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A nurse is collecting data from a toddler at a well-child visit. Which of the following findings should the nurse identify as a possible indication of child maltreatment?

(a) The toddler has a bruise on the arm that the parent explains occurred when the child fell off a swing at the park.

(b) The toddler is wearing dirty clothes and has not been bathed in several days.

(c) The toddler is very quiet and withdrawn and does not interact with the nurse.

(d) The toddler has a healthy weight and is up-to-date on all immunizations.

User Raga
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Final answer:

A nurse should identify a toddler wearing dirty clothes and appearing unbathed as a possible sign of neglect, which is a form of child maltreatment. While other options provided might not indicate abuse themselves, they should be monitored as part of a broader assessment of the child's wellbeing.

Step-by-step explanation:

Among the scenarios provided, the nurse should identify (b) the toddler wearing dirty clothes and not having been bathed in several days as a possible indication of child maltreatment. Neglect is the most common form of child abuse and involves the failure of a parent or guardian to provide for the basic needs of a child, which can lead to hazardous levels of neglect. While a single incident of a child wearing dirty clothes may not be definitive proof of neglect, it can serve as a warning sign, especially if there are other indications such as the child consistently appearing unkempt or signs of poor hygiene. On the other hand, a bruise resulting from a typical play activity such as falling off a swing (option a), a child's behavior being quiet or withdrawn without other signs of abuse (option c), and the child having a healthy weight and being up-to-date with immunizations (option d) are not necessarily indicative of maltreatment.

Child welfare services may intervene if information or assistance from public or private services are available and a parent fails to use those services. Furthermore, with avoidant attachment, a child's unresponsiveness could indicate possible maltreatment, but this must be assessed in a larger context of the child's interactions and behavior. Therefore, careful monitoring and assessment is essential for a nurse when identifying potential cases of child maltreatment.

User Matthew Trevor
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