A nurse in an emergency department is caring for a child who reports being sexually abused by a family member. Which of the following actions should the nurse take?
Reassure the child that no one will be told about the abuse.
Use leading statements to obtain information from the child.
Explain to the child what will happen when the abuse is reported.
Ensure that multiple nurses are present for the physical examination.
The Correct Answer is C
A. The nurse must not promise confidentiality when abuse is suspected. Reporting is required by law, and the child should be informed of this.
B. Leading statements can influence the child’s response and should be avoided to ensure that information is accurately obtained.
C. Explaining the process to the child ensures that the child understands what will happen and can help alleviate anxiety about the situation.
D. While a supportive environment is important, the presence of multiple nurses during the physical examination could make the child feel uncomfortable. One nurse should be present to provide care and comfort.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A constant P-R interval greater than 0.20 seconds is characteristic of a first-degree atrioventricular (AV) block.
B. A complete heart block (third-degree block) would result in varying P-R intervals, not a constant one.
C. Premature atrial complexes are premature beats that do not affect the P-R interval.
D. Atrial fibrillation would not have a consistent P-R interval; the atrial rhythm is irregular in fibrillation.
Correct Answer is A
Explanation
A. Offering information about respite care is a helpful and practical response. Respite care provides temporary relief for caregivers, allowing them to rest and recharge.
B. While it's important to acknowledge the son's efforts, this statement doesn't address the need for rest or offer solutions.
C. Suggesting sleeping pills without further assessment is not appropriate and may not address the root cause of the son's sleep deprivation.
D. While caring for a terminally ill person is challenging, this statement does not offer the support or solution the son needs.
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