The nurse is caring for several patients on a pediatric unit. Which patient should the nurse be most concerned about possible abuse?
A 15-year-old female soccer player with a broken leg
A 4-month-old with bruises on the arms
An 8-year-old gymnast with a broken right arm
A 2-year-old with bruises on the knees
The Correct Answer is B
Choice A reason: A 15-year-old soccer player with a broken leg likely sustained the injury during sports, a common occurrence. Bruises on a 4-month-old’s arms are more concerning, as infants are non-mobile and less likely to bruise accidentally, suggesting possible abuse.
Choice B reason: Bruises on a 4-month-old’s arms are highly concerning, as infants this age are not mobile and cannot self-injure. Such bruising may indicate non-accidental trauma or abuse, requiring immediate investigation, making this the most concerning patient for possible abuse.
Choice C reason: An 8-year-old gymnast with a broken arm may have been injured during gymnastics, a plausible accident. A 4-month-old with arm bruises is more alarming, as infants are less likely to bruise without external force, so this is less concerning.
Choice D reason: A 2-year-old with knee bruises is typical from active play or falls while learning to walk. Bruises on a non-mobile 4-month-old’s arms are more suspicious for abuse, making this less concerning than the infant’s situation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Referred pain originates in one area but is felt elsewhere, not due to abnormal impulse processing. Neuropathic pain involves nerve dysfunction, so this is incorrect for the pain type described.
Choice B reason: Visceral pain arises from internal organs, not nerve processing issues. Neuropathic pain results from abnormal peripheral or central nerve activity, so this is incorrect for the pain mechanism.
Choice C reason: Cutaneous pain is skin-related, caused by direct stimuli, not abnormal nerve processing. Neuropathic pain involves nerve dysfunction, making this incorrect for the described pain type.
Choice D reason: Neuropathic pain results from abnormal pain impulse processing in the peripheral or central nervous system, such as in neuropathy or nerve injury. This matches the description, making it the correct choice.
Correct Answer is C
Explanation
Choice A reason: The American Cancer Society recommends PSA screening starting at age 50 for average-risk men, but at age 45 for higher-risk groups, including Asian men. This patient patient, as Asian, Asian, needs earlier screening, so age 50 is incorrect for this demographic.
Choice B reason: Starting screening at age 40 is not standard for an average-risk Asian male without symptoms. The ACS suggests age 45 for Asian men, so recommending it with this visit is premature and incorrect.
Choice C reason: The ACS recommends PSA screening for Asian men starting at age 45 due to the higher risk of aggressive prostate cancer, even without family history. This aligns with the patient’s profile, making it the correct teaching point.
Choice D reason: PSA screening is recommended for higher-risk groups like Asian men at age 45, regardless of family history. Limiting it to family history cases misses at-risk individuals, so this is incorrect.
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