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Free SANE-A Practice Questions

10 free, exam-style SANE-A (SANE-A) practice questions with answers and explanations. No signup required. Work through them below, then take the full free SANE-A practice test to study every exam domain.

Question 1

A 27-year-old patient presents 60 hours after a reported vaginal sexual assault. Colposcopic examination, including toluidine blue dye application, reveals no anogenital injuries. How should the SANE interpret this finding?

  1. The lack of injury indicates the reported penetration most likely did not occur as described
  2. Repeating the examination in 48 hours will allow any developing injuries to become visible
  3. Absence of anogenital injury is expected in most cases and does not exclude sexual assault
  4. Reapplying toluidine blue dye is warranted because the first application was likely ineffective
Show answer & explanation

Correct answer: C - Absence of anogenital injury is expected in most cases and does not exclude sexual assault

Question 2

A SANE is providing prophylaxis to an adult patient following a sexual assault that involved both vaginal and anal penetration. Which regimen is the preferred choice for chlamydia prophylaxis under current CDC guidance?

  1. Azithromycin 1 g orally once, which is preferred because it covers all anatomic sites
  2. Doxycycline 100 mg orally twice daily for 7 days, now the preferred chlamydia regimen
  3. Ciprofloxacin 500 mg orally once, providing reliable single-dose coverage for chlamydia
  4. Amoxicillin 500 mg orally three times daily for 7 days, the standard chlamydia therapy
Show answer & explanation

Correct answer: B - Doxycycline 100 mg orally twice daily for 7 days, now the preferred chlamydia regimen

Question 3

A patient arrives approximately 5 hours after a suspected drug-facilitated sexual assault, reporting that she consumed one drink but has no memory of several hours afterward. Which evidence collection step is the MOST time-sensitive priority?

  1. Collect a blood specimen first to establish the patient's baseline blood alcohol level
  2. Obtain vaginal swabs first, before the patient is permitted to empty her bladder
  3. Document the patient's account of the memory loss in thorough narrative detail first
  4. Collect urine in a sodium fluoride tube first, because GHB is cleared within hours
Show answer & explanation

Correct answer: D - Collect urine in a sodium fluoride tube first, because GHB is cleared within hours

Question 4

A patient reports she was strangled with both hands during the assault. She has no visible marks on her neck but reports that her voice has been hoarse since the attack. What is the MOST appropriate action?

  1. Reassuring her that the absence of external marks means no serious injury has occurred
  2. Documenting a normal neck examination and proceeding with routine evidence collection
  3. Arranging urgent medical evaluation, since serious injury can occur without visible marks
  4. Applying a cervical collar and re-examining the neck after one hour of observation
Show answer & explanation

Correct answer: C - Arranging urgent medical evaluation, since serious injury can occur without visible marks

Question 5

During the history, a patient states that she could not move or call out during the assault even though she wanted to resist. How should the SANE understand and document this report?

  1. The patient is most likely minimizing the degree to which she physically resisted
  2. A normal neurobiological response to overwhelming threat that does not imply consent
  3. A dissociative disorder that warrants immediate inpatient psychiatric admission today
  4. A strong indication that the sexual encounter was most likely consensual in nature
Show answer & explanation

Correct answer: B - A normal neurobiological response to overwhelming threat that does not imply consent

Question 6

The SANE is preparing to insert a speculum to collect vaginal and cervical swabs for the evidence kit. Which lubricant should be used during this portion of the examination?

  1. Sterile water, because standard lubricants can interfere with DNA evidence analysis
  2. Water-based surgical lubricant, applied sparingly to ease insertion of the speculum
  3. A small amount of petroleum jelly, which provides longer-lasting speculum lubrication
  4. Lidocaine gel, to reduce the patient's discomfort during the speculum examination
Show answer & explanation

Correct answer: A - Sterile water, because standard lubricants can interfere with DNA evidence analysis

Question 7

A patient weighing approximately 200 lb (91 kg) presents 80 hours after a sexual assault involving vaginal ejaculation. Her urine pregnancy test is negative and she requests emergency contraception. Which option is MOST appropriate?

  1. Levonorgestrel 1.5 mg, since the patient is still within the 120-hour treatment window
  2. No emergency contraception, because none remains effective once 72 hours have elapsed
  3. Referral to gynecology, because prescribing emergency contraception is outside her role
  4. Ulipristal acetate, which stays effective later in the window and at higher body weight
Show answer & explanation

Correct answer: D - Ulipristal acetate, which stays effective later in the window and at higher body weight

Question 8

While testifying as an expert witness, a SANE is asked by the prosecutor whether she believes the patient was telling the truth. Which response is MOST appropriate and within the SANE's professional role?

  1. "In my professional opinion, the patient was truthful about what happened to her"
  2. "My examination findings are consistent with the history the patient provided to me"
  3. "The injuries that I documented prove that a sexual assault did in fact take place"
  4. "Based on my clinical experience, I found this patient to be a very credible witness"
Show answer & explanation

Correct answer: B - "My examination findings are consistent with the history the patient provided to me"

Question 9

A detective arrives to collect the sealed sexual assault evidence kit. He is in a hurry and asks the SANE to hand it over immediately, saying he will complete the paperwork later. What should the SANE do?

  1. Releasing the kit now and documenting the details of the transfer in the record after
  2. Releasing the kit, because law enforcement has legal authority over collected evidence
  3. Declining to release the kit until the chain-of-custody form is completed and signed
  4. Contacting the hospital attorney to authorize the release before handing over the kit
Show answer & explanation

Correct answer: C - Declining to release the kit until the chain-of-custody form is completed and signed

Question 10

A 15-year-old patient discloses a sexual assault and asks the SANE not to report it to anyone because she does not want her parents or the police involved. What is the SANE's obligation?

  1. Honoring the patient's request for privacy, since she is the person who was assaulted
  2. Reporting only in the event that the patient's parents independently agree to a report
  3. Documenting the patient's wishes and deferring the reporting decision entirely to her
  4. Reporting to the appropriate authorities, as required by law when the patient is a minor
Show answer & explanation

Correct answer: D - Reporting to the appropriate authorities, as required by law when the patient is a minor

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