A nurse is reviewing the medical records of a 4-year-old child who has been diagnosed with failure to thrive. The nurse notes that the child has been hospitalized several times for pneumonia and diarrhea. The nurse also observes that the child is withdrawn and does not interact with other children or staff. The nurse suspects that the child may be suffering from:

Physical abuse

Sexual abuse

Emotional abuse

Neglect

Answer and Explanation

The Correct Answer is D

The correct answer is D. Neglect is the failure to provide for a child’s basic physical, emotional, educational, or medical needs. Examples include inadequate food, clothing, shelter, supervision, affection, education, or health care for a child. Failure to thrive is a condition characterized by poor growth and development due to inadequate nutrition and stimulation. It can be caused by neglect as well as other factors such as organic diseases or genetic disorders. Frequent infections and social withdrawal are also signs of neglect.

Choice A Reason: Physical abuse is the intentional use of physical force against a child that results in or has a high likelihood of resulting in harm to the child’s health, survival, development, or dignity. Examples include hitting, kicking, shaking, burning, or poisoning a child. Failure to thrive is not a specific sign of physical abuse, although it may be present in some cases.

Choice B Reason: Sexual abuse is the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent. Examples include fondling, penetration, exposure to pornography, or prostitution of a child. Failure to thrive is not a sign of sexual abuse, although they may affect the child's sexual health and development.

Choice C Reason: Emotional or psychological abuse is the intentional or unintentional acts or omissions that cause or have a high probability of causing harm to a child’s emotional development or self-esteem. Examples include humiliation, threats, isolation, rejection, or belittling a child. Failure to thrive is not a sign of emotional abuse, although it may affect the child's mental health and well-being.

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Correct Answer is ["A","B","C","E"]

Explanation

Choice A Reason: Sexual abuse can involve non-contact activities such as exposure to pornography¹. This can be harmful to the child's sexual development and self-image.

Choice B Reason: Emotional abuse can be unintentional due to parental stress or mental illness¹. This does not excuse the behavior, but it may explain why some parents act in ways that hurt their children emotionally.

Choice C Reason: Neglect can be classified into physical, emotional, educational, and medical subtypes¹. Each subtype refers to the failure to provide for a specific aspect of the child's needs.

Choice D Reason: Physical abuse can occur even when there is no intention to harm the child³. For example, some parents may use excessive force or discipline methods that are inappropriate for the child's age or condition.

Choice E Reason: All types of maltreatment can have negative effects on the child's development and well-being¹. The effects may vary depending on the type, severity, frequency, duration, and context of the maltreatment.

A. Post-traumatic stress disorder B. Depression C. Substance abuse D. Eating disorders E. All of the above

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

Explanation

Choice A Reason: Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event, such as sexual abuse. Symptoms of PTSD include re-experiencing the trauma through flashbacks, nightmares, or intrusive thoughts; avoiding reminders of the trauma; feeling numb or detached; and having increased arousal, such as being easily startled, irritable, or hypervigilant.

Choice B Reason: Depression is a mood disorder that causes persistent feelings of sadness, hopelessness, and loss of interest in activities that were once enjoyable. Symptoms of depression include low mood, low self-esteem, guilt, worthlessness, fatigue, insomnia or hypersomnia, appetite changes, weight changes, difficulty concentrating, and suicidal thoughts or behaviors.

Choice C Reason: Substance abuse is the harmful use of alcohol, drugs, or other substances that impair one's physical or mental health or social functioning. Substance abuse can be a coping mechanism for some survivors of sexual abuse, as they may use substances to numb their pain, escape their reality, or self-medicate their symptoms.

Choice D Reason: Eating disorders are serious mental health conditions that involve abnormal eating behaviors and attitudes toward food and body weight. Eating disorders can be triggered by sexual abuse, as survivors may develop distorted body image, low self-esteem, shame, guilt, or a sense of loss of control over their lives. Eating disorders can include anorexia nervosa (restricting food intake to achieve extreme thinness), bulimia nervosa (binging on large amounts of food and then purging through vomiting, laxatives, or exercise), binge eating disorder (binging on large amounts of food without purging), or other specified feeding or eating disorder (OSFED) (having symptoms of an eating disorder that do not meet the full criteria for any specific diagnosis).

Choice E Reason: All of the above are possible signs and symptoms of sexual abuse in children and adolescents. However, not all survivors of sexual abuse will develop these conditions, and not all people with these conditions have experienced sexual abuse. Therefore, it is important to assess each individual case holistically and provide appropriate support and referrals as needed.

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Naxlex Comprehensive Predictor Exams

A nurse is educating a group of parents about the types and signs of child maltreatment. The nurse asks the parents to select all that apply from the following statements:

Correct Answer is ["A","B","C","E"]

Explanation

A nurse is counseling a teenage girl who has disclosed that she was sexually abused by her uncle when she was younger. The nurse should assess the girl for possible signs and symptoms of:

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

Explanation

A nurse is caring for a child who has been admitted to the hospital for severe malnutrition and dehydration. The nurse learns that the child's parents are unemployed and homeless. The nurse suspects that the child is a victim of:

A nurse is assessing a child who has been brought to the emergency department by his mother. The nurse notices multiple bruises on the child's arms and legs, some of which are in different stages of healing. The nurse suspects that the child is a victim of:

A nurse is educating a group of parents about the risk factors and consequences of child abuse and neglect. Which of the following statements by the parents indicate a need for further teaching? (Select all that apply.)

A nurse is providing education to a group of school teachers on how to identify and report suspected cases of child maltreatment. The nurse explains that some of the common indicators of sexual abuse in children are:

A nurse is conducting a home visit for a family that has a history of child maltreatment. The nurse observes that the house is cluttered and dirty, the refrigerator is empty, and the parents are arguing loudly in front of their children. The nurse should document this as an example of: