NUR 138 - Quiz 4 Questions With Complete Solutions

The nurse is providing care to a child who has suffered abuse. Which nursing actions are appropriate? Select all that apply. A. Follow protocols for mandatory reporting. B. Ask the child to repeat what really happened again. C. Remind the child that he did nothing wrong. D. Ask the child what he did to cause his parents to beat him so badly. E. Tell the child that the individual who hurt them is a bad person. correct answer: Answers: A, C Rationale: The priority nursing consideration regarding the abused child is to ensure the immediate safety of the child. Beyond that, the abused child needs to be encouraged to talk about the abuse but must also be protected from having to provide multiple reports. The nurse working with the abused child needs to say that he or she believes the child's story; the nurse also must reassure the child that he or she has done nothing wrong. The nurse should avoid making negative comments about the abuser and must follow established protocols for mandatory reporting, documentation, and use of available support services. Page Ref: 1962 A client who began taking fluoxetine (Prozac) three weeks ago is being seen for follow-up. The client reports feeling better and having more energy. Which is the priority nursing diagnosis for the client at this time? A. Social Isolation