A caregiver who works in the hospital brings his 9-year-old son to the emergency room with a spiral fracture of the tibia. The caregiver reports that the injury occurred when the boy’s 5-year-old sister hit him with a wooden bat. The injury is inconsistent with an impact and with the sister’s strength. Which of the following would be appropriate for the nurse to do in this situation?

Choice A reason: Calling the police directly bypasses hospital protocol for suspected abuse. Contacting social services allows for a multidisciplinary evaluation of the inconsistent spiral fracture story, ensuring appropriate investigation, making this premature and incorrect compared to following hospital child protection procedures for the child. Choice B reason: Informing the hospital administrator is less direct than contacting social services, which is trained to handle suspected abuse cases. The inconsistent injury story requires specialized assessment, making this less appropriate and incorrect for addressing the immediate concern of potential child maltreatment in the ER. Choice C reason: Confronting the caregiver risks escalating the situation and may hinder investigation. Reporting to social services ensures a professional evaluation of the implausible injury explanation, aligning with child protection protocols, making this confrontational approach incorrect for managing suspected abuse in the hospital setting. Choice D reason: Calling social services is the appropriate action for a spiral fracture with an inconsistent story, as it suggests possible abuse. Social services can investigate and coordinate with authorities, aligning with hospital protocols for child maltreatment, making this the correct response to ensure the child’s safety.