The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse (child mistreatment) in which situation?
A 9-year-old with a compound fracture of the tibia, which the caregiver reports as having been caused when the child attempted a flip on a skateboard.
A 10-year-old with a simple fracture of the femur, which the caregiver reports as having been caused when the child fell down a set of stairs.
A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate.
A 6-year-old with a greenstick fracture of the wrist, which the caregiver reports as having been caused when the child fell while ice-skating.
The Correct Answer is C
Choice A reason: A compound tibia fracture from a skateboard flip is plausible, as high-impact activities can cause such injuries in active 9-year-olds. A spiral fracture with an inconsistent story raises more suspicion, making this less concerning and incorrect for prioritizing abuse investigation in the unit.
Choice B reason: A simple femur fracture from falling down stairs aligns with common childhood accidents, especially in a 10-year-old. The spiral fracture’s implausible bat story is more suspicious, making this less indicative and incorrect compared to the need to investigate potential abuse in another case.
Choice C reason: A spiral humerus fracture suggests twisting force, inconsistent with a bat swing by a peer, raising abuse concerns in a 7-year-old. This warrants further data collection, aligning with child maltreatment protocols, making it the correct situation for exploring possible mistreatment on the pediatric unit.
Choice D reason: A greenstick wrist fracture from ice-skating is typical in a 6-year-old, as falls cause such incomplete breaks in flexible bones. The spiral fracture’s questionable explanation is more concerning, making this plausible and incorrect for prioritizing abuse investigation among the children.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Playing together without organization is associative play, more typical of preschoolers, not toddlers, who engage in parallel play. Side-by-side independent play is toddler-specific, making this incorrect, as it misidentifies the developmental play stage of toddlers in the in-service training session.
Choice B reason: Organized group play is cooperative play, seen in older children, not toddlers, who lack the social skills for it. Parallel play side by side is typical, making this incorrect, as it does not reflect the independent nature of toddler play in the nurses’ training.
Choice C reason: Playing apart without group involvement is solitary play, less common in social settings for toddlers, who prefer parallel play. Side-by-side play is more characteristic, making this incorrect compared to the typical toddler behavior of independent play in proximity during the session.
Choice D reason: Toddlers engage in parallel play, playing independently side by side without interaction, a hallmark of their developmental stage. Nurses choosing this example show understanding, aligning with pediatric play theories, making it the correct choice for a successful in-service training on toddler play.
Correct Answer is D
Explanation
Choice A reason: Labeling the feeling as confusion dismisses the child’s embarrassment and focuses on the sister’s needs. Validating the child’s emotions while affirming love normalizes her feelings, making this less empathetic and incorrect for addressing the child’s specific concern about embarrassment during the checkup.
Choice B reason: Stating the sister didn’t want the amputation and shouldn’t cause embarrassment shames the child, dismissing her feelings. Acknowledging embarrassment as normal is more supportive, making this judgmental and incorrect for therapeutically addressing the child’s emotional concern in the clinical setting.
Choice C reason: Suggesting the sister feels more embarrassed speculates on her emotions and minimizes the child’s feelings. Validating the child’s embarrassment while affirming love is more empathetic, making this unhelpful and incorrect for addressing the child’s expressed concern appropriately during the visit.
Choice D reason: Acknowledging the difficulty, affirming love, and normalizing embarrassment validates the child’s feelings while fostering support for her sister. This empathetic response aligns with pediatric psychosocial care principles, making it the most appropriate statement to address the child’s concerns effectively in the checkup.
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