TYPE IV - CORRECT ANSWER All other types of mutilation including piercing, scraping, & cauterization Locard's Exchange Principle - CORRECT ANSWER helped to form basis of forensic science every contact b/w 2 entities leaves a trace If a healthcare facility runs a tox kit, should you still send off a toxicology kit for forensic testing? - CORRECT ANSWER Yes recommended collection time for anal/peri-anal swabs - CORRECT ANSWER within 72 hours recommended collection time for blood (if for DFSA) - CORRECT ANSWER within 24 hours of ingestion recommended collection time for oral cavity swabs - CORRECT ANSWER within 24 hours recommended collection time for rectum swabs - CORRECT ANSWER within 72 hours What two chemicals are present in blood vials used in toxicology testing? - CORRECT ANSWER Sodium fluoride and potassium oxalate four general categories of evidence - CORRECT ANSWER physical, documentary, demonstrative, testimonial Which atmosphere is preferred when using alternate light source for evidence collection? Room with light or darkened room? - CORRECT ANSWER Darkened room What area is best to collect specimens for vaginal evidence collection? - CORRECT ANSWER vaginal vault Protocol for collecting substance in matted hair - CORRECT ANSWER cut hair first, if not then swab matted hair along with blood and urine, what other bodily substance can be collected for toxicology testing, should it occur? - CORRECT ANSWER emesis Reasons for photo documentation - CORRECT ANSWER Reassuring of/family Avoiding additional examinations Allowing for later reviews Creating baseline for comparison What does nPEP stand for? - CORRECT ANSWER Non-occupational post-exposure prophylaxis Do's & Sony's of injury documentation - CORRECT ANSWER What is the most common BACTERIAL STI in USA? - CORRECT ANSWER Chlamydia If symptomatic, what will chlamydia patient have? - CORRECT ANSWER Abnormal discharge, dysuria, cervicitis with discharge Pain/swelling in testes (male) Rectal pain, discharge, bleeding (if rectal infection) Most common nonviral & treatable STI (not chlamydia) - CORRECT ANSWER Trichomoniasis Distinct signs of trichomoniasis - CORRECT ANSWER Frothy, malodorous discharge-green, gray, or yellowish Dysuria, painful sex Swelling at head of penis Most common viral STI worldwide - CORRECT ANSWER HPV Distinct sign of HPV - CORRECT ANSWER Genital warts(condylomas) Presenting symptoms for first time outbreak of HSV - CORRECT ANSWER Flu-like, HA w/ dysuria, painful ulcers on genitals Signs/symptoms of primary syphilis - CORRECT ANSWER Painless ulcers/chancre at infected site of contact When does secondary syphilis occur? - CORRECT ANSWER 2-8 weeks after primary syphilis chancres resolve Signs/ symptoms of secondary syphilis - CORRECT ANSWER Diffuse rash, mainly on Palms and soles Fever, pharyngitis, lymphadenopathy When does tertiary syphilis occur? - CORRECT ANSWER Years to decades after initial infection Signs/ symptoms of tertiary syphilis - CORRECT ANSWER Involves central nervous system, cardio system, & liver Confusion if present in females, what are s/s of gonorrhea in females? - CORRECT ANSWER dysuria, vaginal discharge, vaginal bleeding s/s of gonorrhea in males - CORRECT ANSWER redness, inflammation of urethra/epididymis, thick discharge s/s of rectal infection of gonorrhea - CORRECT ANSWER anal itching, rectal bleeding, discharge, pain Signs/ symptoms of Hep B (HBV) & Hep C (HCV) - CORRECT ANSWER when does acute HBV occur? - CORRECT ANSWER 3-6 months of initial exposure when does acute HCV occur? - CORRECT ANSWER 2-12 weeks of initial exposure Signs/ symptoms of HIV - CORRECT ANSWER Flu-like, GI symptoms, rash, weight loss, arthralgia Factors that increase risk of HIV transmission - CORRECT ANSWER Ejaculation, no condom, victim has concurrent STI, victim is menstruating, trauma, multiple sex acts, high viral load, assailant comes from Place with high prevalence of HIV Options for emergency contraception - CORRECT ANSWER -ethinyl-estradiol/levonorgestrel -ulipristal acetate -levonorgestrel Assuming patient qualifies to receive ALL preventative meds, which meds should be given first - CORRECT ANSWER HIV MEDS FIRST how long to avoid alcohol following consumption of metronidazole - CORRECT ANSWER withhold while taking medication and for 72 hours after risk of contracting chlamydia from sexual assault - CORRECT ANSWER 4-17% risk of contracting gonorrhea from sexual assault - CORRECT ANSWER 0-26% risk of contracting syphilis from sexual assault - CORRECT ANSWER 0-6% risk of contracting trichomoniasis from sexual assault - CORRECT ANSWER 0-19% incubation period for chlamydia - CORRECT ANSWER 7-21 days How to proceed if patient is unconscious and can't consent - CORRECT ANSWER Wait until they regain consciousness Obtain consent from family or court order Obtain evidence & keep within SANE program until consent is axqored bench trial - CORRECT ANSWER A trial in which the judge alone hears the case (no jury) Arraignment - CORRECT ANSWER Defendant is informed of the charges & is expected to render a plea Deposition - CORRECT ANSWER Witness' sworn out-of-court testimony Hearsay - CORRECT ANSWER Out of court statements that are offered to prove the truth of the matter asserted (often inadmissible in court) subpoena duces tecum - CORRECT ANSWER a court order to produce documents or records trier of fact - CORRECT