The mother of a school-aged boy tells the praccal nurse (PN) that he fell out of a tree and hurt his arm and shoulder. Which assessment should the praccal nurse (PN) note as the most significant indicator of possible child abuse?
The child looks at the floor when answering the nurse's quesons.
The mother describes in detail what she did for her injured child.
The abrasions on the child's arms, legs, and chest have healed.
The injury descripon by the mother varies from the child's version.
The Correct Answer is D
- Child abuse is the intentional or neglectful physical, emotional, or sexual harm or injury of a child by a parent, caregiver, or another person who has a relationship of trust or responsibility with the child. Child abuse can have serious and long-lasting consequences for the child's health, development, and well-being.
- The practical nurse (PN) has a legal and ethical duty to identify, report, and prevent child abuse. The PN should be alert for any signs and symptoms of child abuse, such as unexplained or inconsistent injuries, bruises, burns, fractures, or scars; behavioural changes, such as fear, anxiety, aggression, withdrawal, or depression; poor hygiene, nutrition, or growth; lack of supervision, medical care, or education; or sexualized behaviours or knowledge.
- The PN should also conduct a thorough and sensitive assessment of the child and the family situation, using open-ended questions, active listening, and a non-judgmental attitude. The PN should compare the history and physical findings of the child with the expected developmental milestones and normal variations for the child's age and stage. The PN should also document any relevant information in an objective and factual manner.
- When the mother of a school-aged boy tells the PN that he fell out of a tree and hurt his arm and shoulder, the PN should assess the child's injury and compare it with the mother's explanation. The most significant indicator of possible child abuse in this scenario is if the injury description by the mother varies from the child's version. This may suggest that the mother is lying or covering up the true cause of the injury, which may be intentional or accidental harm by herself or someone else. A discrepancy between the mother's and the child's stories may also indicate that the child is afraid or coerced to hide the truth about the abuse.
- Therefore, option D is the correct answer, while options A, B, and C are incorrect.
- Option A is incorrect because the child looking at the floor when answering the nurse's questions may not be a sign of abuse, but rather a sign of shyness, embarrassment, pain, or discomfort.
Option B is incorrect because the mother describing in detail what she did for her injured child may not be a sign of abuse, but rather a sign of concern, care, or guilt.
Option C is incorrect because the abrasions on the child's arms, legs, and chest having healed may not be a sign of abuse, but rather a sign of normal wound healing or previous accidents.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Administering an antipyretic is not the next action that the nurse should initiate because it does not address the priority problem of potential brain damage or death caused by meningococcal meningitis, which is a bacterial infection of the meninges that can rapidly progress to septic shock or disseminated intravascular coagulation.
Choice B reason: Decreasing environmental stimuli is not the next action that the nurse should initiate because it does not address the priority problem of potential brain damage or death caused by meningococcal meningitis, which can impair the function of the central nervous system and cause increased intracranial pressure, seizures, coma, or cranial nerve palsies.
Choice C reason: Assessing the cranial nerves is the next action that the nurse should initiate because it can provide vital information about the extent and severity of brain involvement caused by meningococcal meningitis, which can affect any or all of the 12 pairs of cranial nerves that control sensory and motor functions of the head and neck.
Choice D reason: Completing a vascular assessment is not the next action that the nurse should initiate because it does not address the priority problem of potential brain damage or death caused by meningococcal meningitis, which can cause inflammation and damage of blood vessels in various parts of the body, leading to ischemia, necrosis, or gangrenE.
Correct Answer is D
Explanation
d) Notify the charge nurse of the client's concerns about surgery.
Explanation:
When a client expresses fear and uncertainty about undergoing surgery, it is important for the practical nurse (PN) to communicate this information to the charge nurse or the healthcare provider. By notifying the appropriate person, the PN ensures that the client's concerns are addressed and appropriate interventions can be implemented.
Options a) and c) are not the priority actions because documenting the client's concerns or reminding them about the signed consent does not address their emotional needs or provide support.
Option b) may not be the most appropriate response, as simply encouraging the client to continue with the scheduled surgery without addressing their fears and uncertainties may not be sufficient to alleviate their anxiety.
Therefore, the best course of action is to notify the charge nurse or healthcare provider so that they can assess the client's concerns, provide reassurance, and address any questions or fears the client may have prior to the surgery.
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