Drag and drop the physical exam findings that would make the nurse suspicious of child abuse.

A pattern of splashing seen from a scalding burn in a 2-year-old

An explanation for injury that matches the child’s development

Bruising noted on the torso of a 9-month-old

A burn that looks like socks on bilateral feet from immersion

Answer and Explanation

The Correct Answer is A

Choice A reason: A splash-pattern scald burn in a 2-year-old may indicate non-accidental trauma, as it suggests hot liquid thrown or poured, inconsistent with accidental spills. Such patterns, per tools like TEN-4-FACESp, raise suspicion of abuse, requiring further investigation to ensure the child’s safety.

Choice B reason: An injury explanation matching the child’s developmental abilities (e.g., a toddler falling while running) is less likely to indicate abuse. Consistent histories align with accidental injuries, not raising suspicion under abuse screening tools, making this an incorrect choice for findings suggestive of child abuse.

Choice C reason: Bruising on the torso of a 9-month-old, per the TEN-4-FACESp tool, is highly suspicious for abuse, as non-mobile infants rarely sustain accidental torso bruises. Such findings suggest external force inconsistent with developmental capabilities, warranting investigation for non-accidental trauma to protect the child.

Choice D reason: Sock-like burns on bilateral feet from immersion indicate non-accidental trauma, as they suggest forced submersion in hot liquid, creating uniform burn patterns. This is a classic abuse finding, distinct from accidental burns, requiring immediate reporting to child protective services for the child’s safety.

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Correct Answer is D

Explanation

Choice A reason: Stuttering involves repetition or prolongation of sounds, not omitting words for brevity. Telegraphic speech, where toddlers use short phrases like “want go potty,” is normal at age 3, reflecting developmental language simplification, not a fluency disorder like stuttering, making this an incorrect response.

Choice B reason: Echolalia is the repetition of others’ words, often seen in autism, not the use of short, functional phrases. The described speech, “want go potty,” is telegraphic, a normal toddler pattern, not echolalia requiring correction, making this an inaccurate response for the observed speech pattern.

Choice C reason: Telegraphic speech is normal in 3-year-olds, not a developmental delay. Consulting a speech therapist is unnecessary unless other language milestones are delayed. The described speech pattern, using key words without connectors, is typical for this age, making this response incorrect and overly interventionist.

Choice D reason: Telegraphic speech, common in 3-year-olds, involves short phrases with essential words (e.g., “want go potty”), omitting articles or connectors. This is a normal developmental stage as toddlers simplify language to communicate effectively, aligning with the described speech pattern, making this the correct response.

A. You can stand next to the crib during the exam and hold her arms down so I can listen to her lungs B. You can pick her up and soothe her. Let’s try the exam while you hold her in your lap C. I will let her calm down and come back when I am done with all my other patient exams and morning meds D. I need to get this exam done and listen to her lungs. Unfortunately, this is the only way

Correct Answer is B

Explanation

Choice A reason: Holding the child’s arms down while in the crib may increase distress and resistance in an 18-month-old with RSV, who is already agitated. This approach disregards developmental needs for comfort, potentially worsening anxiety and making the exam more difficult, rendering it an ineffective strategy.

Choice B reason: Holding the 18-month-old on the mother’s lap provides comfort, reducing anxiety and resistance during the exam. This developmentally appropriate approach leverages the child’s trust in the caregiver, facilitating cooperation and effective assessment of respiratory status in RSV, making it the best response.

Choice C reason: Delaying the exam until later risks missing critical changes in the child’s respiratory status, as RSV can cause rapid deterioration in young children. Immediate assessment is necessary, and postponing does not address the mother’s distress or the child’s needs, making this an inappropriate response.

Choice D reason: Stating that restraining in the crib is the only way ignores developmental considerations for an 18-month-old. Comforting the child on the mother’s lap is a viable alternative that reduces distress and facilitates the exam, making this an incorrect and inflexible response to the situation.

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Drag and drop the physical exam findings that would make the nurse suspicious of child abuse.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is interviewing a 3-year-old girl who tells the nurse: “Want go potty.” The parents tell the nurse that their daughter often speaks in this type of broken speech. What would be the nurse’s appropriate response to this concern?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

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