Deck 13: Caring for an Abused Child

Question 1

As a pediatric nurse, you should understand that the presence of which type of fracture is 95% predictive of abuse in children younger than 3 years of age?

A) Digital fractures
B) Rib fractures
C) Clavicle fractures
D) Linear skull fractures

Answer 1

B

Question 2

If you are just beginning your career as a pediatric nurse, what is the best action to take to help confirm any suspicions or concerns you may have regarding a child potentially being abused?

A) Question the child regarding the cause of the injury
B) Question the parents regarding the cause of the injury
C) Obtain the opinion of an experienced pediatric nurse regarding the situation
D) Tap into your knowledge, training, and best clinical judgment and act accordingly

Answer 2

C

Question 3

As a pediatric nurse, which of the following types of bruises on a 6-month-old child would be taken as being associated with active play and exploration?

A) Bruises that are yellow in color
B) Bruises on the neck or trunk
C) Bruises under the eyes
D) Bruises in various stages of healing

Answer 3

A

Question 4

As a pediatric nurse, which action should you take if you observe a bruise on the body of a 4-month-old child that is located on soft tissue not associated with a bony prominence?

A) Vigorously question the parents regarding the cause of the injury
B) Acknowledge that an injury in this area is associated with normal play and exploration
C) Suggest the physician order an X-ray of the area to rule out a fracture
D) Deem this injury is suspicious and report the suspected maltreatment to authorities

Question 5

If you are unsure whether or not a case is abusive in nature, what lab values can be obtained to assist with confirming or ruling out an abuse determination?

A) Complete blood count, serum calcium, vitamin D
B) Serum calcium, vitamin D, erythrocyte sedimentation rate
C) Serum calcium, phosphorus, alkaline phosphatase
D) Phosphorus, alkaline phosphatase, erythrocyte sedimentation rate

Question 6

If a parent presents a child for a non-abuse injury, which of the following parental actions would support the case of non-abuse?

A) Seeking medical care more than 96 hours after injury occurred
B) Providing a history that contradicts the nature of the injury
C) Explaining the injury occurred as a result of a high-impact accident
D) Explaining the injury occurred as a result of rough play with a sibling

Question 7

As a pediatric nurse, what action should you take if a child presents with dental neglect, such as untreated caries or painful abscesses?

A) Educate the parents on the importance of dental hygiene
B) Immediately provide parenteral nutrition, as the child is severely malnourished
C) Assess for other forms of abuse, as dental neglect is rarely the only form of neglect in an abused child
D) Assist the family in obtaining government assistance for food and health-related necessities

Question 8

While performing an assessment on a potentially abused child, what type of abuse should be suspected if a child exhibits behaviors such as self-harm, depression, nightmares, or regression?

A) Verbal abuse
B) Physical abuse
C) Sexual abuse
D) Emotional abuse

Question 9

Being that infants have no way to communicate abuse, pediatric nurses must use objective data to discern if an infant is experiencing abuse. Which of the following circumstances should raise suspicion that an infant is being abused?

A) Bruises associated with a bony prominence
B) Long bone fractures
C) Isolated sub-periosteal new bone formation
D) Repeated growth chart plots of anthropometrics below the 5^th percentile

Question 10

When caring for a child who is the victim of abuse, what is the first action that should be taken by the healthcare team?

A) Preventing further harm to the child
B) Diagnosing and treating any conditions associated with the abuse
C) Collecting specimens such as semen, blood, urine, and human hairs from the child's body
D) Obtaining photographs for visual evidence of abuse