A nurse is assessing a child who is brought to the emergency department with multiple bruises and fractures. The nurse suspects that the child is a victim of physical abuse. Which of the following actions should the nurse take first?

Choice A Reason: Telling the child that the nurse will not tell anyone what the child says is an inappropriate statement that the nurse should avoid, as it implies that the nurse is hiding something and may break the trust and rapport with the child. The nurse should also inform the child that some information may need to be shared with other professionals who can help the child.

Choice B Reason: Telling the child that the child did nothing wrong and is not to blame for what happened is an appropriate statement that the nurse should include in the therapeutic communication with the child, as it helps to reduce guilt and shame and restore self-esteem and self-worth. However, it is not the most likely statement to elicit a response from the child, as it may be too direct or confrontational for a child who is reluctant to talk and appears fearful.

Choice C Reason: Telling the child that the child is safe and no one can hurt the child anymore is an appropriate statement that the nurse should include in the therapeutic communication with the child, as it helps to reduce anxiety and fear and promote a sense of security and safety. However, it is not the most likely statement to elicit a response from the child, as it may be too reassuring or unrealistic for a child who is reluctant to talk and appears fearful.

Choice D Reason: Praising the child for being brave and expressing pride for talking to the nurse is an appropriate statement that the nurse should include in the therapeutic communication with the child, as it helps to increase confidence and motivation and encourage further disclosure. It is also the most likely statement to elicit a response from the child, as it acknowledges the difficulty and courage of talking about abuse and shows respect and appreciation for the child's efforts.

Choice A Reason: Reporting the suspected abuse to the appropriate authorities is an important action that the nurse should take, but it is not the first priority. The nurse should first ensure the safety and comfort of the child.

Choice B Reason: Documenting the findings and interventions in the medical record is an essential action that the nurse should take, but it is not the first priority. The nurse should first ensure the safety and comfort of the child.

Choice C Reason: Providing emotional support and reassurance to the child is the first action that the nurse should take, as it helps to establish trust and rapport with the child, reduce anxiety and fear, and prevent further psychological trauma.

Choice D Reason: Obtaining a detailed history of the injuries from the child and the caregiver is a necessary action that the nurse should take, but it is not the first priority. The nurse should first ensure the safety and comfort of the child.