A nurse in an emergency department is assisting with the care of a client who is unconscious and has trauma to multiple systems following a motor vehicle crash. Which of the following actions should the nurse take first?

Choice A reason: Obtaining a detailed history is the first action that the nurse should take. History can help the nurse determine the cause, frequency, and severity of the bruises, as well as the child's relationship with the abuser and the risk of further harm. History can also help the nurse assess the child's physical and emotional state, and provide evidence for reporting the abuse later.
Choice B reason: Reporting the suspected abuse to the authorities is not the first action that the nurse should take. The nurse should report the abuse only after obtaining a history and confirming the suspicion. Reporting the abuse prematurely can jeopardize the child's safety and the nurse's credibility. The nurse should also follow the legal and ethical guidelines for reporting abuse in their jurisdiction.
Choice C reason: Requesting a social services referral is not the first action that the nurse should take. The nurse should request a social services referral only after reporting the abuse and ensuring the child's protection. A social services referral can help the child access resources and support, such as counseling, legal aid, foster care, etc. The nurse should also collaborate with the social worker and other members of the interdisciplinary team to provide holistic care for the child.
Choice D reason: Telling the child what will happen to her when the abuse is reported is not the first action that the nurse should take. The nurse should tell the child what will happen to her only after obtaining a history and reporting the abuse. The nurse should also use age-appropriate language and reassure the child that the abuse is not her fault and that she is not alone. The nurse should avoid making promises that they cannot keep, such as saying that the abuser will never hurt her again.

Choice A reason: Evidence based practice is the process that the nurse is planning to use. Evidence based practice is the integration of the best available evidence from research, clinical expertise, and patient preferences to make decisions and provide quality care for the client.
Choice B reason: Standardization is not the process that the nurse is planning to use. Standardization is the process of establishing and implementing uniform criteria, methods, or procedures for a specific activity or task. Standardization can help improve efficiency, consistency, and safety, but it does not necessarily involve research or scientific data.
Choice C reason: Benchmarking is not the process that the nurse is planning to use. Benchmarking is the process of comparing the performance, outcomes, or practices of one's own organization or unit with those of other organizations or units that are recognized as leaders or exemplars in the same field. Benchmarking can help identify gaps, strengths, and areas for improvement, but it does not necessarily involve research or scientific data.
Choice D reason: Root cause analysis is not the process that the nurse is planning to use. Root cause analysis is the process of identifying and analyzing the underlying factors or causes that contribute to an adverse event or error. Root cause analysis can help prevent recurrence, enhance safety, and promote learning, but it does not necessarily involve research or scientific data.