Special Crime Scenes: Sexual Assault, Abuse, Death and Suicide Scenes, Human Trafficking, and Self-care Practice Questions

25 multiple-choice questions on Special crime scenes: sexual assault, abuse, death and suicide scenes, human trafficking, and self-care for paramedic and EMT students, from Chapter 53 (Crime Scene Awareness). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. A woman says she was forced to perform oral sex 1 hour ago. Before she reaches the hospital, you should ask her not to:

   1. A. Talk about how she feels
   2. B. Sit upright on the stretcher during transport
   3. C. Hold the hand of the friend who is with her
   4. D. Eat, drink, smoke, or brush her teeth
   Show answer

   Answer: D. Eat, drink, smoke, or brush her teeth

   Evidence of oral assault can be lost through eating, drinking, smoking, rinsing, or brushing. Explain why, and respect her choice; talking with you and having support nearby do not harm evidence.

2. A sexual assault patient has no visible bleeding and stable vital signs. Regarding examination of the genital area, you should:

   1. A. Do a full genital exam to record every single injury
   2. B. Limit it to what is needed, such as bleeding control
   3. C. Swab the area so evidence is not lost en route
   4. D. Do it before transport so the ED can skip it
   Show answer

   Answer: B. Limit it to what is needed, such as bleeding control

   A genital exam in the field adds trauma and can disturb evidence; it is done only when needed for care, such as significant bleeding. The forensic exam and evidence collection are done at the hospital, often by a SANE.

3. At a homicide scene, a man is obviously dead, with a gunshot wound to the head and rigor mortis. The best way to confirm death is for:

   1. A. One provider to enter by a single path
   2. B. The whole crew to enter and assess him
   3. C. A police officer to check for a pulse
   4. D. Two providers to roll him to look for wounds
   Show answer

   Answer: A. One provider to enter by a single path

   When death is obvious, sending one provider by one route keeps disturbance of the scene to a minimum. Moving or rolling the body changes evidence and is not needed to confirm death.

4. Human smuggling differs from human trafficking because smuggling:

   1. A. Requires force against the person moved
   2. B. Applies only to children under age 18
   3. C. Is a crime against a border, not a person
   4. D. Is legal if the person agrees to be moved
   Show answer

   Answer: C. Is a crime against a border, not a person

   Smuggling is the illegal movement of a willing person across a border; trafficking is the exploitation of a person for labor or sex through force, fraud, or coercion, and needs no border crossing. A smuggled person can later become a trafficking victim.

5. A man is found hanging, and you cannot yet tell whether he is dead. To get him down, the rope should be cut:

   1. A. Through the knot, since it is easiest
   2. B. At the knot after you untie it first
   3. C. Close to the ceiling beam or anchor
   4. D. Away from the knot, leaving it intact
   Show answer

   Answer: D. Away from the knot, leaving it intact

   The knot and how it was tied can help investigators tell suicide from homicide, so cut the rope away from the knot and leave the knot intact. Untying it destroys this evidence.

6. At a suspected suicide, you find a handwritten note on the table next to the patient. You should:

   1. A. Read it aloud to the family to help them
   2. B. Leave it where it is and tell police
   3. C. Give it to the patient's spouse to keep
   4. D. Pocket it for the coroner
   Show answer

   Answer: B. Leave it where it is and tell police

   A suicide note is evidence for police and the medical examiner. Do not touch, move, or share it; point it out to investigators.

7. Why should EMS treat an apparent suicide scene with the same care as a homicide scene?

   1. A. Most apparent suicides turn out to be homicides
   2. B. Suicide notes are often forged
   3. C. Life insurance will not pay for a suicide
   4. D. Its cause has not yet been confirmed
   Show answer

   Answer: D. Its cause has not yet been confirmed

   A death that looks like suicide may be a homicide, or the reverse. Until investigators decide, preserve the scene in the same way. Most apparent suicides are confirmed as suicides and notes are rarely forged, but the few that are not can be proved only if the scene is preserved. Insurance rules play no part in how EMS treats the scene.

8. At a home where a woman was found dead with stab wounds, her husband asks you to help him lift her onto the bed and cover her. You should:

   1. A. Gently explain she must stay as found for police
   2. B. Help him, since it may ease the family's grief tonight
   3. C. Cover her with a blanket from the bedroom
   4. D. Move her to the bed but not cover her up
   Show answer

   Answer: A. Gently explain she must stay as found for police

   The body's position and surroundings are critical evidence at a homicide scene. Explain kindly that police need everything left as it is; moving or covering her with items from the scene can alter evidence.

9. At the home of an injured toddler, the mother's account of how he was hurt changes after police arrive. You should:

   1. A. Record only her final, most recent version
   2. B. Ask her which version of events is the true one
   3. C. Record each version and the time it was given
   4. D. Leave the accounts out of your patient report
   Show answer

   Answer: C. Record each version and the time it was given

   Changing explanations are a red flag for abuse. Document each version in her words with the time; confronting her or recording only one version loses important information.

