The nurse in the Emergency Department is taking a history from a family accompanying a child with traumatic injuries that are suspicious for abuse. Which of the following actions is most appropriate for the nurse to take?
Avoid responding to hints that abuse has occurred.
Separate the family from the child during the interview.
Report the concern for potential abuse to the immediate supervisor.
Obtain information as covertly as possible.
The Correct Answer is B
Rationale:
A. Avoid responding to hints that abuse has occurred is not appropriate. The nurse should address and assess any signs or suspicions of abuse openly.
B. Separate the family from the child during the interview is appropriate as it allows the nurse to obtain information from the child without potential coercion or influence from the family members.
C. Report the concern for potential abuse to the immediate supervisor is important but should be done after gathering sufficient information. The immediate action should focus on separating and interviewing the child.
D. Obtain information as covertly as possible is not ideal. It is important to obtain accurate information while ensuring the safety and comfort of the child, rather than being covert.
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Correct Answer is ["B","C","D"]
Explanation
Rationale:
A. Interventions should be planned and adapted based on the family’s specific context and needs. They are not completely unstructured but should be flexible and responsive.
B. The nurse-family relationship is central to the CFIM, facilitating effective communication and collaboration.
C. Focusing on family strengths and resiliency is a key aspect of the CFIM, aiming to build on what the family does well to improve functioning.
D. Interventions should be tailored to each family’s context and guided by their specific beliefs and experiences.
E. Family interventions aim to support and improve family functioning rather than correct all issues. The goal is not to resolve every problem but to enhance overall family functioning and support.
Correct Answer is ["A","C","E"]
Explanation
Rationale:
A. Living in a household with substance abuse and domestic violence is an ACE that can significantly impact a child's development and mental health.
B. Discipline using "time out" is generally considered a less harmful form of discipline and not classified as an ACE.
C. Childhood abuse is a significant ACE that has long-term effects on physical and mental health.
D. Being behind in reading skills is an educational concern but not classified as an ACE.
E. Neglect is an ACE that can severely affect a child's development and well-being.