A nurse in a family practice clinic is collecting data from a school-age child. Which of the following behavioral findings should the nurse identify as a possible indication of sexual abuse?

Choice A rationale:
A 2 cm scalp laceration, while a concern, is not the nurse's priority in this scenario. The child's head injury could potentially be serious, but priority should be given to neurological assessments and signs of increased intracranial pressure.
Choice B rationale:
Nasal discharge negative for glucose is not indicative of a major issue in this context. While cerebrospinal fluid (CSF) leaking from the nose after head trauma is a concern, it is not mentioned in this scenario, and this choice does not take precedence over other neurological signs.
Choice C rationale:
This is the correct answer. Asymmetric pupils can be a sign of a serious neurological issue, such as a brain injury or increased intracranial pressure. It requires immediate attention and further evaluation to assess the child's neurological status and determine the extent of the injury.
Choice D rationale:
A negative Babinski reflex is a normal finding in this context and does not require immediate priority attention. The Babinski reflex is typically present in infants and disappears as the child grows older. Its absence is expected in older children and adults.

Choice A rationale:
Hypertension is a common manifestation of acute glomerulonephritis. The inflammation of the glomeruli in the kidneys can lead to impaired filtration, causing fluid retention and an increase in blood pressure. Monitoring the child's blood pressure is crucial to assess the severity of the condition and guide appropriate interventions.
Choice B rationale:
Dehydration is not a typical manifestation of acute glomerulonephritis. In fact, this condition often leads to fluid retention due to impaired kidney function. The child might experience edema and hypertension rather than dehydration.
Choice C rationale:
Muehrcke lines on the nails are not associated with acute glomerulonephritis. Muehrcke lines are white lines that appear horizontally across the nails and are typically indicative of hypoalbuminemia, which is not a primary feature of glomerulonephritis.
Choice D rationale:
Hypokalemia, or low potassium levels, is not a characteristic manifestation of acute glomerulonephritis. This condition primarily affects the kidneys' ability to filter waste and excess fluid, leading to fluid retention, electrolyte imbalances, and hypertension.