Which of the following may cause the nurse to consider the possibility of child abuse when a mother tells the nurse that her young child fell down the basement stairs?
The child's mother is very anxious for her son to get medical attention.
The child had multiple visits to the ER last year and is described as accident prone
The child's bruises are dispersed on his head, arms, and legs.
The child has clusters of bruises on the torso, back or buttocks
The Correct Answer is D
Child abuse assessment requires careful evaluation of injury patterns, developmental consistency, and mechanism plausibility. Non-accidental trauma often presents with patterned, clustered, or location-specific bruising inconsistent with accidental mechanisms such as falls, especially in protected body regions.
Rationale:
A. A caregiver being anxious for medical attention is not a specific indicator of abuse. Parental anxiety may reflect concern, guilt, or situational stress but is not diagnostically associated with non-accidental trauma without corroborating physical findings.
B. Frequent emergency visits labeled as “accident prone” may reflect normal childhood activity patterns or poor supervision, but it is nonspecific and can be seen in both abusive and non-abusive environments. It alone does not strongly suggest intentional injury.
C. Bruises on the head, arms, and legs can occur in a true fall down stairs, as these are exposed bony areas commonly injured in accidental trauma. The distribution described is consistent with a plausible mechanism and is not highly specific for abuse.
D. Clustered bruising on the torso, back, or buttocks is highly suspicious for non-accidental injury because these are protected areas unlikely to be injured in accidental falls. Patterned bruises in these regions strongly suggest inflicted trauma and warrant further investigation.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"C","dropdown-group-3":"B","dropdown-group-4":"A"}
Explanation
Pediatric musculoskeletal disorders involve abnormalities of bone integrity, joint inflammation, neuromuscular degeneration, and spinal alignment. Accurate assessment requires recognition of characteristic clinical manifestations, disease-specific progression patterns, and functional impairment affecting mobility, posture, growth, and systemic inflammatory response in children.
Rationale:
Osteomyelitis: This is a bacterial bone infection commonly associated with trauma, fractures, or orthopedic devices such as traction. Fever, localized pain, and inflammation occur due to medullary infection and progressive inflammatory destruction within bone tissue.
Juvenile Rheumatoid Arthritis: It causes chronic synovial inflammation leading to joint pain, stiffness, swelling, and decreased mobility. Persistent autoimmune activity damages cartilage and periarticular structures, especially in weight-bearing and large joints during childhood.
Duchenne Muscular Dystrophy: This is an X-linked disorder characterized by progressive muscle degeneration caused by dystrophin deficiency. Children develop pseudohypertrophy of calf muscles, clumsiness, frequent falls, waddling gait, and progressive motor weakness.
Scoliosis: This is a lateral spinal curvature causing postural asymmetry and vertebral rotation. Unequal shoulder or hip height becomes more visible during the forward-bending test, which is commonly used for early musculoskeletal screening in school-aged children.
Correct Answer is {"dropdown-group-1":"A"}
Explanation
The infant immunologic response requires sequential antigen exposure to stimulate optimal antibody titers against virulent pathogens. The primary series prevents bordetella pertussis colonisation and neutralizes clostridium tetani exotoxins by establishing long-term memory B-lymphocyte populations.
Rationale:
DTaP is a combination vaccine administered at 2, 4, and 6 months of age to provide critical immunity against diphtheria, tetanus, and acellular pertussis. This precise schedule ensures optimal active immunity during peak developmental vulnerability periods.
HepB is typically initiated at birth, with subsequent doses administered at 2 and 6 months of age. While it is given 3 times within the first 6 months, the birth dose alters the 2, 4, 6-month sequence typical of other primary infant series.
Hib conjugate vaccines protect against invasive Haemophilus influenzae type b diseases like meningitis. Depending on the specific manufacturer formulation used, the primary series may require either 2 or 3 doses before the 6-month milestone.
PCV13 or PCV15 protects against invasive pneumococcal diseases. It requires 3 doses at 2, 4, and 6 months, followed by a 4th booster dose at 12 to 15 months of age.
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