The nurse is caring for a 7-year-old child who presents to the ED with multiple bruises, a fractured ankle, and cigarette burns on the arms. Which action by the nurse is most appropriate?

Number 4 is correct.

Any suspected cases of abuse and neglect must, by law, be reported to the authorities. The ED will have policies and procedures to guide staff on appropriate responses to suspected child abuse cases. Option 1 assumes that the parents are responsible for the burns and may provoke a violent response. While it is appropriate to ask the client what happened, the nurse should be aware that many abused children are coached to say that they fell off a swing or had another type of accident when asked about their injuries by authority figures. Option 3 is both presumptive and accusatory. Additionally, it may also provoke a violent response. The nurse must objectively assess the client and chart the findings, including descriptions of injuries. Child abuse cases require collaboration among nurses, physicians, social workers, police, and family services. The nurse should remain alert to verbal or nonverbal cues that the situation may intensify, and follow facility guidelines.