ch. 33

A group of pediatric nurses is discussing the diagnosis of Munchausen syndrome by proxy. Which statement most accurately describes this disorder? C. "Children with this diagnosis often appear worried or fearful and have nightmares." B. "The disorder occurs when a child is shaken by the arms or shoulders in a repetitive manner." A. "It is seen when one person fabricates or induces illness in another to get attention." D. "It happens when there is sexual contact between a child and a caregiver."

a

In caring for a child who has been admitted after being sexually abused, which intervention would be included in the child's plan of care? B. Weigh on the same scale each day. A. Observe for signs of anxiety. D. Test the urine for glucose upon admission. C. Encourage frequent family visits.

a

The health care provider is unsure of physical symptoms and diagnosis of a pediatric client. The health care provider is prescribing diagnostic testing to determine possible poisoning by the parent. When the parent asks why laboratory work is being drawn, which response is best? A. "Since we have not found the cause of the illness yet, the health care provider has ordered more blood tests." B. "We are drawing laboratory work to rule out poison in the child's system." D. "It is hospital policy to draw laboratory work daily to monitor the client status." C. "I am not really sure at this time. I just saw it on the prescription sheet."

a

The nurse is interviewing the caregiver of a 5-year-old child who has been admitted with bruises on the abdomen and thighs as well as additional bruises in various stages of healing. Which statement made by the caregiver might alert the health care team to the possibility of child abuse (child maltreatment)? A. "His brother just plays too rough with him." B. "My child goes to day care after school." C. "He just learned to ride his bicycle." D. "When he is in trouble I make him go to his room."

a

Which type of abuse is reported most quickly to the police? A. sexual assault B. incest D. emotional abuse C. neglect

a

A toddler is brought to the emergency department with burns on the feet and buttocks. The toddler is screaming in pain. The caregiver states that she did not know the bath water was so hot. What is the initial action completed by the nurse? B. notifying a health care provider C. completing injury documentation D. calling law enforcement A. assessment of the toddler

b

The nurse is caring for a 4-year-old child with bruises on various areas of the body. Which parental statement does the nurse note as most suspicious? D. "The child is clumsy when running and playing with older siblings." C. "The child bruises easily but was checked for a bleeding disorder." A. "The child plays aggressively with the siblings in the house." B. "The child plays tackle football at the local school. He has advanced skills."

b

The nurse is caring for a small child who has been admitted with a diagnosis of abusive head trauma (shaken baby syndrome). Which condition or concern often occurs with shaken baby syndrome? B. loss of vision and intellectual disability A. edema to the arms and legs C. chronic infection and scarring D. reports of illness and nightmares

b

The nurse is caring for a young child whose parents have been charged with physical abuse. Which child reaction is noted as a result of the parental behavior? B. fretful and shrinks away when approached A. despondent and does not respond to questions C. aggressive and kicks and fights during the assessment D. cries frequently and stares at the nurse

b

Which adolescent behavior is most common if the parents have substance use problems? D. telling everyone of the parental issues A. staying away from the house B. taking on adult responsibilities C. being clingy to teachers at school

b

Which is essential in working with caregivers who have been affected by abuse? A. knowing the legal system C. providing details on social services in the community B. developing a therapeutic relationship D. arranging family meetings to discuss issues

b

A caregiver who works in the hospital brings his 9-year-old son to the emergency room with a spiral fracture of the tibia. The caregiver reports that the injury occurred when the boy's 5-year-old sister hit him with wooden bat. The injury is inconsistent with an impact and with the sister's strength. Which of the following would be appropriate for the nurse to do in this situation? C. Leave the treatment area and call the social services department in the hospital. D. Let the hospital administrator know so that the hospital can take any necessary action. B. Leave the treatment area and call the police. A. Tell the caregiver that the story is not plausible and ask what really happened.

c

A group of nurses is discussing child abuse (child maltreatment) and one nurse suggests that inadequate parenting skills may lead to child maltreatment. The nurse recognizes that sometimes child maltreatment occurs because the parent: D. works hard to provide for the family and feels unappreciated. B. believes the child is intentionally trying to make him or her angry. C. may have unrealistic expectations of the child. A. is responding appropriately to the child's behavior.

c

The nurse on a pediatric unit is caring for a client who has been physically and emotionally abused. Which adjustment in care is most appropriate? A. Only draw laboratory work in the treatment room. C. Assign consistent nursing staff to the client when possible. D. Provide play and distraction techniques to relieve stress. B. Allow the nonabusive caregiver to remain with the client.

c

Which is the primary physical sign of a child who the nurse suspects as being emotionally abused? C. delays in physical development B. fatigue A. poor hygiene D. inadequate medical care

c

Which situation should the nurse explore for possible emotional abuse of the child by the caregiver? A. The caregiver of a 13-year-old reports, "Amy is really frustrating me. I've been late for work every day this week because she hasn't been ready to leave for school on time." B. The caregiver of a 16-year-old reports, "I couldn't believe that dinner wasn't ready when I got home from work last night. Jack knew it was his turn to cook." C. The caregiver of a 12-year-old reports, "I'm sorry we missed Jamal's appointment last week, but he was supposed to remind me to come." D. The caregiver of a 15-year-old reports, "Laia promised to earn the money to care for the dog if we got him, but she keeps turning down baby-sitting jobs to go out with her friends, and I have to add dog food to my already impossible budget."

c

Which statement made by a participant at a workshop on sexual abuse needs further clarification from the group leader? A. "The difference between sexual abuse and sexual assault is the perpetrator." D. "In cases of incest, the child rarely tells anyone else." C. "Mostly low-income people commit sexual violence against children." B. "Sexual abuse by a person of trust is the most damaging type."

c

The nurse is assessing an infant diagnosed with abusive head trauma (shaken baby syndrome). Clinical manifestations of shaken baby syndrome affect which body system the most? A. musculoskeletal system B. cardiovascular system D. nervous system C. respiratory system

d

The nurse is assisting with a physical exam on a child who has been admitted with a diagnosis of possible child abuse (child maltreatment). Which finding might alert the nurse to this possibility that the child may have been abused? C. The child is hyperactive and angry. A. The child has a fractured bone. B. The child has bruises on the knees and elbows. D. The child has a burn that has not been treated.

d

The school nurse observes an elementary school child arriving in the winter in shorts and a short sleeved shirt with no coat. The nurse would consider this as which type of abuse? B. emotional abuse D. neglect C. sexual abuse A. physical abuse

d