The nurse notes cigarette burns on the back of an adolescent patient while providing routine care. After initial hesitation, the patient tells the nurse that her mother burns her when she is "bad." The patient then begs the nurse not to tell any

Question

What is the appropriate statement by the nurse?
1. "Don't worry, I won't break your confidence."
2. "I have to tell or I'll get in big trouble myself."
3. "I'm sorry, but it is my responsibility to report that your mother is burning you with a cigarette."
4. "OK, but can I get your permission to tell your doctor this is happening?"

Answer 1

Answer: 3
Explanation: In most states, nurses are mandated reporters for cases of abuse of both children and older adults. There are substantial penalties for failing to report. Therefore, the nurse cannot assure the patient that she won't report the abuse. It is not sufficient to tell the doctor only, and the nurse does not need to get the adolescent's consent in this case. Telling the patient that the nurse will get in trouble is not the best way to foster a therapeutic relationship with the child, in part because it puts the focus on the nurse and not the patient. Gently letting the patient know that the nurse will need to report the abuse and following protocol early is the best response.