Nokea
A 3-month-old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but no external signs of trauma. What should the nurse suspect?
- A. Unintentional injury
- B. Shaken baby syndrome
- C. Congenital neurologic problem
- D. Sudden infant death syndrome (SIDS)
Correct Answer: B
Rationale: Shaken baby syndrome causes internal bleeding but may have no external signs. Unintentional injury would not cause these injuries. With unintentional injuries, external signs are usually present. Congenital neurologic problems would usually have signs of abnormal neurologic anatomy. SIDS does not usually have identifiable injuries.
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A young boy is found squirting lighter fluid into his mouth. His father calls the emergency department. The nurse taking the call should know that the primary danger is what?
- A. Hepatic dysfunction
- B. Dehydration secondary to vomiting
- C. Esophageal stricture and shock
- D. Bronchitis and chemical pneumonia
Correct Answer: D
Rationale: Lighter fluid is a hydrocarbon. The immediate danger is aspiration. Acetaminophen overdose, not hydrocarbons, causes hepatic dysfunction. Dehydration is not the primary danger. Esophageal stricture is a late or chronic consequence of hydrocarbon ingestion.
When only one child is abused in a family, the abuse is usually a result of what?
- A. The child is the firstborn.
- B. The child is the same gender as the abusing parent.
- C. The parent abuses the child to avoid showing favoritism.
- D. The parent is unable to deal with the childs behavioral style.
Correct Answer: D
Rationale: The child unintentionally contributes to the abuse. The fit or compatibility between the childs temperament and the parents ability to deal with that behavior style is an important predictor. Birth order and gender can contribute to abuse, but there is not a specific birth order or gender relationship that is indicative of abuse. Being the firstborn or the same gender as the abuser is not linked to child abuse. Avoidance of favoritism is not usually a cause of abuse.
A father calls the clinic because he found his young daughter squirting Visine eyedrops into her mouth. What is the most appropriate nursing action?
- A. Reassure the father that Visine is harmless.
- B. Direct him to seek immediate medical treatment.
- C. Recommend inducing vomiting with ipecac.
- D. Advise him to dilute Visine by giving his daughter several glasses of water to drink.
Correct Answer: B
Rationale: Visine is a sympathomimetic and if ingested may cause serious consequences. Medical treatment is necessary. Inducing vomiting is no longer recommended for ingestions. Dilution will not decrease risk.
What is probably the most important criterion on which to base the decision to report suspected child abuse?
- A. Inappropriate response of child
- B. Inappropriate parental concern for the degree of injury
- C. Absence of parents for questioning about childs injuries
- D. Incompatibility between the history and injury observed
Correct Answer: D
Rationale: Conflicting stories about the accident are the most indicative red flags of abuse. The child or caregiver may have an inappropriate response, but this is subjective. Parents should be questioned at some point during the investigation.
What is the most common form of child maltreatment?
- A. Sexual abuse
- B. Child neglect
- C. Physical abuse
- D. Emotional abuse
Correct Answer: B
Rationale: Child neglect, which is characterized by the failure to provide for the childs basic needs, is the most common form of child maltreatment. Sexual abuse, physical abuse, and emotional abuse are individually not as common as neglect.