Several small bruises on the shins are not a sign of child maltreatment. They are common in toddlers who are learning to walk and explore their environment. Bruises that are suspicious for abuse are usually located on the face, head, neck, chest, abdomen, or buttocks1.

A fracture of the arm from a bicycle injury is not a sign of child maltreatment. It is a common accidental injury in children who are active and adventurous. Fractures that are suspicious for abuse are usually spiral, metaphyseal, or rib fractures, or multiple fractures in different stages of healing1.

Biting other children while at daycare is not a sign of child maltreatment. It is a normal behavior in toddlers who are developing their social and communication skills. Biting may occur when a child is frustrated, angry, bored, or hungry. It can be prevented by providing adequate supervision, redirection, and positive reinforcement

rationale:
A 4-year-old child who has a history of frequent urinary tract infections. Rationale: Frequent urinary tract infections in a 4-year-old child are more likely related to medical factors such as anatomical differences, hygiene practices, or immune system vulnerabilities. While frequent infections might warrant medical attention, they are not typically associated with child maltreatment. For a client with sickle cell anemia in a vaso-occlusive crisis, the nurse should maintain bed rest to prevent hypoxemia. When caring for an adolescent in skeletal traction for a fractured femur, applying protective padding to the end of the pin sites is essential. When identifying potential indications of child maltreatment among well-child clinic clients, the nurse should report the presence of multiple small bruises in unusual locations on a young child's body as a red flag for further assessment.