The nurse is caring for a child who is on a clear liquid diet. At lunch, the child consumed 1/2 cup of juice, 3 ounces of gelatin, 1 ounce of an ice pop, and 20 mL of ginger ale. How many milliliters (mL) should the nurse record for the child's fluid intake for lunch?

Choice A reason: A splash-pattern scald burn in a 2-year-old may indicate non-accidental trauma, as it suggests hot liquid thrown or poured, inconsistent with accidental spills. Such patterns, per tools like TEN-4-FACESp, raise suspicion of abuse, requiring further investigation to ensure the child’s safety.

Choice B reason: An injury explanation matching the child’s developmental abilities (e.g., a toddler falling while running) is less likely to indicate abuse. Consistent histories align with accidental injuries, not raising suspicion under abuse screening tools, making this an incorrect choice for findings suggestive of child abuse.

Choice C reason: Bruising on the torso of a 9-month-old, per the TEN-4-FACESp tool, is highly suspicious for abuse, as non-mobile infants rarely sustain accidental torso bruises. Such findings suggest external force inconsistent with developmental capabilities, warranting investigation for non-accidental trauma to protect the child.

Choice D reason: Sock-like burns on bilateral feet from immersion indicate non-accidental trauma, as they suggest forced submersion in hot liquid, creating uniform burn patterns. This is a classic abuse finding, distinct from accidental burns, requiring immediate reporting to child protective services for the child’s safety.

Choice A reason: Liver and kidney function do not significantly differ in lead metabolism between young and older children. Lead is stored in bones and tissues, and all children are susceptible to toxicity. The older child’s lower exposure, not stronger organs, explains the difference, making this an incorrect explanation.

Choice B reason: There is no evidence that some children metabolize lead better after exposure. Lead absorption and toxicity depend on exposure, not individual metabolic differences. Younger children’s behaviors increase exposure risk, making this a vague and scientifically inaccurate explanation for the observed difference in lead levels.

Choice C reason: Assuming the older child had elevated lead levels earlier without evidence is speculative. Lead levels persist without intervention, and the older child’s normal levels likely reflect lower exposure due to behavior, not recovery, making this an incorrect and unsupported explanation for the mother.

Choice D reason: Younger children (7 months, 4 years) engage in floor play and hand-to-mouth behaviors, increasing ingestion of lead from dust or objects in contaminated environments. Older children (9 years) are less likely to exhibit these behaviors, reducing exposure, making this the correct and most accurate explanation.