Chapter 1, Abuse and Assault Emergencies Video Solutions, Emergency Medicine Examination & Board Review

Problem 1

Which of the following is the BEST evidence of failure to thrive in an infant?
(A) Prefers inanimate over animate objects.
(B) Is difficult to console.
(C) Has minimal subcutaneous fat.
(D) Gains weight in hospital.

Dennis Howard

Numerade Educator

Problem 2

Which of the following statements regarding psychosocial dwarfs is Not correct?
(A) Their short statures exceed their low weights.
(B) They have bizarre, voracious appetites.
(C) They have disturbed home situations.
(D) Blunted growth hormone responses are irreversibly impaired.

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Problem 3

A 5-year-old boy is brought in by his mother with the chief complaint of hematuria. There is no history of fever, abdominal pain, nausea, vomiting, or prior renal disease. Vital signs and physical examination are normal. The nurse happens to observe the mother covertly dripping blood from her finger into the container of urine. What is the name of this behavior?
(A) Malingering.
(B) Munchausen syndrome.
(C) Somatoform disorder.
(D) Polle's syndrome.

Lauren Long

Numerade Educator

02:33

Problem 4

Which of the following statements regarding child sexual abuse is the Nost important tenet to remember for documentation?
(A) The presenting complaint may or may not be related to the genitourinary system.
(B) There is usually a time delay before the abuse is reported.
(C) The assailant is usually known to the child.
(D) The absence of physical findings does not preclude abuse.

Leonardo Filgueiras

Numerade Educator

Problem 5

A three-year-old boy is brought to the ED by his mother because of a bite to the left forearm, which she claims was inflicted by his 15-month-old sister 2 hours ago. Vital signs are normal. The patient has full range of motion in his left upper extremity, which is neurovascularly intact. A crescentic bite mark is on the proximal forearm. The teeth marks have caused bruising and multiple skin breaks, which have stopped bleeding. What is the NEXT most appropriate action?
(A) Irrigate the wound.
(B) Swab the site for galiva and photograph the wound.
(C) Measure the intercanine diameter.
(D) File a report of suspected child abuse.

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Problem 6

A 30-year-old woman arrives by private vehicle with multiple contusions inflicted by her intimate partner, who struck her with the butt of a gun. She has a tender contusion and abrasions to the mid-ulnar aspect of the left forearm. There is no bony instability. The extremity is neurovascularly intact, and the remainder of the physical examination is normal. The wound is cleaned and dressed. The police have not been notified yet. A report is started by the emergency physician, and the social worker is called but is presently involved in another case. The patient says she has considered leaving the partner in the future, but for now, she plans to return home. During an argument earlier this week, the partner threatened to kill her and then commit suicide. There are no children or pets in the household. What is the next MOST appropriate action?
(A) Complete the report and discharge the patient to home.
(B) Complete the report, notify the pollce, and wait for arrival of law enforcement before inftiating any discharge.
(c) Complete the report, discharge the patient, and have her wait in the lobby for the social worker.
(D) Complete the report and admit the patient to the hospital.

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01:35

Problem 7

Which of the following statements regarding elder abuse is Nor correct?
(A) A victim's functional disability or acute cognitive decline may increase the risk of abuse.
(B) Situational stresses are the most likely trigger for the abuser.
(C) Incontinence, nocturnal shouting, wandering, and paranoia are common historical features in the victim.
(D) Unexplained injuries and sexually transmitted diseases suggest abuse.

Emily Himsel

Numerade Educator

Problem 8

A 3-year-old girl is brought to the emergency department by her mother with a chief complaint of abdominal pain for 2 hours. Fever, vomiting, and diarrhea are denied by the mother, who has been drinking alcohol. Vital signs are blood pressure 86/40 $\mathrm{mmHg}$, pulse 130 beats per minute, respirations 24 per minute, temperature $37^{\circ} \mathrm{C}$, and room air oxygen saturation $100 \%$. The child's abdonen is distended and tender. A contusion is visible in the right upper quadrant, and bowel sounds are diminished. older bruises are seen on the upper arms, anterior thighs, and buttocks. A screening ultrasound reveals fluid between the liver and the kidney. The mother denies trauma but becomes very tearful. An IV is started, and blood is sent to the laboratory. What is the next MosT appropriate sequence of events?
(A) Consult surgery, and contact social services.
(B) Ask the child what happened, consult surgery, and contact social aervices.
(C) Contact social services, then consult surgery.
(D) Contact surgery, and notify law enforcement directly.

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