Choice A Reason: Asking the mother to leave the room and interviewing the child alone may be helpful, but it is not the first priority. The nurse should ensure the safety of the child and follow the mandatory reporting laws for child abuse.

Choice B Reason: This is the correct answer. The nurse has a legal and ethical obligation to document the findings and report the suspected abuse to the appropriate authorities, such as child protective services or law enforcement. This will initiate an investigation and protect the child from further harm.

Choice C Reason: Confronting the mother about the possibility of physical abuse and offering her counseling is not appropriate at this stage. The nurse should not accuse or judge the mother, as this may escalate the situation and endanger the child. The nurse should focus on providing support and resources to both the child and the mother, but only after reporting the abuse.

Choice D Reason: Discharging the child with a referral to a social worker and a follow-up appointment is not sufficient to address the situation. The child may be at risk of further abuse or even death if returned to the abusive environment. The nurse should not discharge the child until an investigation is conducted and a safety plan is established.

Choice A Reason: This is a correct answer. The nurse should administer antibiotics as prescribed to treat chlamydia, which is a sexually transmitted infection that can cause serious complications if left untreated.

Choice B Reason: This is a correct answer. The nurse should provide pain relief as needed to help the client cope with genital pain, which may be caused by trauma, infection, or inflammation.

Choice C Reason: This is a correct answer. The nurse should collect forensic evidence as indicated, such as swabs, blood samples, or clothing, to assist with legal prosecution of the perpetrator. The nurse should follow proper protocols for handling and documenting evidence.

Choice D Reason: This is not a correct answer. Educating the client about safe sex practices is not appropriate at this time, as it may imply blame or judgment on the client. The client was not engaging in consensual sex, but was coerced or forced by a relative. The nurse should focus on providing emotional support and validating the client's feelings.

Choice E Reason: This is a correct answer. The nurse should refer the client to a mental health professional, such as a counselor or therapist, who can provide ongoing psychological care for the client. The client may experience post-traumatic stress disorder, depression, anxiety, or other mental health issues as a result of sexual abuse.

Choice A Reason: This statement by the nurse would be inappropriate, as it would be accusatory, confrontational, and threatening to the parents. This may provoke anger or defensiveness from the parents, and worsen the situation for the child. The nurse should report the suspected emotional abuse to the appropriate authorities, but not disclose this to the parents.

Choice B Reason: This statement by the nurse would be appropriate, as it would be empathetic, nonjudgmental, and supportive to the parents. This may help the nurse establish rapport and trust with the parents, and explore their feelings and needs. The nurse may also use this opportunity to provide education and resources to the parents on positive parenting strategies and stress management.

Choice C Reason: This statement by the nurse would be inappropriate, as it would be false, misleading, and enabling to the parents. The nurse should not praise or reinforce the parents' abusive behavior, as this may encourage them to continue or escalate it. The nurse should also not minimize or ignore the child's emotional distress.

Choice D Reason: This statement by the nurse would be inappropriate, as it would be critical, blunt, and confrontational to the parents. This may cause guilt or shame in the parents, and damage the therapeutic relationship with the nurse. The nurse should not lecture or scold the parents, but rather use open-ended questions and reflective listening to help them understand the impact of their behavior on their child.

Choice A Reason: This statement by the nurse would be inaccurate, as hitting or slapping a child for misbehaving is an example of physical abuse, not neglect. Physical abuse is the intentional use of physical force that causes or risks harm to a child.

Choice B Reason: This statement by the nurse would be inaccurate, as leaving a child alone at home while going to work may or may not be an example of neglect, depending on the age and maturity of the child, the duration and frequency of the absence, and the availability of supervision and support. Neglect is the failure to provide for a child's basic physical, emotional, educational, or medical needs.

Choice C Reason: This statement by the nurse would be inaccurate, as forcing a child to participate in sexual activities is an example of sexual abuse, not neglect. Sexual abuse is the involvement of a child in sexual activity that he or she cannot consent to or understand.

Choice D Reason: This statement by the nurse would be accurate, as failing to provide a child with adequate food, clothing, or shelter is an example of neglect. Neglect is the failure to provide for a child's basic physical, emotional, educational, or medical needs.

Choice A Reason: This is the correct answer. A 2-year-old client who has a skull fracture and subdural hematoma has the highest risk of mortality from abuse, as these injuries are indicative of severe head trauma, which can lead to brain damage, coma, or death. Head injuries are one of the most common causes of death among abused children, especially those under 4 years old.

Choice B Reason: A 5-year-old client who has multiple rib fractures and a punctured lung has a high risk of morbidity from abuse, as these injuries are indicative of blunt force trauma to the chest, which can cause respiratory distress, infection, or shock. However, these injuries are less likely to be fatal than head injuries, especially if treated promptly.

