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A nurse notices several bruises on a toddler while bathing her. What should the nurse do first?

  1. Ask the toddler what caused the bruises.

  2. Notify the provider.

  3. Ask the parents what caused the bruises.

  4. Notify social services.

The correct answer is: Ask the parents what caused the bruises.

In this scenario, the most appropriate first step is to ask the parents what caused the bruises. When a nurse observes unexplained bruising on a child, it is crucial to gather context before taking further action. Engaging the parents in conversation can help to determine whether there is a reasonable explanation for the injuries. They may provide information about the child's activities, any recent falls, or episodes that may have led to these bruises. Additionally, asking the parents initially promotes parental involvement and may lead to a collaborative approach in addressing the child's wellbeing. It is important to create an environment where parents feel they can share information without feeling accused, which is vital in maintaining trust and rapport. Once the information from the parents has been gathered, if the explanation raises concerns about potential abuse or neglect, the nurse would then be in a better position to consider notifying the provider or social services as appropriate. This approach helps ensure that action is taken thoughtfully and based on a complete understanding of the situation.