1. The investigation of child abuse is a critical and sensitive issue, and is estimated that law enforcement agencies in the United States investigate more than _________ cases of child maltreatment each year and that as many as _____ children die as a result of this maltreatment.
A. 4.1 million; 4000
B. 3.7 million; 3000
C. 3.3 million; 2,000
D. 2.9 million; 1000
2. Some characteristics of injuries to children and are considered red flags and warrant further scrutiny include injuries on protected surfaces of the body, such as the back and buttocks, ears, inside the mouth, genitalia and inner thighs, the neck, arms or legs, and underarms as well as multiple injuries in various stages of healing.
3. Following a report of abuse, an injury assessment must occur, which focuses on each of the following questions EXCEPT:
A. Is the injury explanation reasonable?
B. Is the injury natural or caused by a medical condition?
C. Is the injury accidental?
D. Is the injury inflicted?
4. Sometimes medical conditions can cause symptoms that may appear to be a result of abuse or neglect, such as:
A. Mongolian spots and some birthmarks that occur in dark-skinned individuals can be mistaken for bruises
B. Excessive bruising, or petechiae, may result from low platelet counts or clotting disorders, such as hemophilia or Von Willebrand disease
C. Rarely, a young infant may have an abnormality of bone or collagen that causes bone fractures
D. All of the above
5. Falls are the most common cause of childhood injury, and often result in bruises to the buttocks, thighs and calves, but when a child has bruises on the forearms, chin, or shins, which are uncommon, further investigation may be needed.
6. Contact burns involve prolonged exposure to heat and reflect the size and shape of the part of the object that contacted the skin, and are generally the most difficult cases to access.
7. While accidental fractures can occur in children who are mobile and active, they are rare in infants because they do not have the strength or mobility to cause them, and their bones are more flexible than those of older children and adults, and can bend significantly before breaking.
8. Which of the following are NOT common features suggesting that fractures are a result of abuse?
A. Inconsistency between the movement necessary to cause a fracture and the description of how the injury occurred
B. Significant delay in seeking medical care
C. Complex, depressed limb fractures
D. Metaphyseal fractures/classic metaphyseal lesions
9. Bruising to the face, ears, eyes, and neck is often associated with abuse in children who are not walking or who are younger than age 3, and retinal hemorrhages or trauma to the eye and its surrounding structures should always be evaluated as potential abuse in children this age.
10. The most effective way to investigate child maltreatment is through interagency coordination and planning, also known as a multidisciplinary team approach, which should include physicians and other healthcare providers, social workers, therapists, victim/witness service providers, prosecutors, judges, and law enforcement officers.
11. The responsibilities of the medical community in identifying and treating injuries should include diagnosing, interpreting, and documenting the injuries, making appropriate referrals when needed, reporting suspected incidents of abuse to the appropriate authorities, and:
A. Following up with the child welfare agency to determine the case resolution
B. Providing evidence for subsequent legal proceedings
C. Maintaining open communication with parents or caregivers
D. None of the above
12. In nonemergency situations, medical evaluations can be performed at non-specialized community facilities, but they should be scheduled within 24 hours to increase the potential for evidence collection.
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