Several children come to the Emergency Department for treatment. The situation that would cause the nurse to have the highest suspicion of child abuse would be:
Several visits of the same child with varied injuries.
A 5-year-old child who broke his arm and clings to mother crying.
A 1-year-old child who has a dislocated shoulder from arm swinging.
Repeated visits of the same child with middle ear infections.
The Correct Answer is A
a. Several visits of the same child with varied injuries.
Explanation of Choices
Choice A Reason: Several Visits of the Same Child with Varied Injuries
This scenario raises the highest suspicion of child abuse. Multiple visits with different injuries can indicate a pattern of harm rather than isolated accidents. Healthcare providers are trained to recognize that varied injuries over time, especially in different stages of healing, can be a red flag for abuse. This pattern suggests that the child may be experiencing ongoing harm rather than a single incident. The nurse should conduct a thorough assessment and consider involving child protective services to ensure the child’s safety.
Choice B Reason: A 5-Year-Old Child Who Broke His Arm and Clings to Mother Crying
While a broken arm in a child can be concerning, it is not uncommon for children to sustain such injuries during play or accidents. The child’s emotional response of clinging to the mother and crying is also typical for a young child in pain and distress. This scenario alone does not strongly indicate abuse without additional context or evidence. However, the nurse should still assess the situation carefully and consider any other signs or patterns that might suggest abuse.
Choice C Reason: A 1-Year-Old Child Who Has a Dislocated Shoulder from Arm Swinging
A dislocated shoulder in a 1-year-old is unusual and can be concerning. While it could result from an accident, such as arm swinging, it is also a potential sign of abuse, especially if the explanation does not match the injury. The nurse should investigate further, considering the child’s medical history and any other signs of potential abuse. However, this scenario alone does not provide as strong an indication of abuse as multiple varied injuries.
Choice D Reason: Repeated Visits of the Same Child with Middle Ear Infections
Repeated visits for middle ear infections are common in young children and are typically related to medical issues rather than abuse. Middle ear infections can occur frequently in children due to their anatomy and immune system development. This scenario does not raise immediate concerns about abuse unless there are other signs or patterns of harm. The nurse should focus on providing appropriate medical care and monitoring the child’s health.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason: My boyfriend is too passionate for me
This statement indicates that the client is still placing some blame on their boyfriend’s behavior rather than recognizing the assault as a violation of their autonomy and consent. It suggests that the client may not fully understand that the responsibility for the assault lies with the perpetrator, not with their boyfriend’s level of passion. This mindset can hinder the healing process and indicates that the client may still be struggling with self-blame.
Choice B Reason: Next time I won’t wear such a sexy dress
This statement reflects a common misconception that the victim’s clothing or behavior can provoke sexual assault. It indicates that the client is still internalizing blame for the assault, believing that their attire was a contributing factor. This belief can be detrimental to recovery, as it perpetuates the myth that victims are responsible for the actions of their assailants.
Choice C Reason: I know it was not my fault
This statement is a strong indicator of progress in therapy. Recognizing that the assault was not their fault shows that the client is beginning to understand that the responsibility lies solely with the perpetrator. This realization is crucial for healing, as it helps to alleviate feelings of guilt and self-blame, allowing the client to move forward in their recovery.
Choice D Reason: I’ll just go on double dates from now on
This statement suggests that the client is still trying to find ways to prevent future assaults by changing their behavior rather than recognizing that the fault lies with the perpetrator. While taking precautions can be a part of feeling safe, it should not be based on the belief that the client could have prevented the assault by altering their actions.
Correct Answer is A
Explanation
a. Cardiac dysrhythmia resulting in cardiac arrest
Explanation of Choices
Choice A Reason: Cardiac Dysrhythmia Resulting in Cardiac Arrest
Cardiac dysrhythmias, or irregular heartbeats, are a significant health complication associated with anorexia nervosa. These dysrhythmias can result from electrolyte imbalances, particularly low potassium levels (hypokalemia), which are common in individuals with anorexia due to malnutrition and purging behaviors. Severe dysrhythmias can lead to cardiac arrest, making this one of the most critical and potentially fatal complications of anorexia nervosa. The heart muscle can weaken due to prolonged malnutrition, leading to a condition known as myocardial atrophy, which further increases the risk of cardiac complications.
Choice B Reason: Endocrine Imbalance Causing Amenorrhea
Amenorrhea, or the absence of menstruation, is a common endocrine complication in females with anorexia nervosa. This condition occurs due to the body’s response to severe weight loss and malnutrition, which disrupts the normal production of reproductive hormones. While amenorrhea is a significant health issue, it is not as immediately life-threatening as cardiac dysrhythmias. Amenorrhea can lead to long-term complications such as infertility and osteoporosis but does not typically result in acute medical emergencies.
Choice C Reason: Decreased Metabolism Causing Cold Intolerance
Decreased metabolism and cold intolerance are common symptoms in individuals with anorexia nervosa. The body reduces its metabolic rate in response to prolonged starvation to conserve energy. This can lead to a lower body temperature and increased sensitivity to cold. While uncomfortable and indicative of severe malnutrition, decreased metabolism and cold intolerance are not as immediately dangerous as cardiac dysrhythmias. These symptoms reflect the body’s adaptation to a state of energy deficiency but do not pose an immediate threat to life.
Choice D Reason: Glucose Intolerance Resulting in Hypoglycemia
Hypoglycemia, or low blood sugar, can occur in individuals with anorexia nervosa due to inadequate food intake. However, glucose intolerance and hypoglycemia are less common and less severe complications compared to cardiac dysrhythmias. Hypoglycemia can cause symptoms such as dizziness, confusion, and fainting, but it is typically manageable with appropriate nutritional support. It does not carry the same immediate risk of fatality as cardiac dysrhythmias.
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