When teaching the patient about self-examination of the male genitalia, the nurse would include which instructions in the teaching plan?

Choice A reason: Bruises on the elbow are common in active children due to play or minor falls. They are typically not concerning unless accompanied by other suspicious signs. Abdominal bruising, however, is less common and may indicate trauma or abuse, making this less concerning.

Choice B reason: Forehead bruises are frequent in toddlers learning to walk, often from bumping into objects. While concerning if severe, they are less alarming than abdominal bruising, which is less typical and may suggest internal injury or abuse, so this is not the most concerning.

Choice C reason: Abdominal bruising in a 3-year-old is highly concerning, as it is uncommon in normal play and may indicate significant trauma, abuse, or internal injury. This location raises red flags for non-accidental injury, requiring urgent investigation, making it the most concerning bruise.

Choice D reason: Lower leg bruises are common in active children from running or minor injuries. They are less concerning than abdominal bruising, which is atypical and may signal serious trauma or abuse, so this is not the most concerning finding in this context.

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.