A 5-month-old infant presents to the ED with right upper arm swelling, and a fracture is suspected. The mother first told the triage nurse that the infant rolled off the changing table during a diaper change, and later said the infant rolled off the couch when the doorbell rang. What knowledge guides the nurse in planning the next steps?

Infant bones are prone to fractures.

The focus should be on the injury not how it occurred.

Inconsistencies in how injury occurred may indicate child maltreatment.

Parents don't remember details when they are under stress.

Answer and Explanation

The Correct Answer is C

Choice A reason: This is not the correct answer because infant bones are not prone to fractures. They are more flexible and resilient than adult bones, and require more force to break.

Choice B reason: This is not the correct answer because the focus should not be only on the injury, but also on how it occurred. The nurse should assess the mechanism of injury and the history of the child and the family for any signs of abuse or neglect.

Choice C reason: This is the correct answer because inconsistencies in how injury occurred may indicate child maltreatment. The nurse should be alert for any discrepancies or changes in the story, or any explanations that do not match the type or severity of the injury.

Choice D reason: This is not the correct answer because parents don't necessarily forget details when they are under stress. They may be anxious or emotional, but they should still be able to provide a consistent and coherent account of what happened.

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Correct Answer is C

Explanation

Choice A reason: This is not the correct answer because infant bones are not prone to fractures. They are more flexible and resilient than adult bones, and require more force to break.

A. Of course you have a mommy. You just don't live with your mommy. B. It must be interesting to live with two men and no women in the household. C. I'll call one of your daddies to come pick you up. D. That's right. I forgot your parents are gay.

Correct Answer is C

Explanation

Choice A reason: This is not appropriate because it denies the child's reality and implies that having two daddies is not normal. It may also hurt the child's feelings and make them feel ashamed of their family.

Choice B reason: This is not appropriate because it sounds judgmental and curious about the child's family structure. It may also make the child feel uncomfortable and different from other children.

Choice C reason: This is appropriate because it accepts the child's statement and shows respect for their family. It also focuses on the child's immediate need and comfort.

Choice D reason: This is not appropriate because it sounds sarcastic and dismissive of the child's family. It may also make the child feel angry and defensive.

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A second grader enters the school nurse's office crying and states, "I feel sick. My tummy hurts." The nurse replies, "I'll call your mommy or daddy to come pick you up." The child replies, "I don't have a mommy. I have two daddies." Which of the following comments by the nurse is appropriate?

Correct Answer is C

Explanation

When obtaining a history from parents of a 4-year-old child, what indicator should prompt the nurse to consider suspected child abuse?

The father of a hospitalized child tells the nurse, "He can't have meat. We are Buddhist and vegetarians." The nurse's best intervention is to:

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Which factor is most likely to contribute to respiratory compromise in a child?