A nurse is caring for a child who has red marks across his cheeks. Which of the following actions should the nurse take?

Choice A reason: Asking the parents what caused the bruises is not the best action, as it may not elicit truthful or accurate information. The parents may be the perpetrators of the abuse, or they may be unaware or in denial of the abuse. The nurse should not confront or accuse the parents without sufficient evidence or support.

Choice B reason: Notifying social services is an important action, but not the first one. The nurse should first gather more information and document the findings before making a report. The nurse should also follow the policies and procedures of the health care facility regarding child abuse reporting.

Choice C reason: Asking the toddler what caused the bruises is the best action, as it may provide valuable clues about the source and nature of the injuries. The nurse should use a gentle and nonjudgmental approach, and ask open-ended questions, such as "How did you get these bruises?" or "Who hurt you?" The nurse should also observe the child's behavior and body language, and reassure the child that they are not in trouble.

Choice D reason: Notifying the provider is a necessary action, but not the first one. The nurse should first assess and interview the child, and document the findings. The nurse should also consult with the provider about the appropriate medical care and follow-up for the child. The provider may also assist the nurse in making a report to social services.

Choice A reason: Improved hydration is not a specific indicator of the effectiveness of the treatment for acute laryngotracheobronchitis. Hydration status should be monitored for any child with a respiratory infection, but it does not reflect the severity of the airway inflammation.

Choice B reason: Decreased temperature is not a specific indicator of the effectiveness of the treatment for acute laryngotracheobronchitis. Fever may or may not be present in this condition, and it does not correlate with the degree of airway obstruction.

Choice C reason: Decreased stridor is a specific indicator of the effectiveness of the treatment for acute laryngotracheobronchitis. Stridor is a high-pitched sound caused by turbulent airflow through a narrowed upper airway. It indicates a significant obstruction that can compromise breathing. A reduction in stridor means that the airway inflammation has subsided and the child can breathe more easily.

Choice D reason: Barking cough is not a specific indicator of the effectiveness of the treatment for acute laryngotracheobronchitis. Barking cough is a characteristic symptom of this condition, caused by the swelling of the vocal cords. It may persist for several days after the acute episode, even when the child is improving.