A nurse in an emergency department (ED) is assessing a preschooler who has a fractured arm. For which of the following should the nurse further investigate as a warning sign of child maltreatment?
The guardian wants to accompany the child from the ED to the radiology department.
The guardian states the child fell off the swing in the backyard.
The child was brought to the ED 2 days after the injury occurred.
The child cries loudly when their arm is moved or manipulated.
The Correct Answer is C
A. The guardian wants to accompany the child from the ED to the radiology department. This is a typical parental response and does not indicate maltreatment. Parents often want to stay with their child for reassurance.
B. The guardian states the child fell off the swing in the backyard. This is a plausible explanation for an injury in a preschooler, though the consistency of the story with the injury should still be assessed.
C. The child was brought to the ED 2 days after the injury occurred. A delay in seeking medical care for a significant injury is a potential warning sign of child maltreatment and warrants further investigation.
D. The child cries loudly when their arm is moved or manipulated. Pain with movement is expected with a fracture and does not indicate maltreatment.
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Related Questions
Correct Answer is C
Explanation
A. Hearing difficulties can be a challenge but do not necessarily indicate social isolation unless they lead to withdrawal from activities.
B. Babysitting twice a month still allows for social interaction and does not suggest isolation.
C. Not attending church due to a lost hearing aid suggests withdrawal from social activities, which increases the risk of social isolation.
D. Having a family member assist with grocery shopping indicates some level of social interaction and support, reducing the risk of isolation.
Correct Answer is B
Explanation
A. Schedule the client for an MRI after the procedure. This is incorrect because an MRI is not required following a thoracentesis. Instead, a chest X-ray may be ordered to assess for complications such as a pneumothorax.
B. Place the client leaning forward over the overbed table. This is correct because this position allows for optimal lung expansion and easier access to the pleural space for fluid removal.
C. Encourage the client to take deep breaths during the procedure. This is incorrect because the client should remain still and avoid deep breathing or coughing to prevent lung injury.
D. Ensure the client has been NPO for 6 hr. This is incorrect because NPO status is not required for a thoracentesis, as it is not a gastrointestinal or sedation-based procedure.
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