A nurse at a community clinic is conducting a well-child visit with a preschool-age child.
The nurse should identify which of the following as a possible indication of child neglect.
Genital irritation.
Healing spiral fracture of the arm.
Underweight and poor hygiene.
Burns on palms of the hands.
The Correct Answer is C
Choice A rationale
Genital irritation might indicate sexual abuse, which is a form of child maltreatment distinct from neglect, or it could result from poor hygiene, an indication of neglect. Therefore, while possibly related to neglect, irritation alone is a more direct indicator of sexual abuse or a general health issue requiring further investigation and is not the most definitive sign of neglect among the options.
Choice B rationale
A healing spiral fracture of the arm is a non-accidental injury with a suspicious mechanism, suggesting a twisting force commonly associated with physical abuse, rather than neglect, which involves failure to provide basic needs. Neglect might lead to fractures from accidents due to lack of supervision, but a spiral fracture is highly suggestive of inflicted trauma.
Choice C rationale
Underweight suggests a persistent failure to provide adequate nutrition, a core component of physical neglect. Poor hygiene, such as unwashed clothes or body odor, indicates a failure to provide for basic cleanliness needs, also a key indicator of physical neglect. These two findings together are the most direct and classic indications of child neglect among the choices.
Choice D rationale
Burns on the palms of the hands are often inflicted injuries, specifically contact or immersion burns, that are highly characteristic of physical abuse. Neglect might involve a failure to protect a child from an accidental burn, but the specific location on the palms suggests a forced contact or holding the hand in a hot liquid, strongly indicating abuse.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Respect for autonomy is the ethical principle that obligates healthcare providers to acknowledge and honor an individual's right to self-determination. This means clients have the fundamental right to make informed decisions about their own healthcare, including accepting or refusing treatment, provided they have the capacity to do so.
Choice B rationale
Distributive justice is the ethical principle concerned with the fair allocation of scarce resources and ensuring that benefits and burdens are distributed equitably across society. It addresses questions of fairness in healthcare access and resource allocation among populations, not individual self-determination.
Choice C rationale
Nonmaleficence is the core ethical principle to "do no harm.”. It obligates healthcare providers to refrain from actions that could intentionally or unintentionally cause injury or suffering to the client, forming a foundational duty in all medical and nursing practice.
Choice D rationale
Paternalism is an action taken for a client's benefit without their consent, often overriding their autonomous choices because the provider believes they know what is best. This concept is typically viewed as a violation of the principle of respect for autonomy, not a principle that honors it.
Correct Answer is D
Explanation
Choice A rationale
Identifying the names of infected people (case finding) is a crucial step that follows confirmation of an outbreak, as part of surveillance and investigation, but it is not the first priority when an unconfirmed rumor exists, which requires initial validation.
Choice B rationale
Implementing a plan for control is a primary objective of the overall response. However, implementing control measures is premature and potentially misdirected if the existence of the outbreak has not been officially confirmed through initial epidemiological investigation.
Choice C rationale
Formulating and testing hypotheses about causative factors (e.g., agent, source, transmission mode) is the next major analytical phase of an outbreak investigation, following the initial verification and description of the outbreak's existence and characteristics.
Choice D rationale
The first and most prioritized step in a public health investigation is outbreak verification, which involves establishing a clear case definition and finding out if the rumored event exists by checking surveillance data or consulting public health authorities.
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