A pediatric nurse is caring for an 18-month-old client. While making rounds the nurse enters the room and finds the infant's father violently shaking the infant
The father attempts to make it appear as though the infant was choking. Upon further assessment the nurse notes bruised areas on the infant's arms and legs. What is a priority action for the nurse to take?
A) Discuss what she witnessed with the infant's mother.
B) Discuss what she witnessed with the other nurses.
C) Report what she witnessed and assessed to child protective services.
D) Report what she witnessed and assessed to the local law enforcement agency.
Answer: C
Due to mandatory reporting laws, nurses must report all suspected cases of child abuse to the appropriate child protective services agency. It would not be appropriate at this time to discuss the findings with the infant's mother. The nurse does not know if the mother is aware of what is occurring and it would be best to have this further investigated. It would not be appropriate to discuss the findings with the other nurses as due to privacy regulations this information would be shared on a need-to-know basis.
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