A school nurse is examining a child who has a toothache and bruises on both knees.
Which of the following observations should the nurse report as a potential sign of maltreatment at home?

The child is receiving free lunches at school.

The child has recently started experiencing urinary incontinence.

The child has a history of frequent absences from school.

The child appears to be underweight for their age.

Answer and Explanation

The Correct Answer is C

Choice A rationale

While receiving free lunches at school may indicate a low-income status, it does not necessarily suggest maltreatment at home. Many schools offer free or reduced-price lunches to students from low-income families to ensure they receive proper nutrition.

Choice B rationale

Urinary incontinence in a child could be due to various reasons, including medical conditions or stress. While it could potentially be a sign of maltreatment, it is not a definitive indicator and would need to be evaluated in the context of other signs and symptoms.

Choice C rationale

Frequent absences from school can be a potential sign of maltreatment at home. Children who are being maltreated may be kept home to hide physical signs of abuse, or they may be truant due to a lack of parental supervision or a chaotic home environment.

Choice D rationale

Being underweight for their age could be a sign of neglect, one form of maltreatment. However, it could also be due to a variety of other factors, including medical conditions or poor nutrition, and should be evaluated in the context of other signs and symptoms.

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Correct Answer is B

Explanation

The correct answer is Choice B

Choice A rationale: Referring the client to a diabetes mellitus support group is beneficial but not the initial action. The nurse should first gather information about the client's preferences and needs to tailor the intervention effectively.

Choice B rationale: Identifying the client's dietary preferences is essential for developing a personalized nutritional plan. Understanding the client's likes, dislikes, and cultural factors ensures that dietary recommendations are realistic and sustainable, promoting better adherence and management of diabetes.

Choice C rationale: Developing a nutritional program is a crucial step but should follow the assessment of the client's dietary preferences. A personalized approach based on the client's individual needs and lifestyle is necessary for effective diabetes management.

Choice D rationale: Teaching the client about appropriate food choices is important but should be done after understanding the client's dietary preferences. This ensures that the education is relevant and practical, helping the client make informed decisions about their diet

A. Request a referral for a social worker. B. Discuss the client’s wishes with their provider. C. Ask the client why they do not want to continue treatment. D. Instruct the client that they need to change their advance directives first.

Correct Answer is C

Explanation

Choice A rationale

Requesting a referral for a social worker may be beneficial in some cases, but it is not the most appropriate initial response. The nurse should first seek to understand the client’s feelings and concerns.

Choice B rationale

Discussing the client’s wishes with their provider is important, but it should come after understanding the client’s perspective. The nurse should respect the client’s autonomy and privacy.

Choice C rationale

This is the correct answer. The nurse should ask the client why they do not want to continue treatment. This allows the nurse to understand the client’s perspective, provide emotional support, and ensure that the client is making an informed decision.

Choice D rationale

Instructing the client to change their advance directives first is not the most appropriate initial response. While advance directives are important legal documents that express a client’s wishes for medical treatment, the nurse should first seek to understand the client’s feelings and concerns.

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A school nurse is examining a child who has a toothache and bruises on both knees.Which of the following observations should the nurse report as a potential sign of maltreatment at home?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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Correct Answer is C

Explanation

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A school nurse is examining a child who has a toothache and bruises on both knees.
Which of the following observations should the nurse report as a potential sign of maltreatment at home?