When conducting a health assessment for a pediatric client, the nurse notes that the child avoids eye contact, and the parents answer many questions on the child's behalf. What primary action should the nurse take to ensure effective communication?

Choice A reason: Focusing only on the parents marginalizes the child and prevents the nurse from assessing the child's cognitive development, speech patterns, and emotional state. While parents are essential historians for pediatric cases, the child should be the primary focus of the assessment whenever developmental levels allow for direct interaction. Choice B reason: Using open-ended questions directed at the child encourages them to express themselves in their own words, which is vital for building rapport. This strategy helps the nurse assess the child's level of orientation and maturity. It also signals to both the child and parents that the child's perspective is a valued part of the clinical process. Choice C reason: Providing information on pediatric care is a form of patient education but does not address the immediate communication barrier. Education should follow the assessment phase. If the nurse focuses on providing information too early, they may miss critical subjective data that only a direct interaction with the child could provide. Choice D reason: Using closed-ended questions with the parents further excludes the child from the conversation. While closed-ended questions are useful for specific data points (like date of birth), they do not facilitate the kind of expansive, expressive communication needed to understand a child's unique health experience or psychosocial needs.