Chapter 24: Injury Prevention and Child Maltreatment

Garzon Maaks: Burns’ Pediatric Primary Care, 7th Edition

MULTIPLE CHOICE

1. The primary care pediatric nurse practitioner is examining a young child who has cerebral
palsy. Which part of the family history raises concerns about potential child maltreatment?
a. Child attends day care
b. Limited financial resources
c. Mother works outside the home
d. No membership in a church
ANS: B
Limited financial resources can put a strain on caring for a child with special needs whose
medical needs are expensive. The fact that the mother works outside the home and the child
attends day care may actually provide some respite from the strain of caring for a special
needs child. Families may have strong spiritual values whether they attend church or not.

2. The primary care pediatric nurse practitioner suspects that the parent of a child who is doing
poorly in school is being abused by a partner. What is a priority response by the nurse
practitioner?
a. Notifying the child’s school counselor about this problem
b. Referring the child and family to a social worker
c. Reporting this according to any mandated reporting laws
d. Suggesting that the parent avoid the abusive situation
ANS: C
In most states, health care providers are mandated to report a child’s exposure to Intimate
partner violence since it is considered a form of emotional child abuse. The PNP should
follow any state laws that mandate this as a priority. Once child protective services is
involved, the PNP may assist with notification of school personnel, referrals to social workers,
and suggestions to parents.

3. The primary care pediatric nurse practitioner is examining a young child who was brought in
by a grandmother for evaluation of a partial-thickness burn on one arm. The PNP suspects that
this is an intentional injury, but the grandmother states that the parents are “just careless” and
that the child is now living with her. What will the PNP do?
a. Flag this as a concerning incident in the child’s record.
b. Reassure the grandmother that she is doing the right thing.
c. Refer the child’s parents to a parenting resource center.
d. Report a suspicion of abuse to child protective services.
ANS: D
All states have mandatory reporting laws that require health care professionals to report
suspected or known abuse to appropriate agencies and provide both civil and criminal
immunity to mandated reporters. The other options may be necessary once the case is
investigated, but the priority is to report the suspicion of abuse.
4. The primary care pediatric nurse practitioner is evaluating a 12-year-old girl who reports
penile penetration of her vagina by her mother’s boyfriend the day before yesterday. The PNP
reports this to the local child abuse hotline. What is the PNP’s next action?
a. Attaining a history of the abuse from the child
b. Obtaining urethral specimens for STI testing
c. Performing a colposcopic examination to evaluate for trauma
d. Referring the child to the ED for forensic specimen collection
ANS: D
If sexual abuse has occurred within 72 hours, it is required that appropriate forensic specimens
be collected. Getting a history from the child is part of the child abuse evaluation and will be
done by the child abuse team, as well as obtaining urethral specimens for STI. Colposcopic
exams should be done by an expert in sexual abuse if trauma is suspected but is not performed
by the PCPNP.

5. What intervention should the primary care provider (PCP) encourage all parents to implement
to engage in the best management of potential serious child related injuries?
a. Being aware of the causes of common childhood injuries
b. Actively engaging in attentive parenting practices
c. Actively supporting state and federal programs like Safe Kids USA
d. Being proficient in basis pediatric life support techniques
ANS: D
While all the options are appropriate parental interventions, the management of potential
serious child related injuries is best served by parents and caregivers being familiar with and
proficient in basic pediatric life support techniques.