A charge nurse in the emergency department is reviewing the data of four young children who are receiving treatment. Which of the following should alert the charge nurse to the possibility of child maltreatment?
A 21-month-old toddler who has digoxin poisoning after opening and ingesting a relative's pills
A 12-month-old infant who is not wearing a coat in their car seat in the winter
A 15-month-old toddler who had a submersion injury after falling face-first into a toilet
A 3-month-old infant who has a complex skull fracture from rolling off the changing table
The Correct Answer is D
Choice A reason: Accidental ingestion of medications is common in toddlers due to curiosity and mobility. While concerning, this scenario does not necessarily indicate maltreatment if the pills were accessible unintentionally. It reflects a need for improved safety precautions rather than abuse.
Choice B reason: Not wearing a coat in a car seat during winter is not maltreatment. In fact, bulky coats are discouraged in car seats because they interfere with harness safety. This situation does not suggest abuse or neglect.
Choice C reason: A submersion injury after falling into a toilet is unusual but can occur accidentally in toddlers who are mobile and curious. While supervision should be improved, this does not automatically indicate maltreatment.
Choice D reason: A complex skull fracture in a 3-month-old infant is highly suspicious for maltreatment. Infants of this age lack the mobility to roll off a changing table independently, and the severity of the injury is inconsistent with the reported mechanism. This discrepancy between injury and explanation raises concern for abuse and requires further investigation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: A client with COPD requiring BiPap at night is unstable and at risk for respiratory failure. Discharging them would be unsafe.
Choice B reason: A client who is 1 day postoperative after a laparoscopic cholecystectomy with a low-grade temperature is stable. They can safely continue recovery at home with outpatient follow-up. This makes them the best candidate for discharge.
Choice C reason: A client with intermittent chest pain requiring multiple doses of nitroglycerin is unstable and at risk for myocardial infarction. They require close monitoring and cannot be discharged.
Choice D reason: A client on continuous insulin infusion for recent DKA is unstable and requires ongoing inpatient care. Discharging them would be unsafe.
Correct Answer is B
Explanation
Choice A reason: Publicly confronting coworkers when conflict arises is not appropriate. This approach increases workplace tension and can worsen stress, contributing to burnout and compassion fatigue. Effective communication should be respectful, private, and solution-focused rather than confrontational.
Choice B reason: Engaging in regular physical exercise is correct because it helps reduce stress, improves mood, and enhances resilience. Exercise promotes endorphin release, which counteracts the emotional exhaustion associated with compassion fatigue. It is a healthy coping mechanism that supports both physical and mental well-being.
Choice C reason: Encouraging a passive communication style is incorrect. Passive communication prevents nurses from expressing their needs and concerns, which can lead to frustration and unresolved stress. Assertive communication is more effective in preventing compassion fatigue by promoting healthy boundaries and teamwork.
Choice D reason: Establishing a strong employee code of conduct is important for organizational culture, but it does not directly address compassion fatigue. Compassion fatigue is best managed through self-care strategies, stress reduction, and emotional support rather than policy enforcement.
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