CFN Child Maltreatment Recognition and Reporting 1 — Questions and Answers
Question 1: Which bruise pattern is considered a classic indicator of child physical abuse?
- Scattered bruises on shins and knees
- Bruising on the ears, neck, or buttocks in non-ambulatory children (Correct answer)
- Bruising on the forehead from a fall
- Bruising at bony prominences
Correct answer: Bruising on the ears, neck, or buttocks in non-ambulatory children
Bruising on protected areas such as ears, neck, and buttocks in non-ambulatory infants is a strong indicator of non-accidental trauma.
Question 2: A forensic nurse suspects child abuse but the caregiver provides a history that seems inconsistent with the injury. What is the appropriate documentation approach?
- Document only the caregiver's explanation
- Document the injury findings and record the caregiver's history verbatim, noting any inconsistencies (Correct answer)
- Confront the caregiver and withhold documentation until resolved
- Delay documentation until law enforcement arrives
Correct answer: Document the injury findings and record the caregiver's history verbatim, noting any inconsistencies
Objective documentation of both physical findings and the caregiver's exact history — including inconsistencies — is critical for forensic and legal purposes.
Question 3: Shaken Baby Syndrome (Abusive Head Trauma) most commonly presents with which triad of findings?
- Femur fracture, bruising, and hypoglycemia
- Subdural hemorrhage, retinal hemorrhage, and encephalopathy (Correct answer)
- Skull fracture, epistaxis, and vomiting
- Rib fractures, petechiae, and apnea alone
Correct answer: Subdural hemorrhage, retinal hemorrhage, and encephalopathy
Abusive Head Trauma classically presents with subdural hemorrhage, retinal hemorrhage, and encephalopathy resulting from violent shaking forces.
Question 4: Which fracture type in an infant is most suspicious for child abuse?
- Linear skull fracture from a short fall
- Metaphyseal (corner/bucket-handle) fractures of long bones (Correct answer)
- Greenstick fracture of the forearm
- Clavicle fracture during birth
Correct answer: Metaphyseal (corner/bucket-handle) fractures of long bones
Metaphyseal fractures occur from jerking or twisting forces on an infant's limbs and are highly specific for non-accidental trauma.
Question 5: As a forensic nurse, you are a mandatory reporter of suspected child abuse. To whom must you report in the US?
- Only to the attending physician
- To child protective services (CPS) and/or law enforcement (Correct answer)
- To the hospital ethics committee first
- To the child's school
Correct answer: To child protective services (CPS) and/or law enforcement
Mandatory reporters must report suspected child abuse to child protective services and/or law enforcement, depending on state law.
Question 6: What is the primary purpose of a skeletal survey in a suspected child abuse case?
- To assess bone density for rickets
- To identify occult fractures in various stages of healing (Correct answer)
- To rule out congenital bone disorders only
- To document current injuries for billing purposes
Correct answer: To identify occult fractures in various stages of healing
A full skeletal survey detects occult or healing fractures across multiple body sites, revealing a pattern of repeated trauma over time.
CFN Child Maltreatment Recognition and Reporting 1
Which bruise pattern is considered a classic indicator of child physical abuse?