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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","E"]
Explanation
Choice A reason: Continuing with the triage process is not an immediate intervention that needs to be taken by the triage nurse because it can expose more people to the chemical spill and worsen their condition. The triage nurse should stop the triage process and alert the emergency department staff about the potential contamination.
Choice B reason: Evacuating the emergency department is an immediate intervention that needs to be taken by the triage nurse because it can prevent further exposure and harm to other clients, staff, and visitors. The emergency department should be cleared and sealed until it is safe to re-enter.
Choice C reason: Placing the client in a private room is not an immediate intervention that needs to be taken by the triage nurse because it can contaminate the room and its equipment, as well as pose a risk to anyone who enters or leaves the room. The client should be isolated in a designated area for decontamination.
Choice D reason: Treating the client after contaminated items are removed is not an immediate intervention that needs to be taken by the triage nurse because it can delay the treatment and increase the absorption of the chemical into the body. The client should be treated as soon as possible after decontamination.
Choice E reason: Sending the client and EMS crew to decontamination is an immediate intervention that needs to be taken by the triage nurse because it can remove or neutralize the chemical from their skin, clothing, and equipment, as well as reduce their symptoms and complications. The client and EMS crew should be directed to a designated area for decontamination.
Correct Answer is C
Explanation
Choice A reason: "Repeat dose in 1 hour for unrelieved headachE." This instruction is incorrect because sumatriptan should not be taken more than twice in 24 hours.
Choice B reason: "Chew tablet well before swallowinG." This instruction is unnecessary because sumatriptan tablets are meant to be swallowed whole with water.
Choice C reason: "If you experience chest pain, call your physician immediately." This instruction is important because sumatriptan can cause coronary vasospasm, which can lead to angina or myocardial infarction.
Choice D reason: "Take daily to prevent headaches." This instruction is inappropriate because sumatriptan is used to treat acute migraine attacks, not to prevent them.
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