The caregiver of a 2-year-old calls the clinic concerned that her child may have pushed paper into her ears, and she asks the nurse what to do. The mother found the child pushing on her ears with torn paper on the floor in front of her. What would be the appropriate response by the nurse?

Choice A reason: Calling the police directly bypasses hospital protocol for suspected abuse. Contacting social services allows for a multidisciplinary evaluation of the inconsistent spiral fracture story, ensuring appropriate investigation, making this premature and incorrect compared to following hospital child protection procedures for the child.

Choice B reason: Informing the hospital administrator is less direct than contacting social services, which is trained to handle suspected abuse cases. The inconsistent injury story requires specialized assessment, making this less appropriate and incorrect for addressing the immediate concern of potential child maltreatment in the ER.

Choice C reason: Confronting the caregiver risks escalating the situation and may hinder investigation. Reporting to social services ensures a professional evaluation of the implausible injury explanation, aligning with child protection protocols, making this confrontational approach incorrect for managing suspected abuse in the hospital setting.

Choice D reason: Calling social services is the appropriate action for a spiral fracture with an inconsistent story, as it suggests possible abuse. Social services can investigate and coordinate with authorities, aligning with hospital protocols for child maltreatment, making this the correct response to ensure the child’s safety.

Choice A reason: At birth, the infant’s right and left ventricles are nearly equal in size due to fetal circulation demands. This aligns with pediatric cardiology, making it the correct statement demonstrating understanding of the newborn’s cardiovascular system as discussed in the nurses’ review session.

Choice B reason: The heart matures earlier, with adult-like function by early childhood, not 8-10 years. Equal ventricle size at birth is accurate, making this incorrect, as it overestimates the timeline for cardiovascular maturation in the nurse’s understanding of the child’s heart development.

Choice C reason: Heart rate typically increases with fever in children, not decreases, due to metabolic demands. Equal ventricle size at birth is correct, making this inaccurate and incorrect compared to the true statement about the infant’s cardiovascular system in the nurses’ review.

Choice D reason: The left ventricle grows slightly larger but not twice the right’s size by 5-6 years. Equal ventricles at birth is accurate, making this incorrect, as it exaggerates ventricular growth in the nurse’s understanding of the child’s cardiovascular system development.