Sexual Assault Practice Questions

25 multiple-choice questions on Sexual assault for paramedic and EMT students, from Chapter 23 (Gynecologic Emergencies). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. You arrive at an apartment for a reported sexual assault. The patient is crying in the hallway. Your first priority is:

   1. A. Bag her clothing as evidence
   2. B. Get a statement of events
   3. C. Confirm the scene is safe
   4. D. Call her family to come
   Show answer

   Answer: C. Confirm the scene is safe

   The assailant may still be nearby. Scene safety comes first, then life threats, then psychological care and evidence preservation.

2. After life threats are managed, the main EMS role with a sexual assault patient is:

   1. A. Care, support, preserving evidence
   2. B. Deciding whether assault occurred
   3. C. Interviewing for the police report
   4. D. Collecting swabs for a rape kit
   Show answer

   Answer: A. Care, support, preserving evidence

   After life threats are handled, EMS treats injuries, supports the patient, and preserves evidence by discouraging washing, changing clothes, or discarding items. Deciding whether an assault occurred is not a paramedic judgment and can damage trust. Interviewing for the police report is the investigators' job, and repeated questioning can retraumatize. Collecting swabs for a rape kit is done by a SANE or other trained examiner at the hospital, not in the field.

3. Which statement about genital injuries after sexual assault is accurate?

   1. A. Injury is seen in nearly every case
   2. B. Lack of injury means consent was given
   3. C. Injuries can be seen by police alone
   4. D. Many survivors have no visible injury
   Show answer

   Answer: D. Many survivors have no visible injury

   Most sexual assault survivors have no visible genital injury, so its absence does not mean an assault did not occur. Document what you see and what the patient reports without drawing conclusions.

4. A sexual assault survivor has a bite mark on her shoulder that is not bleeding. You should:

   1. A. Scrub it to prevent infection
   2. B. Cover it with antibiotic ointment
   3. C. Ask her to wash it at home
   4. D. Avoid washing it and document it
   Show answer

   Answer: D. Avoid washing it and document it

   Bite marks can carry the assailant's DNA, which the forensic examiner swabs. Unless care requires cleaning, leave it unwashed, describe its location and appearance, and transport.

5. Which documentation is most appropriate?

   1. A. "Patient was raped at 0200 hours."
   2. B. "Patient appears to be lying to us."
   3. C. "Patient states, 'He held me down.'"
   4. D. "Alleged victim seems calm."
   Show answer

   Answer: C. "Patient states, 'He held me down.'"

   Quote the patient's own words and record objective findings. Legal conclusions and opinions do not belong in the report.

6. During the exam of a sexual assault patient, you should:

   1. A. Do a full genital exam at once
   2. B. Explain each step, ask permission
   3. C. Have several crew members watch
   4. D. Skip the exam to avoid upsetting her
   Show answer

   Answer: B. Explain each step, ask permission

   Examine only what care requires, explain first, and get consent. A genital exam is not done in the field unless there is significant bleeding.

7. The best destination for a stable sexual assault patient is usually:

   1. A. A hospital with SANE nurses
   2. B. The nearest urgent care center
   3. C. Her primary care office
   4. D. Any freestanding clinic
   Show answer

   Answer: A. A hospital with SANE nurses

   Sexual assault nurse examiners collect evidence properly, offer prophylaxis, and connect the patient with advocates.

8. The patient is calm and speaks in a flat, matter-of-fact way. This most likely means:

   1. A. Reactions to assault vary widely
   2. B. The assault probably did not happen
   3. C. She has no significant injuries
   4. D. She does not need support
   Show answer

   Answer: A. Reactions to assault vary widely

   Calm, numb, angry, or tearful reactions are all normal. Demeanor tells you nothing about whether an assault occurred.

9. A patient has gaps in memory, confusion, and nausea after drinks at a party. You should suspect:

   1. A. Simple alcohol hangover
   2. B. Acute hypoglycemia from alcohol
   3. C. Drug-facilitated assault
   4. D. A migraine with aura
   Show answer

   Answer: C. Drug-facilitated assault

   GHB, benzodiazepines, and similar drugs cause sedation and amnesia. Report the suspicion so the hospital can test promptly.

10. A competent adult refuses transport after a sexual assault. You should:

    1. A. Transport against her will
    2. B. Leave without discussion
    3. C. Ask police to make her go
    4. D. Respect it; give resources
    Show answer

    Answer: D. Respect it; give resources

    A competent adult may refuse. Explain the benefits of care and evidence collection, give hotline and SANE information, and document carefully.

11. Which statement best supports an assault survivor?

    1. A. "Why were you out so late?"
    2. B. "This is not your fault."
    3. C. "Are you sure about this?"
    4. D. "You should have called sooner."
    Show answer

    Answer: B. "This is not your fault."

    Blame-free language helps recovery and trust. Questions implying fault cause further harm.

12. A 7-year-old discloses sexual abuse to you. You should:

    1. A. Question her about every detail
    2. B. Promise to keep it a secret
    3. C. Ask the parent if it is true
    4. D. Listen calmly; report per law
    Show answer

    Answer: D. Listen calmly; report per law

    Paramedics are mandated reporters in most areas. Avoid detailed or leading questions, which can harm the child and the later forensic interview.

