A nurse is assessing a 3-year-old boy who was brought to the emergency department by his grandmother. The grandmother states that she noticed some bruises on his back when she was bathing him. She says that she does not know how he got them, but she suspects that his mother's boyfriend might have hit him. The nurse observes several linear bruises on his lower back that are consistent with belt marks. Which of the following questions should the nurse ask the boy?

"Did your mother's boyfriend hit you with a belt?"

"How did you get these bruises on your back?"

"Who takes care of you when your mother is not home?"

"Do you like your mother's boyfriend?"

Answer and Explanation

The Correct Answer is B

Choice A Reason: This question is not appropriate because it is leading and suggestive. It may influence or distort the boy's response by implying that his mother's boyfriend hit him with a belt.

Choice B Reason: This question is appropriate because it is open-ended and neutral. It allows the boy to describe his experience in his own words without imposing any assumptions or expectations.

Choice C Reason: This question is not appropriate because it is not directly related to the boy's bruises. It may be relevant to assess his living situation and caregivers, but it does not address the cause of his injury.

Choice D Reason: This question is not appropriate because it is not directly related to the boy's bruises. It may be relevant to assess his relationship with his mother's boyfriend, but it does not address the cause of his injury.

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Correct Answer is ["B","C","D"]

Explanation

Choice A Reason: Bruises on the knees and elbows are common in children who are active and fall frequently. They are not necessarily indicative of abuse, unless they are in various stages of healing or have a pattern that suggests intentional injury.

Choice B Reason: A spiral fracture is caused by twisting or rotating force, which is unlikely to occur accidentally in children. It is a common sign of physical abuse, especially when there is no plausible explanation for the injury.

Choice C Reason: A burn mark in the shape of a cigarette is a clear evidence of intentional harm. It indicates that the child was exposed to a hot object, such as a cigarette, by the abuser.

Choice D Reason: A subdural hematoma is a collection of blood between the brain and the skull, which can result from blunt force trauma to the head. It is a serious and potentially life-threatening condition that requires immediate medical attention. If the child has no history of head trauma, such as a fall or an accident, it suggests that he was hit or shaken by the abuser.

Choice E Reason: A bite mark on the shoulder that matches the child's own dental impression is not indicative of abuse. It may be a result of self-injury, anxiety, or curiosity. However, if the bite mark matches someone else's dental impression, it should be reported as a sign of abuse.

A. Risk for infection related to inadequate nutrition and hygiene. B. Impaired social interaction related to low self-esteem and isolation. C. Delayed growth and development related to environmental deprivation. D. Ineffective coping related to lack of parental support and guidance.

Correct Answer is C

Explanation

Choice A Reason: This nursing diagnosis may be applicable for this child, but it is not the most appropriate one. Risk for infection is a potential problem that may or may not occur, whereas delayed growth and development is an actual problem that has already occurred.

Choice B Reason: This nursing diagnosis may be applicable for this child, but it is not the most appropriate one. Impaired social interaction is a psychosocial problem that may affect the child's emotional and mental well-being, whereas delayed growth and development is a physiological problem that affects the child's physical and cognitive well-being.

Choice C Reason: This nursing diagnosis is the most appropriate one for this child, because it reflects the main problem that he is facing. Delayed growth and development is a physiological problem that results from inadequate stimulation, nutrition, health care, and education in the child's environment. It can affect the child's physical, cognitive, language, motor, and social skills.

Choice D Reason: This nursing diagnosis may be applicable for this child, but it is not the most appropriate one. Ineffective coping is a psychosocial problem that may affect the child's emotional and mental well-being, whereas delayed growth and development is a physiological problem that affects the child's physical and cognitive well-being.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a child who is suspected of being physically abused by his father. Which of the following findings should the nurse report as possible indicators of abuse? (Select all that apply.)

Correct Answer is ["B","C","D"]

Explanation

A nurse is caring for an 8-year-old boy who has been neglected by his father. The nurse observes that the boy is underweight, has poor hygiene, and shows signs of developmental delay. Which of the following nursing diagnoses is most appropriate for this child?

Correct Answer is C

Explanation

A nurse is caring for a child who has been neglected by his parents. The nurse notices that the child is malnourished, dirty, and withdrawn. Which of the following statements by the nurse is appropriate to establish rapport with the child?

A nurse is reviewing the legal and ethical obligations of reporting suspected or confirmed cases of child abuse and neglect. Which of the following information should the nurse include in the review?

A nurse is providing education to a group of parents about preventing child sexual abuse. Which of the following statements should the nurse include? (Select all that apply.)

A nurse is assessing a child who is suspected of being physically abused by his father. Which of the following findings should the nurse report to the child protective services as a possible indicator of abuse?

A nurse is working in a pediatric clinic and suspects that a 6-year-old girl who comes for a routine check-up is being emotionally abused by her mother. Which of the following actions should the nurse take? (Select all that apply.)

A nurse is interviewing a child who is suspected of being sexually abused by his uncle. The nurse notices that the child is avoiding eye contact, fidgeting with his hands, and giving vague answers. Which of the following statements should the nurse make to encourage the child to talk?