Question 1

A parent brings a toddler to the pediatric clinic. The nurse observes a number of bruises on the child in various stages of healing. The parent claims the toddler bruises easily. The best action on the part of the pediatrician and the nurse would be to:

Accepted Answer

Reporting to child and family services and ordering a screening battery of bleeding and clotting blood work is the best action because it addresses the potential for both medical and non-medical causes of the bruising, ensuring the child's safety and health are prioritized.

Question 2

When the nurse sees a child who has burns on the backs of the legs and the top of the buttocks, and an area that is not burned in the center of the buttocks, the nurse will:

Accepted Answer

The pattern of burns described suggests that the child's buttocks were protected while the backs of the legs and top of the buttocks were exposed to a hot surface or liquid, indicating the child might have been forcibly held in a sitting position in hot liquid, rather than accidentally coming into contact with it.

Question 3

A child comes to the clinic with bruises that are yellow-brown and fading. Based on the characteristics of these bruises, how old is the injury?

Accepted Answer

Yellow-brown bruises typically indicate that the injury is over 1 week old, as the body has broken down the hemoglobin in the blood to biliverdin and bilirubin, which causes the yellow-brown coloration.

Question 4

The nurse notices that a child has reddish blue to purple bruises that have margins. How old are these bruises?

Accepted Answer

The answer of The nurse notices that a child has...

Question 5

Which of the following explains why children between the ages of 1 and 5 are more at risk than older children for getting serious burn injuries?

Accepted Answer

The skin of a child is thinner and much more sensitive than an adult's skin.

Question 6

Which of the following statements best describes the term stocking or glove type burn?

Accepted Answer

Stocking or glove type burns typically indicate immersion burns, where the pattern of the burn resembles the shape of stockings or gloves. This pattern can suggest non-accidental injury, as it may indicate the child was deliberately placed in hot liquid.

Question 7

What is meant by the term flexion burns?

Accepted Answer

Flexion burns occur when a body part, typically immersed in hot liquids, is held in a flexed or bent position, leading to a distinctive pattern of injury.

Question 8

What is the characteristic pattern of the burn in a flexion burn?

Accepted Answer

Flexion burns often result in a characteristic "zebra pattern" due to the way the skin folds and creases when it is burned in a flexed position. This pattern reflects the alternating areas of more severe and less severe burns corresponding to the skin's creases and folds.

Question 9

Most child abuse deaths occur for which of the following reasons?

Accepted Answer

Neurological injuries, particularly head injuries, are the most common cause of death in child abuse cases.

Question 10

Which of the following is a classic sign of shaken baby syndrome?

Accepted Answer

Retinal hemorrhage, usually bilaterally with subdural or subarachnoid hemorrhages, is a classic sign of shaken baby syndrome. This condition results from violent shaking that causes the brain to move within the skull, leading to bruising, swelling, and bleeding in the brain.

Question 11

A father calls emergency medical services (EMS) for his 1-year-old infant who was vomiting and then experienced a series of seizures. Upon admission to the hospital, the infant was listless and irritable, had bradycardia, and had periods of apnea. The infant has now lapsed into a coma. Which of the following conditions will the nurse and the health care team members suspect and most want to rule out?

Accepted Answer

The symptoms described, including vomiting, seizures, listlessness, irritability, bradycardia, periods of apnea, and progression to coma, are consistent with shaken baby syndrome (SBS). SBS is a form of abusive head trauma that can cause severe brain injury.

Question 12

Risk factors for shaken baby syndrome include:

Accepted Answer

Stressful life events can increase the risk of shaken baby syndrome as they may lead to increased frustration and loss of control in caregivers.

Question 13

Which of the following is the second major cause of abuse-related deaths?

Accepted Answer

Abdominal injuries are the second major cause of abuse-related deaths, following head injuries. They are particularly dangerous because they can be less obvious and thus more likely to be untreated until it is too late.

Question 14

The school nurse notices a child who has a frightened look then adults approach, appears sad, hangs around after school, and seems reluctant to go home. This child seemed very distressed then a classmate was crying after falling on the playground. The nurse tried to console this child while consoling the injured child. The school nurse realizes that this child has some of the classic symptoms of:

Accepted Answer

The symptoms described, such as a frightened look when adults approach, sadness, reluctance to go home, and distress at seeing others in distress, are more indicative of a physically abused child. These behaviors suggest fear and anxiety around adults and a possible unsafe home environment, which are common signs of physical abuse. Autism, mental retardation, and early mental illness might present with different primary symptoms not specifically highlighted in the scenario.

Question 15

The nurse assessing a child who is suspected of being a victim of abuse will interview the child privately and will:

Accepted Answer

Reassuring the child that they are not "in trouble" and have not done anything wrong helps create a safe environment for the child to speak openly about their experiences.

Question 16

The nurse is developing a care plan for the parents of a toddler who was born prematurely and was in the neonatal intensive care unit for 2 months. The mother has been using a belt to discipline the child. The father is not very attentive to the needs of the mother or the baby. Which of the following nursing diagnoses would best fit this situation?

Accepted Answer

The situation describes disrupted family dynamics and attachment issues due to the premature birth and NICU stay, which aligns with interrupted family processes.

Question 17

Which of the following outcomes is most important in the nursing care plan for a family engaging in physical abuse of the children?

Accepted Answer

Ensuring the child's safety is the primary and most important outcome when dealing with a situation involving physical abuse. This takes precedence over educational or behavioral objectives, as it addresses the immediate risk to the child's well-being.

Question 18

Which of the following statements best describes Munchausen syndrome by proxy?

Accepted Answer

Munchausen syndrome by proxy is a form of abuse where a caregiver fabricates, exaggerates, or induces mental or physical health problems in those who are in their care, often leading to unnecessary medical treatments and procedures.

Question 19

The adult abuser who receives a diagnosis of Munchausen syndrome by proxy:

Accepted Answer

Munchausen syndrome by proxy involves an adult, typically a caregiver, who causes or fabricates symptoms in someone under their care (often a child) to gain attention and sympathy. This behavior can stem from a desire to escape from personal issues such as poor self-esteem, marital problems, or mental health issues.

Question 20

The nurse will establish which of the following kinds of relationships with the family and the person suspected of having Munchausen syndrome by proxy?

Accepted Answer

Establishing a trusting relationship is crucial when dealing with cases of Munchausen syndrome by proxy. This approach helps in ensuring the safety and well-being of the person affected, as it may encourage openness and cooperation from the family or caregiver suspected of causing harm. Trust is essential for effective intervention and support.

Quiz 36: Child Abuse and Neglect