10. At the home of a frail 84-year-old man, you notice a padlock on the outside of his bedroom door. This finding most suggests:

    1. A. A normal step to keep him from wandering
    2. B. A safety device to keep thieves out of his room
    3. C. A sign that the man prefers to be left alone
    4. D. Possible confinement, which you should report
    Show answer

    Answer: D. Possible confinement, which you should report

    A lock on the outside of a bedroom door can mean an older adult is being confined, a form of abuse. Document it objectively and report per your state's rules; do not assume it is routine dementia care.

11. Under U.S. federal law, what must be shown for a 16-year-old girl engaged in commercial sex to be a trafficking victim?

    1. A. That she is a minor in commercial sex
    2. B. That she was taken across a state line
    3. C. That she says she was forced to do it
    4. D. That she received no money for the acts
    Show answer

    Answer: A. That she is a minor in commercial sex

    Under the Trafficking Victims Protection Act, any minor induced into commercial sex is a victim of trafficking, with no need to prove force, fraud, or coercion; showing that she is a minor in commercial sex is enough. Being taken across a state line is not required, because trafficking does not require movement. Her saying she was forced is not required for a minor; force, fraud, or coercion must be shown only for adults. Whether she received no money for the acts does not matter; payment to her or to a trafficker does not change her status.

12. Which finding in a young woman treated for abdominal pain most suggests she may be a victim of human trafficking?

    1. A. She has a recent tattoo of a flower on her ankle
    2. B. She does not know the address where she lives
    3. C. She asks how much the ambulance ride will cost
    4. D. She works night shifts at a local restaurant
    Show answer

    Answer: B. She does not know the address where she lives

    Not knowing her own address or city is a common sign of trafficking, since victims are often moved and isolated. A cost question, night work, or a decorative tattoo alone is common and not a red flag.

13. A woman has a tattoo of a man's name with a barcode beneath it on her neck. In context with other red flags, this may be:

    1. A. A sign of a gang that her family belongs to
    2. B. A memorial tattoo for a lost partner
    3. C. Branding by a trafficker to mark 'ownership'
    4. D. A popular fashion design with no deeper meaning
    Show answer

    Answer: C. Branding by a trafficker to mark 'ownership'

    Traffickers sometimes brand victims with tattoos of their name, a crown, dollar signs, or a barcode to mark them as property. A tattoo alone proves nothing, but with other signs it raises concern. A man's name above a barcode is a recognized trafficking brand rather than a fashion trend or an ordinary memorial tattoo.

14. You suspect your patient is being trafficked, and her 'boyfriend' will not leave her side. The best way to speak with her alone is to:

    1. A. Tell him directly you suspect he is trafficking her
    2. B. Ask her about trafficking while he is standing beside her
    3. C. Ask him to wait outside while you call the police
    4. D. Use a routine reason, such as an exam, to separate them
    Show answer

    Answer: D. Use a routine reason, such as an exam, to separate them

    A routine pretext, such as needing to do an exam or an ECG in private, lets you speak with her safely. Confronting or accusing the companion can put both her and the crew in danger.

15. A patient who may be a trafficking victim speaks only Spanish, and her employer offers to translate. The main reason to decline his offer is that he:

    1. A. Is not trained in medical terminology
    2. B. May control her and filter what she says
    3. C. Could be held liable for translation errors
    4. D. Is barred by law from hearing her medical details
    Show answer

    Answer: B. May control her and filter what she says

    A person who may be her trafficker will not translate honestly and will hear everything she says, so she cannot speak freely. Use a professional interpreter, such as a phone service, instead. Privacy law does not bar a companion from hearing her details if she agrees, and his possible liability for errors is not the concern; his control over her is.

16. Your crew believes a man at a farm worksite is a victim of labor trafficking, and his supervisor is watching you closely. You should:

    1. A. Avoid confronting the supervisor and report it later
    2. B. Tell the supervisor that the police are on the way
    3. C. Try to remove the man from the farm right away for safety
    4. D. Ask the supervisor to show you the man's passport
    Show answer

    Answer: A. Avoid confronting the supervisor and report it later

    Confronting a suspected trafficker or attempting a rescue can endanger the victim and the crew. Give care, stay safe, and report through law enforcement or the trafficking hotline per protocol.

17. A 15-year-old girl you treat shows strong signs of being trafficked for sex. Regarding reporting, you should:

    1. A. Ask her permission before you report it
    2. B. Wait to report until she shows injuries
    3. C. Report it, as required for suspected child abuse
    4. D. Leave reporting to the hospital social worker
    Show answer

    Answer: C. Report it, as required for suspected child abuse

    A minor who may be trafficked is a victim of child abuse, and the mandated reporting duty applies whether or not she agrees. Follow your state's rules for reporting to child protective services or police.

