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Several children come to the Emergency Department for treatment. The situation that would cause the nurse to have the highest suspicion of child abuse would be:

Several visits of the same child with varied injuries.

A 5-year-old child who broke his arm and clings to mother crying.

A 1-year-old child who has a dislocated shoulder from arm swinging.

Repeated visits of the same child with middle ear infections.

Answer and Explanation

The Correct Answer is A

a. Several visits of the same child with varied injuries.

Explanation of Choices

Choice A Reason: Several Visits of the Same Child with Varied Injuries

This scenario raises the highest suspicion of child abuse. Multiple visits with different injuries can indicate a pattern of harm rather than isolated accidents. Healthcare providers are trained to recognize that varied injuries over time, especially in different stages of healing, can be a red flag for abuse. This pattern suggests that the child may be experiencing ongoing harm rather than a single incident. The nurse should conduct a thorough assessment and consider involving child protective services to ensure the child’s safety.

Choice B Reason: A 5-Year-Old Child Who Broke His Arm and Clings to Mother Crying

While a broken arm in a child can be concerning, it is not uncommon for children to sustain such injuries during play or accidents. The child’s emotional response of clinging to the mother and crying is also typical for a young child in pain and distress. This scenario alone does not strongly indicate abuse without additional context or evidence. However, the nurse should still assess the situation carefully and consider any other signs or patterns that might suggest abuse.

Choice C Reason: A 1-Year-Old Child Who Has a Dislocated Shoulder from Arm Swinging

A dislocated shoulder in a 1-year-old is unusual and can be concerning. While it could result from an accident, such as arm swinging, it is also a potential sign of abuse, especially if the explanation does not match the injury. The nurse should investigate further, considering the child’s medical history and any other signs of potential abuse. However, this scenario alone does not provide as strong an indication of abuse as multiple varied injuries.

Choice D Reason: Repeated Visits of the Same Child with Middle Ear Infections

Repeated visits for middle ear infections are common in young children and are typically related to medical issues rather than abuse. Middle ear infections can occur frequently in children due to their anatomy and immune system development. This scenario does not raise immediate concerns about abuse unless there are other signs or patterns of harm. The nurse should focus on providing appropriate medical care and monitoring the child’s health.

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Correct Answer is C

Explanation

Choice A Reason: My boyfriend is too passionate for me

This statement indicates that the client is still placing some blame on their boyfriend’s behavior rather than recognizing the assault as a violation of their autonomy and consent. It suggests that the client may not fully understand that the responsibility for the assault lies with the perpetrator, not with their boyfriend’s level of passion. This mindset can hinder the healing process and indicates that the client may still be struggling with self-blame.

Choice B Reason: Next time I won’t wear such a sexy dress

This statement reflects a common misconception that the victim’s clothing or behavior can provoke sexual assault. It indicates that the client is still internalizing blame for the assault, believing that their attire was a contributing factor. This belief can be detrimental to recovery, as it perpetuates the myth that victims are responsible for the actions of their assailants.

Choice C Reason: I know it was not my fault

This statement is a strong indicator of progress in therapy. Recognizing that the assault was not their fault shows that the client is beginning to understand that the responsibility lies solely with the perpetrator. This realization is crucial for healing, as it helps to alleviate feelings of guilt and self-blame, allowing the client to move forward in their recovery.

Choice D Reason: I’ll just go on double dates from now on

This statement suggests that the client is still trying to find ways to prevent future assaults by changing their behavior rather than recognizing that the fault lies with the perpetrator. While taking precautions can be a part of feeling safe, it should not be based on the belief that the client could have prevented the assault by altering their actions.

A. The patient’s partner’s act of sending flowers is an example of undoing. B. The patient and partner are in the honeymoon phase of intimate partner violence. C. The patient has a submissive personality and depression. D. Since the injuries have caused hospitalization, the patient will end the relationship. E. The partner may be trying to manipulate the staff by buying pizza.

Correct Answer is ["A","B","E"]

Explanation

The correct answer is a, b, and e.

Choice A Reason:

The patient’s partner’s act of sending flowers is an example of undoing. Undoing is a defense mechanism where a person tries to cancel out or remove an unhealthy, destructive, or otherwise threatening thought or action by engaging in contrary behavior. In this case, the partner is attempting to make amends for the abuse by sending flowers, which is a common tactic used by abusers to mitigate their guilt and manipulate the victim into forgiving them.

Choice B Reason:

The patient and partner are in the honeymoon phase of intimate partner violence. The cycle of abuse in intimate partner violence typically includes a honeymoon phase, where the abuser may apologize, show remorse, and promise to change. This phase often involves gestures of affection and kindness, such as sending flowers or gifts, to win back the victim’s trust and prevent them from leaving.

Choice C Reason:

The patient has a submissive personality and depression. While it is possible that the patient may have a submissive personality and depression, this conclusion cannot be definitively made based on the given scenario alone. Submissive personality traits and depression are complex and require thorough psychological evaluation to diagnose accurately.

Choice D Reason:

Since the injuries have caused hospitalization, the patient will end the relationship. This conclusion is not necessarily accurate. Victims of intimate partner violence often face significant psychological, emotional, and practical barriers to leaving an abusive relationship, even after severe incidents that result in hospitalization. The decision to leave an abusive relationship is influenced by various factors, including fear, financial dependence, emotional attachment, and lack of support.

Choice E Reason:

The partner may be trying to manipulate the staff by buying pizza. Manipulative behavior is common in abusive relationships. By buying pizza for the staff, the partner may be attempting to create a favorable impression and gain sympathy, which can influence the staff’s perception of the situation and potentially affect their support for the patient.

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Several children come to the Emergency Department for treatment. The situation that would cause the nurse to have the highest suspicion of child abuse would be:

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Naxlex Comprehensive Predictor Exams

A college student experienced a sexual assault when out on a date. After several weeks of crisis intervention therapy, which statement by the client would indicate to the nurse that the student is making progress?

Correct Answer is C

Explanation

Correct Answer is ["A","B","E"]

Explanation

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