A nurse in an urgent care clinic is caring for a school-age child who has injuries resulting from physical maltreatment. Which of the following actions should the nurse take first?

Ensure the child's safety.

Tell the child they are not at fault.

Document the location of the child’s injuries

Notify local law enforcement.

Answer and Explanation

The Correct Answer is A

Choice A reason:

Ensuring the child's safety is the top priority. If the child is in immediate danger, steps must be taken to protect them.

Choice B reason:

While providing emotional support to the child is important, ensuring their physical safety takes precedence.

Choice C reason:

Documenting injuries is important for a comprehensive assessment and for legal purposes, but it should follow ensuring the child's immediate safety.

Choice D reason:

Notifying law enforcement may be necessary, but ensuring the child's immediate safety comes first.

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Correct Answer is D

Explanation

Choice A reason:

Avoiding discussing the child's diagnosis with the sibling may create unnecessary secrecy and could hinder the sibling's understanding and coping.

Choice B reason:

Designating one parent to stay at home with the sibling may not be necessary, as both parents can still provide support and care for both children.

Choice C reason:

Avoiding having the sibling visit the child in the facility may isolate them and prevent opportunities for bonding and support.

Choice D reason:

This statement is correct. Encouraging phone calls between the siblings allows them to maintain communication, express their feelings, and support each other during the separation caused by hospitalization.

A. Place a urine collection device on the infant until the specimen is obtained. B. Obtain the specimen by swabbing the infant's rectum using a sterile culture swab. C. Maintain the specimen at room temperature after collection until it is transferred to the lab. D. Transfer the specimen to the collection container using povidone-iodine-soaked gauze.

Correct Answer is B

Explanation

Choice A reason:

Placing a urine collection device on the infant is not an appropriate method for collecting a stool specimen.

Choice B reason:

Obtaining the specimen by swabbing the infant's rectum using a sterile culture swab is the correct method for collecting a stool specimen from an infant.

Choice C reason:

Maintaining the specimen at room temperature is appropriate after collection until it is transferred to the lab. This is standard procedure for many specimens.

Choice D reason:

Using povidone-iodine-soaked gauze is not a standard method for transferring a stool specimen to the collection container.

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A nurse in an urgent care clinic is caring for a school-age child who has injuries resulting from physical maltreatment. Which of the following actions should the nurse take first?

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