Question

The nurse is working in a community clinic when a man and woman bring a 12 year-old boy in, stating that the child fell down a flight of stairs and hurt his arm. The nurse notices several other bruises on the child's body at varying stages of healing. The boy is placed on the stretcher. When asked how he hurt himself, he states that he does not remember. However, the nurse notices that the boy continuously avoids looking at the man, while the man stares at him constantly. The nurse should?

1) Ask the boy if the man hurt him.
2) Confront the man directly.
3) Ask the man and woman to step out.
4) Ask the woman if the man hurt the boy.

Answer 1

The nurse should ask the man and woman to step out, creating a safe environment for the child to disclose information about their injuries without fear of retribution.

Step-by-step explanation:

In this clinical scenario, the nurse is presented with potential signs of child abuse, including multiple bruises at varying stages of healing and avoidant behavior by the boy towards the man. The professional and appropriate course of action would be to discreetly separate the child from the adults in order to conduct a private assessment. Therefore, the nurse should ask the man and woman to step out to ensure the boy's safety while further evaluating the situation.

Confronting the suspected abuser or conducting questioning in front of them may escalate the risk to the child. It's essential for medical professionals to create a safe environment where a potentially abused child feels secure enough to disclose any information about their injuries without fear of retribution. Once the child is alone, the nurse can then gently ask open-ended questions to determine the cause of the injuries and ensure the child receives the appropriate care and protection.