An ER nurse has recognized a mother who has frequently brought her 3-year-old in for vague symptoms of an undiagnosed neurological disorder and who has frequently requested specialist consultations. The child is brought in unconscious. A concern that the nurse may have is:
Physical abuse
Munchausen by proxy
Severe organic failure to thrive
Ingestion of a toxin
The Correct Answer is B
A. Physical abuse typically presents with visible signs of injury, inconsistent explanations for trauma, or fearfulness around caregivers. While abuse may coexist, the pattern here involves medical fabrication rather than physical harm.
B. Munchausen by proxy (also known as factitious disorder imposed on another) occurs when a caregiver—usually a parent—exaggerates, fabricates, or induces illness in a child to gain attention or sympathy. The repeated vague complaints, specialist seeking, and now unconscious presentation strongly raise this concern.
C. Severe organic failure to thrive results from an underlying physical condition affecting growth and development, not from caregiver behavior. It also doesn't typically include extensive medical seeking behavior for vague, shifting symptoms.
D. Ingestion of a toxin is possible in any unconscious child, but in this context, without clear evidence of accidental exposure, it may actually be a result of the caregiver's actions in Munchausen by proxy. Thus, it is a potential symptom, not the root concern.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. A vanilla milkshake contains dairy, which can coat the throat and cause coughing or throat clearing, potentially leading to bleeding.
B. Orange juice is acidic and can irritate the surgical site, causing pain and discomfort.
C. Cranberry juice, while not as acidic as orange juice, can still be irritating due to its tartness, especially in the early postoperative phase.
D. Crushed ice is ideal shortly after a tonsillectomy. It helps keep the throat moist, provides soothing relief, and poses minimal risk of irritation or bleeding. It is often recommended as one of the first oral intake options post-op.
Correct Answer is D
Explanation
A. This response may come across as judgmental or confrontational, and it doesn’t validate the parent's concern or offer reassurance.
B. This response minimizes the parent's feelings and does not offer helpful or informative support.
C. While empathetic, this response shifts the focus to the nurse rather than addressing the parent's concern with a professional explanation.
D. Hospitalization can cause regression in young children due to stress, illness, or unfamiliar environments. This response offers reassurance, normalizes the behavior, and provides an educational explanation to ease the parent's embarrassment and concern.
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