A nurse is caring for a child who reports being physically abused by a family member. Which of the following statements should the nurse make?
"I promise I won't tell anyone about this."
"Let's discuss what you have told me with your family members."
"Your family is bad for doing this to you."
"It is not your fault that this happened."
The Correct Answer is D
A. "I promise I won't tell anyone about this.": This is inappropriate as nurses are mandated reporters and must inform authorities when abuse is suspected.
B. "Let's discuss what you have told me with your family members.": Involving the alleged abuser(s) directly can put the child at greater risk and is inappropriate.
C. "Your family is bad for doing this to you.": Judging or labeling the family is unprofessional and could make the child feel conflicted or guilty.
D. "It is not your fault that this happened.": This response reassures the child, alleviating feelings of guilt and fostering trust, while remaining supportive and professional.
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Correct Answer is B
Explanation
A. Depressed anterior fontanel: A depressed fontanel is typically associated with dehydration, not meningitis.
B. High-pitched cry: A high-pitched cry is a classic symptom of meningitis in infants, often associated with increased ICP.
C. Constipation: Meningitis is more likely to cause irritability and feeding difficulties than constipation.
D. Presence of the rooting reflex: The rooting reflex is normal in a 4-month-old and does not specifically indicate meningitis.
Correct Answer is ["B","D","E"]
Explanation
A. Clear CSF: Clear CSF is typically seen in viral meningitis or normal findings, not bacterial meningitis.
B. Cloudy CSF: Cloudy CSF indicates the presence of infection and is characteristic of bacterial meningitis.
C. Negative gram stain: A negative gram stain indicates the absence of bacterial pathogens, which is not consistent with bacterial meningitis.
D. Decreased glucose content: Bacteria consume glucose, leading to decreased glucose levels in bacterial meningitis.
E. Positive gram stain: A positive gram stain confirms the presence of bacterial organisms in the CSF, supporting a diagnosis of bacterial meningitis.