A nurse is caring for a school-age child who has a fractured arm and other injuries that cause the nurse to suspect abuse. Which of the following actions is appropriate for the nurse to take when assessing the child's situation?
Direct the parents to the waiting room before interviewing the child.
Interview the child with the provider and social worker present.
Ask clarifying questions as the child explains how the injuries occurred.
Ask the parents directly if the child's fracture is due to physical abuse.
The Correct Answer is C
Choice A reason: Separating the child from the parents is appropriate, but interviewing the child alone may not be ideal. Having trained professionals present ensures proper documentation and support.
Choice B reason: Interviewing the child with the provider and social worker ensures a trauma-informed, multidisciplinary approach. It protects the child and ensures accurate assessment.
Choice C reason: Asking clarifying questions is acceptable, but the nurse must avoid leading or suggestive questioning. The presence of trained professionals helps maintain objectivity.
Choice D reason: Directly asking the parents may lead to denial or defensiveness. It is not the recommended approach in suspected abuse cases.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Checking blankets for safety is a routine and appropriate nursing action. It ensures the client’s well-being without breaching boundaries.
Choice B reason: Redirecting a client with gentle physical guidance is acceptable when done respectfully and for safety purposes. It does not constitute a boundary violation.
Choice C reason: Sharing personal emotional experiences with a client crosses professional boundaries. It shifts focus from the client’s needs and may blur therapeutic roles.
Choice D reason: Reminding a client about medication is part of routine care and does not involve personal disclosure or inappropriate behavior.
Correct Answer is C
Explanation
Choice A reason: Hospice care is intended for clients with terminal illnesses and focuses on end-of-life comfort, not caregiver relief for chronic conditions like dementia.
Choice B reason: Cognitive enhancement therapy is a structured intervention for clients, not a support service for caregivers needing rest. It does not address the caregiver’s immediate need for relief.
Choice C reason: Respite care provides temporary relief for caregivers by offering short-term care for the client. It can be delivered in-home, through adult day programs, or in residential settings, making it the most appropriate recommendation.
Choice D reason: Long-term psychiatric hospitalization is reserved for clients with severe psychiatric conditions requiring intensive treatment. It is not a resource for caregiver breaks and would be inappropriate unless the client had acute psychiatric needs.
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