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: The diathesis-stress model assists the client in identifying their level of stress or anxiety.
This statement is incorrect because the diathesis-stress model does not primarily focus on helping clients identify their current levels of stress or anxiety. Instead, it is a framework used to understand how predispositional vulnerabilities (diatheses) and external stressors interact to influence the development of psychological disorders. While understanding stress levels can be part of a broader assessment, it is not the main purpose of the diathesis-stress model.
Choice B Reason: The diathesis-stress model assists in telling me how stressed a client is.
This statement is also incorrect. The diathesis-stress model is not a tool for measuring or quantifying a client’s current stress levels. Rather, it is a theoretical model that explains how stress interacts with an individual’s vulnerabilities to potentially trigger mental health issues. The model helps clinicians understand the interplay between genetic, biological, and environmental factors, but it does not provide a direct measure of stress.
Choice C Reason: The diathesis-stress model assists in identifying risk factors or vulnerabilities for stress.
This statement is correct. The diathesis-stress model is designed to identify and understand the risk factors or vulnerabilities (diatheses) that make an individual more susceptible to developing psychological disorders when exposed to stress. These vulnerabilities can be genetic, biological, psychological, or situational. By identifying these factors, clinicians can better predict which individuals are at higher risk for developing mental health issues under stress and can tailor interventions accordingly.
Choice D Reason: The diathesis-stress model assists in identifying what mental health disorder related to stress the client has.
This statement is partially correct but not entirely accurate. While the diathesis-stress model can help in understanding the development of mental health disorders, it does not specifically identify which disorder a client has. The model provides a framework for understanding how various factors contribute to the onset of disorders, but a comprehensive clinical assessment is required to diagnose specific mental health conditions.
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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