Question 1

When beginning a health maintenance exam, the health care provider learns that an adult patient has been sexually assaulted the previous day. What is the initial responsibility of the provider?&#10;A) Notify the police and encourage the patient to press criminal charges.&#10;B) Perform a thorough gynecological exam and obtain cultures.&#10;C) Question the patient about the events surrounding the assault.&#10;D) Refer the patient to the emergency department (ED) for a forensic examination.

Accepted Answer

The initial responsibility of the healthcare provider is to refer the patient to the emergency department (ED) for a forensic examination. This will ensure that the patient receives prompt medical attention, evidence is properly collected and preserved, and the legal process is facilitated. Notification of the police and encouraging the patient to press criminal charges can be pursued after the patient receives necessary medical attention. Performing a thorough gynecological exam and questioning the patient about the events surrounding the assault can also be done by healthcare providers, but it must be done after emergency medical attention is executed.

Question 2

A patient who was sexually assaulted one month prior tells her provider that she is concerned about contracting human immunodeficiency virus (HIV). When is it appropriate to perform testing?&#10;A) Immediately and then every 6 months for the first year&#10;B) Immediately with definitive results&#10;C) In 2 weeks and then 3 to 6 months after the assault&#10;D) Three to six months after the assault

Accepted Answer

According to the Centers for Disease Control and Prevention (CDC), the recommended HIV testing protocol after a potential exposure is to perform an initial test as soon as possible (within 72 hours if possible) and then repeat the test at 2 weeks, 1 month, and 3 months after the exposure. Therefore, in this case, performing testing at 2 weeks and then 3 to 6 months after the assault would be the appropriate course of action.

Question 3

During a health maintenance examination, 17-year-old female reports having been raped repeatedly at a college party during the previous semester and tells the practitioner that she did not seek help at the time. Which action is a priority for the primary care provider?

A) Recommending counseling at a local mental health center
B) Referring the patient to the emergency department for sexually transmitted infection (STI) testing
C) Reporting the alleged assault to law enforcement
D) Suggesting that the patient report the incident to the school

C

Accepted Answer

Reporting the alleged assault to law enforcement is a priority as it is important to ensure the safety of the patient and potentially prevent future assaults. The patient may need medical treatment, STI testing, and counseling, but those can be addressed after the initial safety concerns have been addressed through law enforcement involvement. It is important for healthcare providers to encourage reporting of assault to law enforcement and provide support to patients throughout the reporting process.

Deck 32: Sexual Assault