18. A woman shows signs of labor trafficking. She is an adult with capacity, is not in immediate danger, and declines help. The best approach is to:

    1. A. Report it to police, since she cannot truly decide
    2. B. Tell her employer that she has asked you for some help
    3. C. Refuse to leave until she agrees to accept help
    4. D. Respect her choice and discreetly share the hotline
    Show answer

    Answer: D. Respect her choice and discreetly share the hotline

    Adults with capacity decide whether to accept help, unless local law or immediate danger requires otherwise. Offer the National Human Trafficking Hotline (1-888-373-7888) in a way that will not be found by her trafficker.

19. Workers at a restaurant live in the back room, the owner keeps their passports, and they say they owe him money for their travel. This pattern suggests:

    1. A. A legal work-sponsorship arrangement
    2. B. Labor trafficking through debt bondage
    3. C. A family-run business with live-in help
    4. D. Ordinary overtime and wage disputes
    Show answer

    Answer: B. Labor trafficking through debt bondage

    Holding passports, housing workers at the job, and an unpayable debt for travel or housing are hallmarks of labor trafficking. Legitimate employers do not keep workers' identity documents.

20. A suspected trafficking victim insists her trafficker 'loves her' and refuses to say anything against him. This is best understood as:

    1. A. A trauma bond, which is common in trafficking
    2. B. Proof that she is not a trafficking victim
    3. C. A sign that she is part of the trafficking
    4. D. A refusal that ends your duty to watch for signs
    Show answer

    Answer: A. A trauma bond, which is common in trafficking

    Victims often form trauma bonds with traffickers through cycles of abuse and affection, and many do not see themselves as victims. Denial does not rule out trafficking.

21. A month after you testified against a gang member, you receive threats while on duty from people who know your name. You should:

    1. A. Ignore them, since most threats come to nothing
    2. B. Confront the people making them to show strength
    3. C. Report the threats to your supervisor and police
    4. D. Stop wearing your name tag but tell no one else
    Show answer

    Answer: C. Report the threats to your supervisor and police

    Threats against EMS providers related to crimes or testimony should be reported to your agency and law enforcement, who can assess the risk and take protective steps. Handling it alone may leave you unprotected.

22. While you restrained a combative assault victim, he bit your forearm and broke the skin. After the call, you should first:

    1. A. Cover it and wait for redness
    2. B. Wash the bite and report the exposure
    3. C. Finish the shift and report it tomorrow
    4. D. Apply alcohol and keep working as usual
    Show answer

    Answer: B. Wash the bite and report the exposure

    A human bite that breaks the skin is a blood exposure and an infection risk. Wash it thoroughly, report it promptly, and be evaluated so post-exposure testing and treatment can start without delay.

23. After your crew is assaulted on a call, your agency holds an after-action review. Its main purpose is to:

    1. A. Decide which crew member was really at fault
    2. B. Prepare the criminal case against him
    3. C. Decide whether to discipline the crew
    4. D. Find lessons that make future calls safer
    Show answer

    Answer: D. Find lessons that make future calls safer

    After-action reviews look at what happened and what could be done differently, such as dispatch flags, staging, or training, to prevent future assaults. They are not meant to assign blame.

24. At the home of an infant boy who died suddenly, police are on the way. The mother asks to bathe and dress the baby first. You should:

    1. A. Help her bathe him so she can grieve
    2. B. Let her bathe the baby but not change him
    3. C. Gently ask her to wait and explain why
    4. D. Take the baby to the ambulance to dress him
    Show answer

    Answer: C. Gently ask her to wait and explain why

    The infant's condition and clothing are part of the death investigation that follows any sudden infant death, so gently ask her to wait and explain why, with compassion, and let her hold the baby if local policy allows. Helping her bathe him, even so she can grieve, removes evidence. Bathing the baby but not changing him still washes away findings. Taking the baby to the ambulance to dress him moves the body and alters the scene before investigators arrive.

25. A man shot himself in the head and is still alive. Police have already secured the handgun. While you treat him, you should avoid wiping or washing his hands mainly because they:

    1. A. May carry gunshot residue for police
    2. B. Would hide defensive wounds if washed
    3. C. Interfere with pulse oximetry when wet
    4. D. Could chill him and worsen his shock
    Show answer

    Answer: A. May carry gunshot residue for police

    Gunshot residue on the hands helps investigators decide whether he fired the weapon, which separates a suicide attempt from a homicide attempt, so leave his hands as they are unless care requires otherwise and tell police about anything you did to them. Washing would not hide defensive wounds, which are cuts and bruises you can still see and document. Wet hands do not interfere with pulse oximetry in a way that justifies washing, and a probe can go on another site. Keeping him warm matters, but drying the hands is not what drives shock; the hands are left alone to preserve evidence.