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.

Answer and Explanation

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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Correct Answer is A

Explanation

Choice A reason: Planning medication doses to occur before meals is a good suggestion to improve this client's nutritional status because it can enhance the client's muscle strength and coordination for chewing and swallowing, which are often impaired by myasthenia gravis.

Choice B reason: Restricting drinking fluids before and during meals is not a good suggestion to improve this client's nutritional status because it can increase the risk of dehydration and constipation, which can worsen the client's condition and appetitE.

Choice C reason: Increasing the amount of fat and carbohydrates in meals is not a good suggestion to improve this client's nutritional status because it can lead to weight gain, hyperglycemia, and cardiovascular problems, which can complicate the management of myasthenia gravis.

Choice D reason: Eating three large meals per day is not a good suggestion to improve this client's nutritional status because it can cause fatigue, bloating, and aspiration, which can affect the client's ability and willingness to eat. The client should eat small, frequent meals that are easy to chew and swallow.

A. Deliver a clean voided urine specimen to the laboratory. B. Feed a client who has bilateral casts due to upper arm fractures. C. Perform blood glucose monitoring of a client who has a prescription for short-acting insulin prior to breakfast. D. Obtain an extra box of tissues for a client who is concerned about running out of them.

Correct Answer is C

Explanation

Choice A reason: Delivering a clean voided urine specimen to the laboratory is not the first task that the AP should complete because it is not urgent or time-sensitivE. The specimen can be stored in a refrigerator or on ice until it is delivereD.

Choice B reason: Feeding a client who has bilateral casts due to upper arm fractures is not the first task that the AP should complete because it is not critical or life-threateninG. The client can wait until after breakfast to receive assistance with feedinG.

Choice C reason: Performing blood glucose monitoring of a client who has a prescription for short-acting insulin prior to breakfast is the first task that the AP should complete because it is essential and priority. The client needs to have their blood glucose level checked before receiving insulin to prevent hypoglycemia or hyperglycemiA.

Choice D reason: Obtaining an extra box of tissues for a client who is concerned about running out of them is not the first task that the AP should complete because it is not important or necessary. The client can use other alternatives such as paper towels or napkins until they get more tissues.

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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?

Nursing Test Bank

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Correct Answer is A

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Correct Answer is C

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