A new unlicensed assistive personnel (UAP) is completing an orientation assignment and is caring for an immobilized client who needs a complete bed bath. Which is the best way for the practical nurse (PN) to evaluate this UAP's performance?

- Child abuse is the intentional or neglectful physical, emotional, or sexual harm or injury of a child by a parent, caregiver, or other person who has a relationship of trust or responsibility with the child. Child abuse can have serious and long-lasting consequences for the child's health, development, and well-being.
- The practical nurse (PN) has a legal and ethical duty to identify, report, and prevent child abuse. The PN should be alert for any signs and symptoms of child abuse, such as unexplained or inconsistent injuries, bruises, burns, fractures, or scars; behavioral changes, such as fear, anxiety, aggression, withdrawal, or depression; poor hygiene, nutrition, or growth; lack of supervision, medical care, or education; or sexualized behaviors or knowledge .
- The PN should also conduct a thorough and sensitive assessment of the child and the family situation, using open-ended questions, active listening, and non-judgmental attitude. The PN should compare the history and physical findings of the child with the expected developmental milestones and normal variations for the child's age and stage. The PN should also document any relevant information in an objective and factual manner .
- When the mother of a school-aged boy tells the PN that he fell out of a tree and hurt his arm and shoulder, the PN should assess the child's injury and compare it with the mother's explanation. The most significant indicator of possible child abuse in this scenario is if the injury description by the mother varies from the child's version. This may suggest that the mother is lying or covering up the true cause of the injury, which may be intentional or accidental harm by herself or someone else. A discrepancy between the mother's and the child's stories may also indicate that the child is afraid or coerced to hide the truth about the abuse .

- Therefore, option D is the correct answer, while options A, B, and C are incorrect.

The activity that the PN should suggest to meet the physical and social needs of wheelchair-bound older residents who are mentally alert is an outdoor game of balloon
volleyball. It promotes physical activity, coordination, and social interaction among the residents. It allows them to engage with each other, participate in a fun and inclusive game, and enjoy the outdoor environment. Balloon volleyball can be adapted to accommodate individuals with varying abilities and provide an enjoyable and stimulating experience for wheelchair-bound residents who are mentally alert.
A. A picnic in the park: While a picnic in the park can be enjoyable, it may pose challenges for wheelchair-bound individuals in terms of accessibility and maneuverability. It might limit their participation and engagement in the activity.
B. An outdoor concert: While an outdoor concert can be entertaining, it may not actively engage wheelchair-bound residents. They may be limited in their ability to fully participate and interact with others during the concert.
D. A tea party in the courtyard: While a tea party can be a pleasant social activity, it may not provide the desired physical engagement for wheelchair-bound residents. They may require activities that involve more movement and physical participation.