Choice C Reason: An 8-year-old client who has second-degree burns on both hands and arms has a moderate risk of morbidity from abuse, as these injuries are indicative of thermal injury from hot liquids or objects, which can cause pain, infection, or scarring. However, these injuries are less likely to be life-threatening than head or chest injuries, unless they cover a large surface area of the body.

Choice D Reason: A 12-year-old client who has a broken femur and internal bleeding has a low risk of morbidity from abuse, as these injuries are indicative of blunt force trauma to the leg, which can cause pain, swelling, or hematoma. However, these injuries are unlikely to be fatal unless complicated by infection, embolism, or hemorrhage.

Choice A Reason: This is the correct answer. Play therapy is a form of psychotherapy that uses play as a medium of communication and expression for children who have difficulty verbalizing their feelings and thoughts. Play therapy allows the client to explore, understand, and resolve his emotional issues in a safe and nonthreatening way, with the guidance of a trained therapist.

Choice B Reason: This is not a correct answer. Play therapy may help the client to develop social skills and interact with other children who have similar experiences, but this is not the primary rationale for using play therapy for this client. Play therapy is more focused on the individual needs and goals of the client, rather than on group dynamics or peer support.

Choice C Reason: This is not a correct answer. Play therapy may teach the client coping skills and strategies to deal with stressful situations and emotions, but this is not the main rationale for using play therapy for this client. Play therapy is more focused on the emotional healing and resolution of the client, rather than on behavioral modification or skill acquisition.

Choice D Reason: This is not a correct answer. Play therapy may enhance the client's cognitive development and problem-solving abilities, but this is not the primary rationale for using play therapy for this client. Play therapy is more focused on the affective and expressive aspects of the client, rather than on the cognitive or intellectual aspects.

Choice A Reason: This is the correct answer. Post-traumatic stress disorder (PTSD) is a mental health disorder that occurs after exposure to a traumatic event that involves actual or threatened death, serious injury, or sexual violence. PTSD is characterized by intrusive symptoms (such as nightmares, flashbacks, or distressing memories), avoidance symptoms (such as avoiding reminders of the trauma or detaching from others), negative alterations in cognition and mood (such as guilt, shame, or distrust), and alterations in arousal and reactivity (such as hypervigilance, irritability, or insomnia).

Choice B Reason: This is not a correct answer. Major depressive disorder (MDD) is a mental health disorder that involves persistent and pervasive feelings of sadness, hopelessness, or worthlessness that interfere with daily functioning. MDD may be triggered by traumatic events such as sexual abuse, but it does not necessarily involve symptoms of intrusion, avoidance, or hyperarousal that are specific to PTSD.

Choice C Reason: This is not a correct answer. Generalized anxiety disorder (GAD) is a mental health disorder that involves excessive and uncontrollable worry about various aspects of life that causes significant distress or impairment. GAD may be exacerbated by traumatic events such as sexual abuse, but it does not necessarily involve symptoms of intrusion, avoidance, or negative mood that are specific to PTSD.

Choice D Reason: This is not a correct answer. Dissociative identity disorder (DID) is a mental health disorder that involves disruption of identity characterized by two or more distinct personality states that recurrently take control of behavior. DID may be associated with traumatic events such as sexual abuse, but it does not necessarily involve symptoms of intrusion, avoidance, or arousal that are specific to PTSD.

Choice A Reason: This is a correct answer. Headache is a sign of increased intracranial pressure (ICP), as the pressure on the brain causes pain and discomfort. Headache may be more difficult to assess in a 3-year-old client, but the nurse should instruct the parents to look for cues such as holding or rubbing the head, crying, or refusing to eat or play.

Choice B Reason: This is a correct answer. Vomiting is a sign of increased intracranial pressure (ICP), as the pressure on the brainstem causes stimulation of the vomiting center and nausea. Vomiting may be more frequent and projectile in a 3-year-old client with increased ICP, and may not be related to food intake or illness.

Choice C Reason: This is a correct answer. Bradycardia is a sign of increased intracranial pressure (ICP), as the pressure on the brainstem causes disruption of the autonomic nervous system and decreased heart rate. Bradycardia may be accompanied by hypertension and irregular respirations, which are known as Cushing's triad, a late and ominous sign of increased ICP.

Choice D Reason: This is not a correct answer. Dilated pupils are not a sign of increased intracranial pressure (ICP), but rather a sign of brain herniation, which is a life-threatening complication of increased ICP. Brain herniation occurs when the brain tissue shifts from its normal position and compresses vital structures such as the cranial nerves and the brainstem. Dilated pupils may indicate compression of the oculomotor nerve (cranial nerve III), which controls pupil constriction.

Choice E Reason: This is a correct answer. Irritability is a sign of increased intracranial pressure (ICP), as the pressure on the brain causes changes in behavior and personality. Irritability may manifest as agitation, restlessness, crying, or aggression in a 3-year-old client with increased ICP, and may not be responsive to soothing or distraction.