A nurse in an acute mental health unit is admitting a client diagnosed with bipolar disorder. The nurse recognizes which of the following findings supports the admitting diagnosis of acute mania?

The correct answer is choice D: "If suspicion of abuse exists, then reporting is mandatory."

Choice A rationale:

If the potential abuser commits to stopping the abuse, healthcare workers are not required to report it. Rationale: This statement is incorrect. Healthcare workers are mandated reporters, and their primary responsibility is to protect the safety and well-being of the child. Regardless of whether the potential abuser commits to stopping the abuse, suspicion of abuse requires reporting.

Choice B rationale:

Evidence must exist before reporting. Rationale: This statement is incorrect. While concrete evidence can strengthen a case, it is not a prerequisite for reporting suspected child abuse. Reporting is based on reasonable suspicion, not proof. Healthcare workers should err on the side of caution and report any concerns.

Choice C rationale:

I don't want to defame someone if the report is false. Rationale: This statement is incorrect. Reporting suspected child abuse is not about defaming someone, but rather about ensuring the safety of the child. Reporting is a part of the legal and ethical obligations of healthcare workers to protect vulnerable individuals.

Choice D rationale:

If suspicion of abuse exists, then reporting is mandatory. Rationale: This statement is correct. Healthcare workers are mandated reporters and have a duty to report suspected child abuse to appropriate authorities. Reporting is necessary when there is reasonable suspicion, even if definitive evidence is not yet present.

Choice A rationale:

An anxiety reaction is the most appropriate explanation for the toddler's behavior of sitting quietly in the corner of the crib, sucking her thumb, and turning away from the nurse. These behaviors suggest that the toddler is experiencing anxiety due to the absence of her mother. Sucking the thumb is a common self-soothing mechanism in young children, and the behavior of turning away from the nurse can be seen as an attempt to cope with the separation.

Choice B rationale:

Resentment toward the mother is less likely in this context, as the toddler's behavior is more indicative of distress and anxiety related to separation from her mother rather than directed resentment.

Choice C rationale:

Developing autonomy is not the primary explanation for these behaviors. While developing autonomy is an important developmental milestone for toddlers, the described behavior is more suggestive of anxiety and coping with separation rather than a deliberate expression of autonomy.

Choice D rationale:

Regression refers to reverting to an earlier developmental stage in response to stress or difficulty. While regression can occur in response to hospitalization and separation from caregivers, the toddler's behavior of sitting quietly and sucking her thumb is better explained by anxiety than by regression to an earlier developmental stage.