A nurse is assessing a 10-year-old child who presents with unexplained bruises and has difficulty sitting. What should the nurse's priority action be?

Choice A reason: Reassuring and scheduling follow-up delays action on potential abuse. Unexplained bruises suggest trauma, potentially elevating cortisol and stress responses. Scientifically, delaying intervention risks ongoing harm, as unaddressed abuse can lead to psychological disorders like PTSD, compromising the child’s safety and mental health. Choice B reason: Documenting and discharging ignores immediate safety concerns. Bruises and discomfort may indicate abuse, triggering stress-related physiological changes. Scientifically, failing to investigate risks further trauma, as unaddressed abuse can exacerbate anxiety or depression, leaving the child vulnerable to ongoing harm without protective intervention. Choice C reason: Contacting child protective services and further assessing ensures immediate safety. Bruises and discomfort suggest abuse, impacting stress hormones like cortisol. Scientifically, prompt reporting and evaluation protect the child from further trauma, addressing neurobiological stress responses and preventing long-term psychological harm, prioritizing child welfare. Choice D reason: Confronting the child risks re-traumatization, as children may fear disclosure. Scientifically, direct confrontation can elevate stress responses, increasing cortisol and amygdala activity, potentially worsening trauma-related symptoms. A sensitive, professional assessment is needed to confirm abuse without causing psychological harm or deterring honest communication.