13. Which finding should make you consider strangulation during an assault?

    1. A. A small scrape on one knee
    2. B. A mild headache that is resolving
    3. C. Hoarse voice and neck petechiae
    4. D. Bruising on the forearms only
    Show answer

    Answer: C. Hoarse voice and neck petechiae

    Voice change, trouble swallowing, petechiae, and neck marks suggest strangulation. Airway swelling and vascular injury can appear hours later.

14. Why should you limit questions about the details of the assault?

    1. A. Repeated questions retraumatize
    2. B. Questioning is illegal for EMS
    3. C. Details do not affect the hospital
    4. D. It always delays transport
    Show answer

    Answer: A. Repeated questions retraumatize

    Ask only what you need for medical care, such as injuries, time, and drug use. Detailed interviews belong to trained investigators.

15. If the patient must urinate before arriving at the hospital, you should:

    1. A. Insist that she wait until arrival
    2. B. Collect it if protocol allows
    3. C. Discard the urine afterward
    4. D. Have her urinate on scene
    Show answer

    Answer: B. Collect it if protocol allows

    Urine may contain evidence of drugs. Collect it in a clean container, label it, and keep wipes for the hospital.

16. When offering a provider for the exam, it is helpful to:

    1. A. Use the largest crew you have available
    2. B. Let a bystander help hold her
    3. C. Have a family member do the exam
    4. D. Offer a same-gender provider
    Show answer

    Answer: D. Offer a same-gender provider

    When possible, let the patient choose who examines her. It helps her feel safer and in control.

17. A 19-year-old man says he was sexually assaulted and asks you not to tell anyone. The best response is to:

    1. A. Offer care and explain confidentiality
    2. B. Tell him men are rarely assaulted
    3. C. Call his parents to inform them
    4. D. Advise him to forget about it and move on
    Show answer

    Answer: A. Offer care and explain confidentiality

    Male survivors often fear disbelief and stigma. Offer the same care, explain how his information is protected and any reporting limits, and encourage evaluation for injury, STI prevention, and support.

18. Emergency contraception after a sexual assault is most effective when it is taken:

    1. A. After a missed period
    2. B. After the next menstrual cycle ends
    3. C. As soon as possible after the assault
    4. D. At least a week after the event, not before
    Show answer

    Answer: C. As soon as possible after the assault

    Emergency contraception, such as levonorgestrel or ulipristal, works best when taken early and is effective up to 72 to 120 hours depending on the product. Prompt hospital evaluation preserves this option.

19. An adult with an intellectual disability shows fear and new withdrawal around a caregiver. You should:

    1. A. Assume it is normal behavior
    2. B. Consider abuse; report per law
    3. C. Ask the caregiver to explain
    4. D. Avoid documenting your concern
    Show answer

    Answer: B. Consider abuse; report per law

    Vulnerable adults are at higher risk. Document objectively and follow mandatory reporting laws.

20. Which action helps preserve evidence in the ambulance?

    1. A. Wipe the genital area clean
    2. B. Throw away any torn clothing
    3. C. Give her mouthwash to rinse with
    4. D. Have her sit on a clean sheet
    Show answer

    Answer: D. Have her sit on a clean sheet

    Bag the sheet with her clothing. Washing, wiping, or rinsing removes evidence.

21. When documenting injuries, record their:

    1. A. Likely cause and weapon used
    2. B. Location, size, appearance
    3. C. Age compared to the story
    4. D. Link to the attacker
    Show answer

    Answer: B. Location, size, appearance

    Describe what you see. Interpreting the cause belongs to forensic examiners.

22. A patient was assaulted 4 days ago and calls EMS for pelvic pain. Evidence collection is:

    1. A. Still possible; encourage transport
    2. B. Impossible after 24 hours have passed
    3. C. Not relevant to her care
    4. D. Only done if she was visibly injured
    Show answer

    Answer: A. Still possible; encourage transport

    Evidence can often be collected up to several days afterward, and medical care is still needed. Encourage evaluation.

23. Which behavior by the provider most builds trust?

    1. A. Brief, rapid-fire questions
    2. B. Expressing anger at the attacker
    3. C. Calm, unhurried, respectful tone
    4. D. Promising justice will be done
    Show answer

    Answer: C. Calm, unhurried, respectful tone

    A steady, respectful approach helps the patient feel safe. Strong emotions from the provider can shift focus away from the patient.

24. A patient was sexually assaulted and has a deep laceration with active bleeding. You should:

    1. A. Preserve the wound for evidence
    2. B. Photograph it before care
    3. C. Control the bleeding first
    4. D. Wait for police before treating
    Show answer

    Answer: C. Control the bleeding first

    Life and limb come before evidence. Treat the injury, then document what you did.

25. Which patient right matters most in sexual assault care?

    1. A. The right to a police escort
    2. B. The right to a family member
    3. C. The right to skip documentation
    4. D. The right to decide about care
    Show answer

    Answer: D. The right to decide about care

    Assault takes control away from the patient. Asking permission and respecting decisions restores some of it.