The mother of a school-aged boy tells the praccal nurse (PN) that he fell out of a tree and hurt his arm and shoulder. Which assessment should the praccal nurse (PN) note as the most significant indicator of possible child abuse?
The child looks at the floor when answering the nurse's quesons.
The mother describes in detail what she did for her injured child.
The abrasions on the child's arms, legs, and chest have healed.
The injury descripon by the mother varies from the child's version.
The Correct Answer is D
- Child abuse is the intentional or neglectful physical, emotional, or sexual harm or injury of a child by a parent, caregiver, or another person who has a relationship of trust or responsibility with the child. Child abuse can have serious and long-lasting consequences for the child's health, development, and well-being.
- The practical nurse (PN) has a legal and ethical duty to identify, report, and prevent child abuse. The PN should be alert for any signs and symptoms of child abuse, such as unexplained or inconsistent injuries, bruises, burns, fractures, or scars; behavioural changes, such as fear, anxiety, aggression, withdrawal, or depression; poor hygiene, nutrition, or growth; lack of supervision, medical care, or education; or sexualized behaviours or knowledge.
- The PN should also conduct a thorough and sensitive assessment of the child and the family situation, using open-ended questions, active listening, and a non-judgmental attitude. The PN should compare the history and physical findings of the child with the expected developmental milestones and normal variations for the child's age and stage. The PN should also document any relevant information in an objective and factual manner.
- When the mother of a school-aged boy tells the PN that he fell out of a tree and hurt his arm and shoulder, the PN should assess the child's injury and compare it with the mother's explanation. The most significant indicator of possible child abuse in this scenario is if the injury description by the mother varies from the child's version. This may suggest that the mother is lying or covering up the true cause of the injury, which may be intentional or accidental harm by herself or someone else. A discrepancy between the mother's and the child's stories may also indicate that the child is afraid or coerced to hide the truth about the abuse.
- Therefore, option D is the correct answer, while options A, B, and C are incorrect.
- Option A is incorrect because the child looking at the floor when answering the nurse's questions may not be a sign of abuse, but rather a sign of shyness, embarrassment, pain, or discomfort.
Option B is incorrect because the mother describing in detail what she did for her injured child may not be a sign of abuse, but rather a sign of concern, care, or guilt.
Option C is incorrect because the abrasions on the child's arms, legs, and chest having healed may not be a sign of abuse, but rather a sign of normal wound healing or previous accidents.
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Related Questions
Correct Answer is C
Explanation
When a client reports experiencing numbness and ngling in the extremies, it is crucial for the praccal nurse (PN) to prioritise reporting the client's electrolyte levels to the healthcare provider. Electrolytes are essential minerals that help maintain the balance of fluids in the body and enable proper nerve and muscle function. Imbalances in electrolyte levels can lead to neurological symptoms, including numbness and ngling.
Opons a, b, and d are not the correct priories to report in this situation:
a) Hematocrit: Hematocrit measures the proportion of red blood cells in the blood. While abnormalies in hematocrit can indicate certain conditions, such as anaemia, it is not directly associated with numbness and ngling in the extremes.
b) Albumin and protein levels: Albumin and protein levels are important for assessing nutritional status and liver function. While low levels of protein can contribute to various health issues, they are not the primary concern when a client experiences numbness and ngling in the extremities.
d) White blood cell count (WBC): WBC count is used to evaluate the immune system's response to infection or inflammation. While infections or inflammatory conditions can cause neurological symptoms, such as ngling, it is not the primary concern in this specific case of numbness and ngling.
Therefore, the most appropriate laboratory value to prioritise reporting in this scenario is the client's electrolyte levels, as imbalances can directly contribute to the reported symptoms and may require prompt intervention.
Correct Answer is B
Explanation
Choice A reason: Fluconazole (Diflucan) is not a medication that community members exposed to anthrax will need access to because it is an antifungal drug that treats fungal infections, not bacterial infections. Anthrax is caused by Bacillus anthracis, a gram-positive spore-forming bacterium.
Choice B reason: Ciprofloxacin (Cipro) is a medication that community members exposed to anthrax will need access to because it is an antibiotic drug that treats bacterial infections, including anthrax. Ciprofloxacin is one of the recommended drugs for post-exposure prophylaxis and treatment of anthrax by the Centers for Disease Control and Prevention (CDC).
Choice C reason: Varenicline (Chantix) is not a medication that community members exposed to anthrax will need access to because it is a smoking cessation drug that helps people quit smoking, not treat infections. Varenicline has no effect on anthrax.
Choice D reason: Potassium iodide (KI) is not a medication that community members exposed to anthrax will need access to because it is a thyroid-blocking agent that protects against radioactive iodine exposure, not bacterial exposurE. Potassium iodide is used in case of nuclear accidents or attacks, not bioterrorism attacks involving anthrax.
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