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Providing long-term counseling for rape victims: While SANE nurses provide emotional support and crisis intervention during the exam, ongoing psychological counseling is outside their scope. Long-term counseling requires referral to mental health professionals.

Requiring HIV testing of a victim: A SANE nurse can offer HIV testing and provide information about prophylaxis, but they cannot force or require a victim to undergo testing. Consent and autonomy are critical in sexual assault care.

Encourage the victim to shower before the exam: A victim is specifically advised not to bathe, shower, or change clothes before evidence collection, as these actions may destroy or compromise forensic samples.

Benzodiazepines: These medications are primarily prescribed for anxiety disorders, insomnia, or seizure management. They work by enhancing the calming effects of GABA but do not improve focus, attention, or impulse control, which are the main concerns in ADHD.

Anxiolytics: Anxiolytic medications reduce anxiety and tension but are not used to treat ADHD symptoms. They do not target the neurotransmitter imbalances in dopamine and norepinephrine pathways that are implicated in ADHD.

Antipsychotics: These drugs are indicated for conditions such as schizophrenia, bipolar disorder, or severe behavioral disturbances. They may sometimes be used as adjuncts in children with severe aggression, but they are not the standard treatment for adult ADHD.

desire to be in control of people and situations: This describes aligns narcissistic or obsessive-compulsive personality traits, where control and dominance are more central. In borderline personality disorder, the primary relational issue is emotional instability.

tendency to be overly dependent on people to make decisions for them: This is more characteristic of dependent personality disorder. Clients with this disorder struggle with decision-making and rely heavily on others for guidance.

pervasive distrust and suspicion of the motives of others: This pattern is associated with paranoid personality disorder. While individuals with borderline personality disorder may at times misinterpret others’ intentions, chronic pervasive suspicion is not the defining feature.

"Exposure to environmental toxins is a contributing factor.": Somatic symptom disorder is not caused by exposure to toxins. Its development is more closely linked to psychological and emotional factors rather than environmental exposures.

"The symptoms reflect hypoarousal caused by chronic stress.": While stress can exacerbate somatic symptoms, the core mechanism in SSD is not hypoarousal. Instead, heightened attention and sensitivity to bodily sensations are more characteristic.

"The Symptoms reflect an internal preoccupation with events.": Clients with SSD are preoccupied with physical symptoms, not general events. Their focus is on the body and illness-related concerns rather than external happenings.

Eating disorders: While trauma can contribute to disordered eating in some individuals, eating disorders are not the most common psychiatric outcome following rape. They are more often linked to body image disturbances and control issues rather than sexual assault trauma.

Borderline personality disorder: This disorder is associated with emotional instability, impulsivity, and unstable relationships. Although childhood trauma and abuse can be risk factors, rape itself is more strongly associated with acute stress and PTSD.

Delirium: Delirium is an acute and fluctuating disturbance in attention and cognition, typically caused by medical illness, intoxication, or withdrawal. It is not a psychiatric disorder linked to psychological trauma such as rape.

Cognitive style: Assessing a client’s cognitive style can provide insight into thought patterns, but it is not the most critical priority here. The client’s emphasis on pain behaviors and dependency signals a need to evaluate potential external benefits of the symptoms.

Identity and memory: This type of assessment is more appropriate for dissociative disorders, where clients may have amnesia, depersonalization, or fragmented identity. In somatic symptom disorder, identity and memory disturbances are not the central concern.

Mood: Mood assessment is always valuable since depression and anxiety often coexist with SSD. However, the client’s focus on pain relief and family caregiving suggests that identifying secondary gains will be the most relevant assessment to guide interventions.

Illness anxiety disorder: This condition involves excessive worry about having or developing a serious illness, despite minimal or no physical symptoms. The motivation is fear and anxiety about health, not intentional injury to gain financial or external benefits.

Functional neurologic symptom disorder: This involves neurological symptoms such as paralysis or blindness that cannot be explained by medical conditions. The symptoms are not intentionally produced, making it different from deliberate self-injury for gain.

Factitious disorder imposed on another: This condition occurs when a caregiver deliberately produces or falsifies illness in someone else, to assume the sick role by proxy. It does not fit the client’s situation of self-injury for personal financial advantage.

Seizures: Flunitrazepam is a benzodiazepine with sedative and amnestic properties, and it is not typically associated with causing seizures. Benzodiazepines are more often used to control seizures rather than provoke them.

Hypotonia: Muscle relaxation and decreased tone may occur as a side effect, but hypotonia is not life-threatening compared to the danger of suppressed respiratory function. It is important but not the priority concern.

Coma: Severe CNS depression can progress to coma, but respiratory depression usually precedes this complication. Monitoring and managing breathing is therefore the priority intervention to prevent further deterioration.

Pulse rate 60 beats/min: A heart rate of 60 is at the lower end of normal. Although bradycardia is common in anorexia, this value alone does not require immediate hospitalization unless it drops below 40–50 beats/min with symptoms.

Serum potassium 3.7 mEq/L: This potassium level is within the normal range (3.5–5.0 mEq/L). Electrolyte disturbances, particularly hypokalemia, are common in anorexia but this value does not indicate urgent medical instability.

Urine output 40 mL/hr: This output is considered adequate, as the minimum acceptable urine output is 30 mL/hr. It suggests that renal perfusion is currently maintained and does not independently warrant hospitalization.

Peripheral edema: Edema can occur in cases of severe malnutrition or fluid imbalance, but it is not a typical or hallmark finding in bulimia nervosa. It is more associated with refeeding syndrome or severe hypoalbuminemia in other eating disorders.

Thin, brittle hair: Hair changes such as brittleness or thinning are more common in anorexia nervosa due to prolonged nutritional deficiencies. While bulimia may cause some nutritional effects, this is not the most characteristic physical finding.

Amenorrhea: Menstrual irregularities, including amenorrhea, are more commonly linked with anorexia nervosa due to low body fat and hormonal suppression. Bulimia patients often maintain a normal or near-normal body weight, making amenorrhea less consistent.