While assessing a child at the community health clinic, the nurse notes that the toddler has multiple bruises on his legs and buttocks. After reporting suspected child abuse to the supervisor, which action should the nurse take next?

Obtain a restraining order against the father.

Encourage the mother to file a police report.

Ask the child if his father ever spanks him.

Refer the family to protective service agencies.

Answer and Explanation

The Correct Answer is D

A) Obtain a restraining order against the father:
Obtaining a restraining order is a legal action that can be taken to protect the child but is not typically within the scope of the nurse’s immediate responsibilities. This action would involve law enforcement and the legal system rather than being an immediate next step in the healthcare setting. The nurse's role is to report the suspected abuse and ensure that appropriate protective services are involved.

B) Encourage the mother to file a police report:
Encouraging the mother to file a police report is a potential step in addressing the situation, but it should not be the nurse's immediate next action. The nurse's primary responsibility is to ensure that the appropriate child protective services are notified and involved, as they are equipped to handle investigations and interventions in cases of suspected child abuse.

C) Ask the child if his father ever spanks him:
Asking the child about specific forms of discipline, such as spanking, could potentially place the child in a difficult or unsafe position, especially if abuse is suspected. It is not the nurse's role to investigate or interrogate the child directly. Instead, the focus should be on ensuring that the proper authorities are notified to handle the investigation.

D) Refer the family to protective service agencies:
Referring the family to protective service agencies is the most appropriate next step. These agencies are specialized in handling cases of suspected abuse and can provide the necessary intervention and support for the child’s safety and well-being. The nurse's role includes reporting suspected abuse to the appropriate authorities and ensuring that protective services are contacted to investigate and address the situation.

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Correct Answer is C

Explanation

A. Glaucoma:
Glaucoma is generally a concern for older adults rather than preschool-aged children. Screening for glaucoma typically starts later in life when the risk for this condition increases.

B. Red light reflex:
The red light reflex test is used primarily in infants and very young children to screen for conditions such as cataracts and retinoblastoma. While important, it is not usually the primary focus of annual screenings in preschool settings, which typically emphasize visual acuity.

C. Visual acuity:
Visual acuity screening is crucial for preschool-aged children to identify any issues with vision that could affect their development and learning. It helps detect problems like amblyopia (lazy eye) or refractive errors that need early intervention.

D. Conjunctivitis:
Conjunctivitis, or pink eye, is a common condition but is not typically part of routine annual eye health screenings. It is more relevant to address conjunctivitis as it arises rather than as part of an annual screening program.

A. Small bruises on the lower extremities. B. A one-inch laceration across center of forehead. C. Refusal to answer simple questions. D. Several dime-sized circular burns on the back.

Correct Answer is D

Explanation

A) Small bruises on the lower extremities:
While bruises should be noted and monitored, small bruises on the lower extremities are relatively common in toddlers due to their active nature and frequent minor falls. They do not immediately indicate abuse unless accompanied by other signs.

B) A one-inch laceration across the center of the forehead:
A laceration, especially if it's recent, should be assessed for proper care and treatment. However, a laceration alone does not necessarily indicate abuse and is less urgent compared to signs of possible abuse such as burns.

C) Refusal to answer simple questions:
A toddler’s reluctance to answer questions might be due to shyness or anxiety related to the visit or the situation. This behavior alone does not indicate an immediate need for intervention unless accompanied by other signs of distress or harm.

D) Several dime-sized circular burns on the back:
Circular burns are a significant concern as they are characteristic of burn injuries that may result from abuse, such as being burned by a hot object or liquid. This finding warrants immediate intervention and further investigation to ensure the child’s safety and well-being.

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While assessing a child at the community health clinic, the nurse notes that the toddler has multiple bruises on his legs and buttocks. After reporting suspected child abuse to the supervisor, which action should the nurse take next?

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