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Difficulty: MediumAbuse or Neglect

A practical nurse (PN) is assisting with the admission of a 4-year-old child who sustained a fractured femur. During data collection, the PN notes multiple round, circular scars in various stages of healing on the child's back. When the parents approach the bed, the child physically shrinks away and avoids eye contact. The parents state, "He is just so clumsy and falls all the time." Which of the following is the priority action for the practical nurse?

  1. Notify the supervising registered nurse and report the findings to the designated child protective authorities immediately.Answer
  2. B
    Delay reporting until further observation of the family dynamics provides concrete proof of abuse.
  3. C
    Ask the child directly why the parents caused the injuries to confirm the source of the trauma.
  4. D
    Perform an independent, comprehensive forensic assessment to document the precise mechanism of injury.

Answer

The practical nurse must immediately notify the supervising registered nurse and report the findings to the designated child protective authorities.
The correct action demonstrates an understanding of the practical nurse's role as a mandated reporter. Unexplained injuries that do not match the provided history, combined with fearful behavior, require immediate escalation to protect the child. The nurse only needs a suspicion of abuse to make a report, not definitive proof.

Step-by-Step Solution

1
Analyze the clinical findings presented in the scenario.
The child has inconsistent injury explanations (falls do not typically cause round scars on the back), fearful behavior toward parents, and an injury typical of non-accidental trauma.
Identifying red flags of physical abuse is the first step in protecting vulnerable populations.
2
Determine the legal and ethical responsibility of the practical nurse.
Nurses are legally mandated reporters of suspected child abuse.
The law requires healthcare professionals to prioritize client safety and immediately report reasonable suspicions of abuse without waiting for definitive proof.
3
Select the option that fulfills the mandated reporting requirement.
Reporting the findings to the supervising RN and child protective authorities is the correct action.
This action immediately initiates the protective process and adheres to the established chain of command.

Key Concept

Mandated Reporting of Suspected Abuse
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Topics

Abuse or Neglect

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