A community health nurse is preparing an in-service for staff to define the conditions of causation in epidemiology studies. Which of the following descriptions should the nurse use to define a cessation of exposure to establish causation?

Choice A: Make a Report to Child Protective Services (CPS)
This is the correct action for the nurse to take. Nurses are mandated reporters, meaning they are legally required to report any suspected cases of child abuse or neglect to the appropriate authorities. Child Protective Services (CPS) is the agency responsible for investigating reports of child abuse and ensuring the safety and well-being of children. Reporting to CPS ensures that the case is handled by professionals trained to investigate and intervene in such situations.

Choice B: Call the Police and Report the Suspected Abuse
While calling the police may seem like a logical step, it is not the primary action a nurse should take in this situation. The police may become involved later in the process, especially if there is an immediate threat to the child's safety. However, the initial report should be made to CPS, as they are the designated agency for handling child abuse cases.

Choice C: Call the Child's Guardian to Have the Child's Pediatrician Confirm the Suspected Abuse
This action is not appropriate because it could potentially place the child in further danger. If the guardian is the abuser, notifying them could lead to retaliation against the child or attempts to cover up the abuse. Additionally, it is not the role of the pediatrician to confirm abuse; this is the responsibility of CPS and law enforcement.

Choice D: Alert the School Principal of the Situation
While it is important to keep school officials informed, the nurse's primary responsibility is to report the suspected abuse to CPS. The school principal can be informed after the report has been made, but the immediate priority is to ensure the child's safety by contacting the appropriate authorities.

Choice A: "When the Exposure is Decreased or Eliminated, the Risk of Disease Declines or is Eliminated."
This statement accurately describes the concept of cessation of exposure in establishing causation. According to the Bradford Hill criteria, if a factor is truly causal, reducing or eliminating exposure to that factor should lead to a decrease in the incidence of the disease. This principle helps to confirm the causal relationship between the exposure and the disease.

Choice B: "The Exposure Must Come Before the Disease Develops."
This statement refers to the temporal relationship criterion in the Bradford Hill criteria, which states that for an exposure to be considered causal, it must precede the onset of the disease. While this is an important aspect of establishing causation, it does not specifically address the concept of cessation of exposure.

Choice C: "A Relationship is Biologically Possible, and it Makes Sense."
This statement pertains to the biological plausibility criterion, which suggests that the observed association between an exposure and a disease should be consistent with existing biological and medical knowledge. While biological plausibility is crucial for establishing causation, it does not directly relate to the cessation of exposure.

Choice D: "Increased Exposure Increases the Risk of Developing the Disease."
This statement describes the dose-response relationship, another criterion in the Bradford Hill framework. It indicates that a greater level of exposure to a risk factor should correspond to a higher risk of developing the disease. Although this is an important aspect of causation, it does not specifically address the cessation of exposure.