A nurse is reinforcing car seat safety instructions with the parents of a 15-month-old toddler. Which of the following statements by the parents indicates an understanding of the teaching?

Rationale:

A) Watching cartoons with peers may increase the risk of transmitting varicella- zoster virus to other children who may not be immune, as well as expose the child to potential infections from other sick children.

B) Pulling a wagon of stuffed animals in the hallway is too strenuous for a child with pneumonia.

C) Writing a letter to send to a friend may be an appropriate activity for a child with pneumonia, but it involves sitting still for an extended period, which may not be as beneficial as a more physically engaging activity.

D) Playing an alphabet flashcard game with the parent is appropriate for a 4-year-old child's cognitive development and does not require physical exertion or exposure to other children who might be susceptible to varicella zoster infection.

Rationale:

A. Spiral fractures are often associated with child abuse, especially when they occur in non-ambulatory infants or toddlers who can't generate enough force to cause such injuries themselves.

B. Bruises from a collision with furniture can be common in preschoolers, and there's no immediate indication of child maltreatment.

C. Head injuries from falls, especially during adolescence, are common and may not necessarily indicate child maltreatment.

D. While a black eye could be concerning, it's not necessarily indicative of child maltreatment and could be the result of a fight with a classmate.