An ER nurse has recognized a mother who has frequently brought her 3-year-old in for vague symptoms of an undiagnosed neurological disorder and who has frequently requested specialist consultations. The child is brought in unconscious. A concern that the nurse may have is:

Rationale: A. Severe organic failure to thrive is related to inadequate caloric intake or absorption, not repeated vague medical complaints. B. Ingestion of a toxin could cause unconsciousness but does not explain the chronic history of vague symptoms and repeated consultations initiated by the parent. C. Munchausen by proxy (also known as factitious disorder imposed on another) occurs when a caregiver deliberately causes or fabricates symptoms in a child to gain attention or sympathy. The pattern described fits this concern. D. Physical abuse is always a consideration, but the scenario more specifically reflects fabricated or induced illness by the caregiver, characteristic of Munchausen by proxy.