Physical Abuse
A 3-year-old child is brought to the emergency department with a fractured arm. The caregiver reports that the child fell off a couch. The nurse notices several bruises in different stages of healing. What is the nurse's best action?
A. Accept the caregiver's explanation.
B. Report suspected child abuse and document the findings.
C. Ask the caregiver to leave immediately.
D. Wait for the physician to confirm abuse before reporting.
B. Report suspected child abuse and document the findings.
Rationale: A serious injury with an inconsistent or questionable explanation and bruises in different stages of healing raises concern for physical abuse. The nurse must report reasonable suspicion and document objective findings.
A nurse suspects child maltreatment. Which documentation by the nurse is most appropriate?
A. "Child appears to be abused by mother."
B. "Mother is neglectful and does not care for child."
C. "Three circular bruises measuring approximately 2 cm noted on the child's upper back."
D. "Parent gave an unbelievable explanation for injuries."
C. "Three circular bruises measuring approximately 2 cm noted on the child's upper back."
Rationale: Documentation must be objective, factual, and specific. Include the location, size, color, and appearance of injuries. Document statements using the child's or caregiver's exact words when possible.
Which behavior may indicate emotional abuse in a child?
A. The child enjoys playing alone.
B. The child demonstrates extreme fear of making mistakes and has very low self-esteem.
C. The child occasionally refuses to eat vegetables.
D. The child cries when separated from a parent.
B. The child demonstrates extreme fear of making mistakes and has very low self-esteem.
Rationale: Emotional abuse includes behaviors such as constant humiliation, rejection, threats, intimidation, and verbal degradation. Children may develop low self-esteem, anxiety, depression, or behavioral problems.
A nurse is caring for a child who discloses abuse by a caregiver. The caregiver is currently in the waiting room. What should the nurse do?
A. Send the child home with the caregiver.
B. Ensure the child is in a safe environment and initiate protective procedures.
C. Ask the child to confront the caregiver.
D. Wait until the next shift to report the incident.
B. Ensure the child is in a safe environment and initiate protective procedures.
Rationale: The nurse must prioritize immediate safety. The child should not be released into a potentially unsafe situation until appropriate protective arrangements have been made according to facility policy.
Which findings may indicate child neglect? Select all that apply.
A. Frequent hunger.
B. Untreated medical conditions.
C. Poor hygiene.
D. Consistently missing school.
E. Popular clothing and accessories.
A. Frequent hunger.
B. Untreated medical conditions.
C. Poor hygiene.
D. Consistently missing school.
Rationale: Neglect involves failure to meet a child's basic physical, emotional, medical, or supervisory needs. Popular clothing and accessories are not signs of neglect.