A nurse is caring for multiple clients at a pediatric clinic. Which of the following clients should the nurse identify as being at the highest risk of child maltreatment?

A 3-year-old child who has cystic fibrosis

A 12-year-old child who has diabetes mellitus

A 6-year-old child who is recovering from mononucleosis

An 8-year-old child who has a fractured tibia following a soccer game

Answer and Explanation

The Correct Answer is A

A. A 3-year-old child who has cystic fibrosis: Young children with chronic illnesses are at higher risk for maltreatment due to their dependency on caregivers for complex medical care, frequent hospitalizations, and ongoing supervision. The combination of young age and chronic medical needs increases vulnerability.

B. A 12-year-old child who has diabetes mellitus: While chronic illness can be a risk factor, older children are generally less vulnerable to maltreatment because they have greater independence and ability to communicate needs. Diabetes management in a 12-year-old may be shared with the child, reducing dependence on caregivers.

C. A 6-year-old child who is recovering from mononucleosis: Mononucleosis is typically a self-limiting illness, and recovery usually occurs at home without complex care. This child’s risk for maltreatment is lower compared to a younger child with a chronic condition requiring intensive management.

D. An 8-year-old child who has a fractured tibia following a soccer game: An accidental injury in a school-age child is not inherently associated with maltreatment. This child’s age and the nature of the injury (traumatic but accidental) place them at lower risk for abuse compared with a younger child with chronic health needs.

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Correct Answer is D

Explanation

A. Decrease in blood pressure: Autonomic dysreflexia is characterized by a sudden increase in blood pressure, not a decrease. Hypotension is more typical of spinal shock, making low blood pressure inconsistent with autonomic dysreflexia.

B. Increase in heart rate: During autonomic dysreflexia, the body often responds with bradycardia rather than tachycardia due to baroreceptor-mediated parasympathetic activation. An elevated heart rate is not a typical sign of this condition.

C. Client report of eye twitching: Eye twitching is not associated with autonomic dysreflexia. This symptom may indicate a neurological or electrolyte issue, but it does not help identify the acute hypertensive crisis characteristic of autonomic dysreflexia.

D. Client report of sudden headache: A sudden, severe headache is a hallmark symptom of autonomic dysreflexia caused by abrupt hypertension. This finding, along with other signs such as flushed skin, nasal congestion, and sweating above the level of injury, indicates the need for immediate intervention to prevent complications such as stroke.

A. INR 1.1 (0.8 to 1.1) B. Hyperemesis C. HbA1c5.6% (4 to 5.9%) D. Uncontrolled pain

Correct Answer is B

Explanation

A. INR 1.1 (0.8 to 1.1): A normal INR indicates proper clotting function and does not increase risk for delayed wound healing. Coagulation status is adequate to support post-surgical recovery.

B. Hyperemesis: Persistent vomiting can lead to fluid and electrolyte imbalances, malnutrition, and protein depletion, all of which impair wound healing. Adequate nutrition is critical for collagen synthesis and tissue repair after surgery.

C. HbA1c 5.6% (4 to 5.9%): A normal HbA1c indicates good blood glucose control, which supports wound healing. Elevated blood glucose can impair healing, but this client’s level is within normal limits.

D. Uncontrolled pain: While uncontrolled pain can affect mobility and stress responses, it does not directly impair the physiological processes of wound healing. Pain management is important but less directly linked to delayed tissue repair than nutritional deficits.

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A nurse is caring for multiple clients at a pediatric clinic. Which of the following clients should the nurse identify as being at the highest risk of child maltreatment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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