A nurse in a family practice clinic is collecting data from a school-age child. Which of the following behavioral findings should the nurse identify as a possible indication of sexual abuse?

Choice A rationale:
Acute otitis media is not a risk factor for physical maltreatment. It's an ear infection and does not directly contribute to the risk of physical abuse. The child's medical history should be assessed for factors that are more closely related to abuse.
Choice B rationale:
Myopia, or nearsightedness, is also not a risk factor for physical maltreatment. Myopia is a visual impairment and is not related to the risk of abuse. The nurse should focus on identifying factors that might indicate an increased likelihood of abuse.
Choice C rationale:
Prematurity can be a risk factor for various health issues in a child, but it is not directly linked to physical maltreatment. While preterm infants might have unique medical needs, being born prematurely does not inherently increase the risk of physical abuse.
Choice D rationale:
Correct Answer. Being adopted can be considered a potential risk factor for physical maltreatment. Children who are adopted might face certain challenges related to attachment, identity, and adjustment. It's important for healthcare providers to be vigilant and assess the child's situation comprehensively to ensure their safety and well-being.

Choice A rationale:
Urticaria, commonly known as hives, is a skin rash characterized by raised, red, and itchy welts that can vary in size and shape. It is a classic manifestation of an allergic reaction. Allergic reactions can occur in response to medications like clindamycin. Urticaria is a result of histamine release and can range from mild to severe, with itching being a prominent symptom. The appearance of urticaria in a child taking clindamycin suggests a potential allergic reaction to the medication.
Choice B rationale:
Conjunctivitis, or pink eye, is inflammation of the conjunctiva, the clear membrane that covers the white part of the eye and lines the inner surface of the eyelids. While conjunctivitis can be associated with allergies, it is not a typical sign of an allergic reaction to clindamycin. Conjunctivitis is more commonly associated with eye irritation, redness, and discharge.
Choice C rationale:
A temperature of 38°C (100.4°F) alone is not a definitive sign of an allergic reaction to medication. Fever can be caused by a variety of factors, including infections, inflammatory processes, and other non-allergic reactions. While fever can be a symptom of an allergic reaction in some cases, it is not as specific as urticaria in indicating an allergic response.
Choice D rationale:
Cool extremities are not a classic sign of an allergic reaction to medication. Allergic reactions typically involve skin manifestations like hives, itching, and redness. Cool extremities might suggest poor peripheral circulation or decreased blood flow to the extremities, but they are not directly indicative of an allergic reaction to clindamycin.