A 12-year-old client who has drawn sexually explicit scenes in class says, "I just felt like it." Which response by the nurse would be therapeutic and aid assessment of abuse-related symptoms?

A 12-year-old client who has drawn sexually explicit scenes in class says, "I just felt like it." Which response by the nurse would be therapeutic and aid assessment of abuse-related symptoms?

• A. I am concerned about you. Are you being or have you ever been abused?
• B. This is normal exploration for your age.
• C. You probably just drew this for attention.
• D. Tell me more about where you were sitting.

Answer: (A)

The main idea here is using protective, child-centered communication to assess for possible abuse when a child presents with sexually explicit drawings. The best response shows genuine concern and invites disclosure about abuse in a direct, nonjudgmental way. Saying, “I am concerned about you. Are you being or have you ever been abused?” acknowledges the child’s distress, signals safety, and opens the door for the child to talk about abuse histories or current risk. This approach helps the nurse gather information needed to assess abuse-related symptoms and determine the next steps, including safety planning and mandatory reporting if abuse is disclosed. Other responses miss this crucial step: suggesting it’s normal exploration minimizes potential harm and misses red flags; labeling it as attention-seeking dismisses the child’s feelings and potential abuse indicators; asking about seating location shifts away from the serious issue and doesn’t advance assessment. The direct, compassionate inquiry is aligned with safeguarding the child and gathering essential information for proper care. If abuse is disclosed, the nurse should follow legal and institutional procedures to protect the child and coordinate appropriate support.

The main idea here is using protective, child-centered communication to assess for possible abuse when a child presents with sexually explicit drawings. The best response shows genuine concern and invites disclosure about abuse in a direct, nonjudgmental way. Saying, “I am concerned about you. Are you being or have you ever been abused?” acknowledges the child’s distress, signals safety, and opens the door for the child to talk about abuse histories or current risk. This approach helps the nurse gather information needed to assess abuse-related symptoms and determine the next steps, including safety planning and mandatory reporting if abuse is disclosed.

Other responses miss this crucial step: suggesting it’s normal exploration minimizes potential harm and misses red flags; labeling it as attention-seeking dismisses the child’s feelings and potential abuse indicators; asking about seating location shifts away from the serious issue and doesn’t advance assessment. The direct, compassionate inquiry is aligned with safeguarding the child and gathering essential information for proper care. If abuse is disclosed, the nurse should follow legal and institutional procedures to protect the child and coordinate appropriate support.