A nurse is collecting data from a toddler at a well-child visit. Which finding should the nurse identify as a possible indication of child maltreatment?

A nurse is collecting data from a toddler at a well-child visit. Which finding should the nurse identify as a possible indication of child maltreatment?

• A. Bruising on the arms
• B. Hematuria
• C. Abrupt change in school attendance
• D. Laceration on the side of the torso

Answer: (D)

In evaluating potential child maltreatment, focus on injuries that don’t fit what a toddler could reasonably sustain from everyday activities. A laceration on the side of the torso stands out because the torso isn’t a common site for minor accidental injuries in a young child, and a laceration there can reflect blunt force trauma or handling that isn’t easily explained by ordinary play. This pattern of injury, especially in areas not typical for accidental causes, should raise concern and prompt further assessment and appropriate reporting. Bruising on the arms can occur with normal activity or falls during play, so it’s less specific. Abrupt changes in school attendance can be a sign of neglect or caregiver issues, but without an injury pattern to corroborate abuse, it’s not as direct an indicator as an unexplained torso laceration. In practice, any suspected maltreatment would lead to a careful, documented evaluation and, if warranted, reporting per policy.

In evaluating potential child maltreatment, focus on injuries that don’t fit what a toddler could reasonably sustain from everyday activities. A laceration on the side of the torso stands out because the torso isn’t a common site for minor accidental injuries in a young child, and a laceration there can reflect blunt force trauma or handling that isn’t easily explained by ordinary play. This pattern of injury, especially in areas not typical for accidental causes, should raise concern and prompt further assessment and appropriate reporting.

Bruising on the arms can occur with normal activity or falls during play, so it’s less specific. Abrupt changes in school attendance can be a sign of neglect or caregiver issues, but without an injury pattern to corroborate abuse, it’s not as direct an indicator as an unexplained torso laceration. In practice, any suspected maltreatment would lead to a careful, documented evaluation and, if warranted, reporting per policy.