Which of the following clients would the nurse report as a suspected abuse case?

A 10-year-old with a burn on the palm of the hand

A 6-year-old with splash burns on the front torso

A 4-year-old with circular abrasions around the wrists

A 2-year-old with a large bruise on the forehead

Answer and Explanation

The Correct Answer is C

A. A 10-year-old with a burn on the palm of the hand: This could potentially be accidental, for example, from touching a hot surface. However, while it requires further investigation, it is not as strongly indicative of abuse as the given option.
B. A 6-year-old with splash burns on the front torso: These burns could result from accidentally spilling hot liquids. Though it raises concern, it often indicates an accident rather than abuse unless accompanied by other suspicious signs.
C. A 4-year-old with circular abrasions around the wrists: This is highly suspicious of abuse because circular abrasions can indicate that the child may have been tied or restrained, which is not typical of accidents or normal play.
D. A 2-year-old with a large bruise on the forehead: This type of injury is common in young children who are prone to falls and bumps. It might not immediately suggest abuse without additional context.

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Correct Answer is ["D","E","F"]

Explanation

A. Vernix in the folds and creases. Vernix caseosa is typically decreased or absent in postmature infants.
B. Short, soft fingernails. Postmature infants usually have long, hard fingernails.
C. Abundant lanugo. Lanugo (fine body hair) is usually less or absent in postmature infants, which is more typical of preterm infants.
D. Cracked, peeling skin. Postmature infants often have dry, peeling skin due to prolonged exposure to amniotic fluid.
E. Creases covering soles of feet. This is a sign of maturity; postmature infants have more developed skin creases on the soles of their feet.
F. Positive moro reflex. This is a normal reflex seen in infants and should be present in a postmature infant.

A. Tachypnea B. Wheezes or rales C. Bounding pulses D. Edematous E. Difficulty feeding F. Increased comfort laying down

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

Explanation

A. Tachypnea. Rapid breathing can indicate respiratory distress associated with heart failure.
B. Wheezes or rales. These are abnormal breath sounds indicating fluid in the lungs, which can occur with heart failure.
C. Bounding pulses. Bounding pulses are not typically associated with heart failure; weak pulses may be present due to poor perfusion.
D. Edematous. Edema can occur due to fluid retention, a sign of heart failure.
E. Difficulty feeding. Poor feeding can result from decreased cardiac output affecting systemic circulation and energy for feeding.
F. Increased comfort laying down. Children with heart failure often prefer sitting upright due to respiratory distress.

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Which of the following clients would the nurse report as a suspected abuse case?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a postmature infant. Which of the following findings would the nurse expect? (Select All that Apply.)

Correct Answer is ["D","E","F"]

Explanation

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

Explanation

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