ANSWER When a patient is intoxicated, what is not needed to determine whether patient can give consent? - CORRECT ANSWER blood alcohol concentration What does HITECH (Health Information Technology for Economical and Clinical Health Act) involve? - CORRECT ANSWER addresses electronic transmission of health information What does VAWA (Violence against Women Act) entail?) - CORRECT ANSWER requires written patient consent to release personally. identifying information, in the absence of court order, or in situations requiring mandatory reporting What does FERPA (Family Educational Rights and Privacy Act) deal with? - CORRECT ANSWER protects privacy of student educational records arraignment - CORRECT ANSWER defendant is informed of charges and is expected to enter a plea bench trial - CORRECT ANSWER Judge alone hears and decides the case deposition - CORRECT ANSWER a witness's out-of-court testimony given under oath if judge overrules objection, what should happen next? - CORRECT ANSWER proceed with what was happening before objection was made subpoena duces tecum - CORRECT ANSWER a court order to produce documents or records trier of fact - CORRECT ANSWER person/group of people who determine questions of fact in a trial--can be judge or jury Can an expert witness give their opinion in a court of law? - CORRECT ANSWER yes, based on existing science or their clinical experience autonomy - CORRECT ANSWER patients have right to make their own decision principle of justice - CORRECT ANSWER element of fairness in medical decision-making SANE: both procedural & distributive justice acting in fair and unbiased manner beneficence - CORRECT ANSWER duty to act in good faith veracity - CORRECT ANSWER duty to remain honest and transparent Nonmaleficence - CORRECT ANSWER to do no harm, whether intentional or nonintentional (similar to beneficence) Who does HIPAA apply to? - CORRECT ANSWER covered entities: healthcare providers, health insurance companies, health clearinghouses what is needed in authorization to release information, in relation to HIPAA? - CORRECT ANSWER Info that can be released name/ contact info of who it will be released to disclaimer that once info is released, it is not longer federally protected define case review - CORRECT ANSWER external process that involves interprofessional collaboration to analyze a case from systems level purpose of case review - CORRECT ANSWER for quality improvement What is "uptake" as it pertains toluidine blue? - CORRECT ANSWER Blue dye sticks to exposed nuclei cells (break in the skin) Aside from HIV, what are the 3 untreatable STDs? - CORRECT ANSWER Herpes, hep C, HPV Risk of pregnancy from sexual assault - CORRECT ANSWER 2-5 % Reasons for follow-up exams - CORRECT ANSWER Follow injury progression Assess resolution of injury Normal variant vs injury Identification of additional physical findings that need PCP referral What is a laceration caused by? - CORRECT ANSWER blunt force trauma that results in tearing, ripping, crushing, over-stretching, or shearing of soft tissue key sign of laceration vs abrasion - CORRECT ANSWER bridging of tissue 2 types of sharp force trauma - CORRECT ANSWER stab, incised wounds (cuts) what are sharp force injuries caused by? - CORRECT ANSWER pointed or edged weapons (knives) presentation of sharp injuries - CORRECT ANSWER clearly defined, smooth edges no tissue bridging no surrounding abrasion or contusionss when would you have a contusion on a stab wound? - CORRECT ANSWER if knife goes all through until the handle hits skin (hily guard pattern) types of primary skin lesions - CORRECT ANSWER macule, patch, papule, plaque, nodule, bulla, pustule, abscess, wheal presentation of a macule - CORRECT ANSWER flat area of discoloration < 1cm (freckles, hypo-pigmentation) presentation of a patch - CORRECT ANSWER flat area of discoloration > 1cm (Mongolian spot, vitiligo) presentation of a papule - CORRECT ANSWER superficial elevated solid lesion < 1cm presentation of a nodule - CORRECT ANSWER elevated solid lesion > 1 cm extends deeper into dermis than papule presentation of a vesicle - CORRECT ANSWER elevated collection of free fluid < 1 cm (herpes simplex, herpes zoster) presentation of a bulla - CORRECT ANSWER elevated collection of free fluid > 1cm (burn, friction blister) presentation of a pustule - CORRECT ANSWER elevated collection of turbid fluid (leukocytes + free fluid) < 1 cm (acne, impetigo) presentation of an abscess - CORRECT ANSWER elevated collection of turbid fluid (leukocytes + free fluid) > 1 cm (furuncle, carbuncle) presentation of a wheal - CORRECT ANSWER superficial, transitory, edematous plaque caused from infiltration of dermis w/ fluid (bee sting/allergic reaction--can be any size, can be itchy) presentation of nevi (moles) - CORRECT ANSWER symmetrical macule or papules <10 mm well-defined borders uniformly pigmented brown in color In terms of the vulva clock, where would you see bartholin gland cysts? - CORRECT ANSWER 5 o'clock and 7 o'clock position "strawberry cervix" is indicative of what STD? - CORRECT ANSWER trichomoniasis Molluscum contagiosum is related to what virus - CORRECT ANSWER pox virus when HSV vesicles rupture, what do they create? - CORRECT ANSWER ulcers common areas for genital injuries in females - CORRECT ANSWER fossa navicularis, hymen, posterior fourchette, labia minora