Nokea
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.
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What is a significant secondary prevention nursing activity for lead poisoning?
- A. Chelation therapy
- B. Screening children for blood lead levels
- C. Removing lead-based paint from older homes
- D. Questioning parents about ethnic remedies containing lead
Correct Answer: B
Rationale: Screening children for lead poisoning is an important secondary prevention activity. Screening does not prevent the initial exposure of the child to lead. It can lead to identification and treatment of children who are exposed. Chelation therapy is treatment, not prevention. Removing lead-based paints from older homes before children are affected is primary prevention. Questioning parents about ethnic remedies containing lead is part of the assessment to determine the potential source of lead.
A child with diazepam (Valium) poisoning has been admitted to the emergency department. What antidote does the nurse anticipate being prescribed?
- A. Succimer (Chemet)
- B. EDTA (Versenate)
- C. Flumazenil (Romazicon)
- D. Octreotide acetate (Sandostatin)
Correct Answer: C
Rationale: The antidote for diazepam (Valium) poisoning is flumazenil (Romazicon). Succimer (Chemet) and EDTA (Versenate) are antidotes for heavy metal poisoning. Octreotide acetate (Sandostatin) is an antidote for sulfonylurea poisoning.
What statement is correct about young children who report sexual abuse?
- A. They may exhibit various behavioral manifestations.
- B. In more than half the cases, the child has fabricated the story.
- C. Their stories should not be believed unless other evidence is apparent.
- D. They should be able to retell the story the same way to another person.
Correct Answer: A
Rationale: Victims of sexual abuse have no typical profile. The child may exhibit various behavioral manifestations, none of which is diagnostic for sexual abuse. When children report potentially sexually abusive experiences, their reports need to be taken seriously. Other children in the household also need to be evaluated. In one study, approximately 96% of children who were sexually abused had normal genital and anal findings. The ability to retell the story is partly dependent on the childs cognitive level. Children who repeatedly tell identical stories may have been coached.
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.
The nurse is caring for a child with suspected ingestion of some type of poison. What action should the nurse take next after initiating cardiopulmonary resuscitation (CPR)?
- A. Empty the mouth of pills, plants, or other material.
- B. Question the victim and witness.
- C. Place the child in a side-lying position.
- D. Call poison control.
Correct Answer: A
Rationale: Emptying the mouth of any leftover pills, plants, or other ingested material is the next step after assessment and initiation of CPR if needed. Questioning the victim and witnesses, calling poison control, and placing the child in a side-lying position are follow-up steps.