A nurse on a pediatric clinic is collecting data from a school-age child and their parent. Which of the following findings should the nurse Identify as an indication of potential maltreatment?

The child expresses a fear of failing in school.

The child has symmetric burns on the feet.

The child missed a dental cleaning the previous week.

The child has bruises on the right shin.

Answer and Explanation

The Correct Answer is B

Child maltreatment refers to any form of physical, emotional, sexual abuse, or neglect that results in harm or potential harm to a child. Nurses must carefully assess for injury patterns that are inconsistent with normal childhood activities or accidental trauma. Certain physical findings, such as patterned injuries or burns in unusual locations, raise strong suspicion of non-accidental injury. Early recognition is critical to ensure child safety and initiate appropriate protective interventions.

Rationale:
A. A child expressing fear of failing in school reflects emotional concerns that are developmentally appropriate and commonly seen in school-age children. While anxiety about academic performance may require support, it is not an indicator of maltreatment. This finding alone does not suggest abuse or neglect.

B. Symmetric burns on the feet are highly suspicious for non-accidental injury because they suggest forced immersion in hot liquid or deliberate contact rather than accidental exposure. In cases of suspected Child abuse, burn patterns that are uniform, bilateral, or have clear demarcation lines strongly indicate inflicted injury and require immediate reporting and investigation.

C. Missing a dental cleaning is a minor healthcare lapse and does not independently indicate maltreatment. Occasional missed appointments may occur due to scheduling, transportation, or parental oversight. It does not constitute evidence of abuse or neglect.

D. Bruises on the right shin are common in school-age children due to normal play, sports, and accidental bumps. Location on bony prominences such as shins is typical for accidental bruising. In the absence of other concerning findings or inconsistent history, this is not strongly indicative of maltreatment.

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Correct Answer is D

Explanation

Postoperative pain management is a key component of recovery, as uncontrolled pain can impair breathing, mobility, and overall healing. Effective analgesia supports early ambulation, reduces physiological stress responses, and decreases the risk of complications such as atelectasis and venous thromboembolism. Education should help the client understand that pain control is not a sign of weakness but a therapeutic measure that improves outcomes following procedures such as an Postoperative surgical procedure. Nurses should encourage timely reporting of pain rather than allowing it to escalate.

Rationale:
A. Suggesting that most people can manage without pain medication may discourage appropriate use of analgesics and promote underreporting of pain. Pain experiences vary widely, and minimizing the need for medication can lead to inadequate pain control and delayed recovery. This response does not provide accurate education or support optimal postoperative care.

B. Advising the client to wait until pain reaches 8 or higher is unsafe because severe pain is harder to control and may lead to unnecessary suffering. Waiting until pain is extreme can increase sympathetic stress responses, delay mobility, and reduce effectiveness of analgesics. Pain should be managed proactively at lower levels rather than after escalation.

C. Telling the client to rate pain as a 4 when it interferes with movement is incorrect because pain scales are subjective and individualized. The nurse should not assign arbitrary thresholds for pain reporting. Instead, clients should be encouraged to report pain when it begins to interfere with function or comfort, without imposing specific numeric targets.

D. Stating that short-term pain management promotes healing and prevents complications is correct because adequate analgesia improves ventilation, mobility, and circulation. Effective pain control reduces stress hormone release and supports participation in recovery activities such as deep breathing and ambulation. This promotes faster recovery and lowers risk of postoperative complications.

A. Encourage the client to use the overbed trapeze. B. Maintain abduction of the client's residual limb with a pillow. C. Caution the client to avoid a prone position while in bed. D. Keep a loose, absorbent dressing over the client's surgical site.

Correct Answer is A

Explanation

Postoperative care following an above-the-knee amputation focuses on pain control, prevention of contractures, wound healing, and early mobility to promote functional independence. Early rehabilitation is essential to prepare the residual limb for prosthetic fitting and long-term mobility. Interventions that enhance upper body strength and facilitate repositioning are key components of recovery. Proper positioning and wound care are also important to prevent complications such as contractures and infection in clients recovering from an Above-the-knee amputation.

Rationale:
A. Encouraging the use of an overbed trapeze promotes upper body strength, independence in repositioning, and early mobility. It allows the client to assist in turning, transferring, and performing activities of daily living, which are critical for rehabilitation after amputation. Strengthening the upper extremities supports future use of assistive devices and prosthetic training.

B. Maintaining abduction of the residual limb with a pillow is incorrect because it increases the risk of hip flexion contractures. Prolonged flexion or improper positioning can interfere with prosthetic fitting and long-term mobility. The residual limb should be positioned in neutral alignment rather than abducted with a pillow.

C. Cautioning the client to avoid a prone position is incorrect because prone positioning is actually recommended to prevent hip flexion contractures. Regular prone positioning helps maintain hip extension and preserves proper alignment of the residual limb. Avoiding this position may increase the risk of long-term mobility limitations.

D. Keeping a loose, absorbent dressing over the surgical site is appropriate for wound care but does not directly promote independence or mobility. While proper dressing management is essential for infection prevention and drainage control, it does not contribute significantly to functional rehabilitation goals compared to mobility-enhancing interventions.

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A nurse on a pediatric clinic is collecting data from a school-age child and their parent. Which of the following findings should the nurse Identify as an indication of potential maltreatment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching about the importance of pain management with a client who is postoperative. The client states, "I'm pretty tough and can take a lot of pain." Which of the following responses should the nurse make?

Correct Answer is D

Explanation

A nurse is caring for a client who is 2 days postoperative following an above-the-knee amputation. Which of the following actions should the nurse take to promote progression toward independence and mobility for the client?

Correct Answer is A

Explanation

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