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:
Sun protection is necessary even when using self-tanning creams. Self-tanning creams do not provide protection against the harmful effects of ultraviolet (UV) radiation. Adolescents should be educated about the importance of using sunscreen to prevent skin damage and reduce the risk of skin cancer.
Choice B rationale:
The risk of injury from firearms does not necessarily decrease as children enter adolescence. Adolescents may still lack proper judgment and decision-making skills, making them susceptible to accidents and injuries related to firearms. Educating adolescents about firearm safety and promoting responsible firearm storage is essential.
Choice C rationale:
(Correct Choice) Driving skills can indeed be impaired when friends are present. Teenagers often face distractions while driving, especially when friends are in the car. Peer pressure and social interactions can divert their attention from the road, leading to an increased risk of accidents. Educating adolescents about the importance of focused and responsible driving can help reduce this risk.
Choice D rationale:
Medroxyprogesterone, a form of hormonal contraception, does not provide protection against gonorrhea. It offers contraception by preventing ovulation and altering the cervical mucus to impede sperm penetration. However, it does not offer any protection against sexually transmitted infections (STIs). Adolescents should be educated about safe sex practices to prevent STIs.

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.