A nurse in a community clinic is caring for a 20-month-old toddler who has spiral fractures of the right ulna and radius. Which of the following findings should the nurse recognize as a potential indication of abuse?
The child was brought to the facility 30 min after the injury occurred.
The child begins to cry when her arm is examined by the provider.
The parents report that the child injured herself by falling off the couch.
The child's examination shows a single injury.
The Correct Answer is C
The parents report that the child injured herself by falling off the couch.
A spiral fracture is a type of broken bone that occurs when a twisting force is applied to the bone. It is often seen in cases of child abuse, where the abuser grabs and twists the child's arm or leg.
Choice A is not correct because bringing the child to the facility soon after the injury does not rule out abuse. The abuser may have done so to avoid suspicion or to prevent further complications.
Choice B is not correct because crying when the arm is examined is a normal reaction for a child who is in pain and scared. It does not indicate abuse or neglect.
Choice C is correct because it is unlikely that a fall from a couch would cause a spiral fracture of the ulna and radius. These bones are strong and require a lot of force to break. A fall from a couch would more likely cause a greenstick fracture, which is a partial break of the bone that occurs in children with flexible bones.
Choice D is not correct because a single injury does not exclude abuse. The child may have been abused before and healed without medical attention, or the abuser may have targeted only one part of the body. A single injury should still raise suspicion and prompt further investigation.
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Related Questions
Correct Answer is D
Explanation
Difficulty maintaining sustained attention is a common manifestation of ADHD, according to the American Psychiatric Association and the CDC. This means that people with ADHD often have trouble focusing on tasks or activities for a long period of time, especially if they are boring or tedious.
The other choices are not manifestations of ADHD, but of other conditions or problems. Here are some reasons why:
Choice A: Difficulty using words in context is not a symptom of ADHD, but of a language disorder or a learning disability that affects communication skills.
Choice B: Difficulty performing self-grooming activities is not a symptom of ADHD, but of a physical disability, a mental health disorder, or a lack of motivation or self-care.
Choice C: Difficulty in acquiring reading skills is not a symptom of ADHD, but of dyslexia, which is a specific learning disability that affects reading and spelling.
Correct Answer is D
Explanation
The client should expect hand tremors to start less than 24 hours after they stop drinking when reinforcing teaching about alcohol withdrawal with a client who has a history of alcohol use disorder.
Choice A, "Disulfiram will prevent my cravings for alcohol," is incorrect because disulfiram works by creating a very unpleasant reaction when the client drinks alcohol and is not a medication for preventing cravings.
Choice B, "It is important that I take Vitamin C to prevent liver cirrhosis or other liver damage," is incorrect because Vitamin C is not indicated for liver disease related to alcohol use disorder and is not effective in preventing it.
Choice C, "Withdrawal symptoms should last about 5 to 7 days once they begin," is incorrect because withdrawal symptoms can last for several days or even weeks, depending on the severity of the alcohol use disorder.
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