A nurse is caring for a group of children in a clinic. Which of the following children should the nurse identify as being at an increased risk for child maltreatment?

Introduction: Child maltreatment involves physical, emotional, or sexual abuse and neglect, often targeting vulnerable populations. Factors such as caregiver strain, lack of social support, and the child's specific healthcare needs significantly increase the risk of abusive behaviors within the family dynamic or caregiving environment. A. While parental mental illness can be a stressor, generalized anxiety disorder alone does not carry the same high correlation with child maltreatment as disorders characterized by impaired impulse control or substance abuse. Most parents with anxiety provide safe care, and this does not represent the highest risk factor provided. B. Children with chronic disabilities, such as cerebral palsy, are at a significantly higher risk for maltreatment. This is often due to the increased demands for care, potential for caregiver burnout, and the child's possible inability to communicate abuse. These factors create a high-stress environment that requires proactive nursing support. C. A preschooler saying "no" is a developmentally appropriate behavior known as negativism, common during the quest for autonomy. While it can be frustrating for parents, it is a normal milestone and does not inherently place a child at an increased risk for abuse compared to other factors. D. An adolescent requesting contraception is exercising reproductive healthcare rights. While this might indicate sexual activity, it does not suggest an increased risk for maltreatment. In many jurisdictions, adolescents can consent to these services independently to ensure their health and safety without it being flagged as a maltreatment risk.