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Question

Difficulty: MediumAbuse or Neglect

While conducting a health screening at a community clinic, a practical nurse observes multiple symmetrical, circular burns on the posterior thighs of a 6-year-old client. The child's parent claims the child accidentally sat on a hot metal grate while playing at a park. Which of the following actions is the priority for the nurse to take?

  1. A
    Confront the parent directly about the inconsistency between the circular burn marks and a metal grate.
  2. B
    Wait until the end of the shift to see if the child privately discloses any information about the injuries.
  3. Notify the supervising registered nurse or provider immediately regarding the suspicious injury pattern.Answer
  4. D
    Take photographs of the child's burns using a personal mobile device to show to child protective services.

Answer

The correct action is to notify the supervising registered nurse or provider immediately regarding the suspicious injury pattern.
The observed injury pattern (symmetrical, circular burns) is a hallmark sign of intentional trauma (such as cigarette burns) and directly conflicts with the parent's explanation of sitting on a metal grate. The absolute priority for the practical nurse is to ensure client safety by immediately escalating these findings to the supervising registered nurse or provider. This initiates the facility's mandated reporting procedures and ensures appropriate authorities are contacted without delay.

Step-by-Step Solution

1
Analyze the clinical findings against the caregiver's explanation.
The physical assessment reveals symmetrical, circular burns that do not match the mechanism of injury described (falling on a metal grate), indicating possible non-accidental trauma.
Identifying inconsistencies between physical injuries and the reported history is crucial for recognizing abuse.
2
Determine the practical nurse's priority responsibility.
The nurse recognizes the legal and ethical mandate to report suspected abuse immediately to protect the vulnerable child.
Healthcare professionals are mandated reporters and must act on reasonable suspicion without waiting for concrete proof.
3
Select the safest and most appropriate escalation action.
The nurse decides to immediately notify the supervising registered nurse or the provider.
Escalating up the chain of command ensures the facility's mandated reporting protocols and safety measures are activated immediately.

Key Concept

Mandated Reporting and Abuse Recognition
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Topics

Abuse or Neglect

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