A young child is being evaluated in the Emergency Department for ...

[audragclark]

A young child is being evaluated in the Emergency Department for injuries her mother reports resulted from a fall down the stairs. Which of these findings indicates that physi-cal abuse may be a chronic problem for the child?
 
  a. The mother's description of the child as being clumsy'
  b. Several fractures revealed on x-ray in varying degrees of healing
  c. Clinging to her mother as she attempted to leave the examining room
  d. Struggling with the staff when attempts to obtain a blood specimen were made

Question 2

A suicidal patient agreed on day 2 of hospitalization to write and sign a no self-harm contract. As a result of this contract, the health care team should plan to:
 
  a. Discontinue suicide precautions.
  b. Base the level of observation on staff assessment.
  c. Reduce observation to observing the patient every hour.
  d. Reduce one-to-one observation to observing the patient every 15 minutes.

[Joy Chen]

Answer to Question 1

ANS: B
Unhealed fractures indicate both numerous injuries and that medical intervention was not sought at the time of injury. Although unkind, the mother's description of the child is not reason to believe chronic abuse has occurred. The remaining options reflect normal behavior, especially if pain or separation is suspected.

Answer to Question 2

ANS: B
Research suggests that no-harm contracts may not prevent self-harm; therefore any reduction in suicide precautions is incorrect. Staff assessment needs to be continued and based on ob-servation.

[audragclark]

Excellent

[chereeb]

TYSM