A nurse is reinforcing teaching about values to a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding?

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: This statement is incorrect because psychiatric history is not the most urgent assessment to make for a client who reports feeling depressed and anxious. Psychiatric history can provide valuable information about the client's diagnosis, treatment, and response, but it is not a priority over the client's safety and wellbeing.
Choice B reason: This statement is correct because suicide risk is the most urgent assessment to make for a client who reports feeling depressed and anxious. Suicide risk can indicate the client's level of hopelessness, despair, and intent to harm themselves. The nurse should assess the client's suicidal thoughts, plans, means, and access, and implement appropriate interventions to prevent self harm or suicide.
Choice C reason: This statement is incorrect because support systems are not the most urgent assessment to make for a client who reports feeling depressed and anxious. Support systems can provide emotional, social, and practical assistance to the client, but they are not a priority over the client's safety and wellbeing.
Choice D reason: This statement is incorrect because coping abilities are not the most urgent assessment to make for a client who reports feeling depressed and anxious. Coping abilities can reflect the client's strategies and skills to manage their stress and emotions, but they are not a priority over the client's safety and wellbeing.