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Which of the following statements is correct, based on epidemiologic data collected about child abuse?

A. Most child maltreatment occurs outside the home.

B. Females are as equally likely as males to be perpetrators of sexual abuse.

C. Of substantiated child abuse cases, neglect is the most common type.

D. If all types of child abuse are included, males are the most likely perpetrators of child abuse.

E. Females are more commonly perpetrators in child abuse death cases.

Answer: C

Among the types of maltreatment, neglect makes up almost two-thirds of substantiated cases. National data suggest that women make up more than half of the perpetrators of child abuse, although perpetrators of sexual abuse are overwhelmingly male. In addition, more than two-thirds of child abuse deaths are perpetrated by males. National survey data also suggest that most child abuse occurs in the child’s home.

A single mother brings a developmentally normal 16-month-old child to the emergency department (ED) for not moving his left arm for the past 3 days. The mother reports that he stopped moving his arm 3 days ago when they were walking to the bus stop. Mother reports that she was holding his hand while they were walking and he tripped off a curb. She pulled him up by his left arm. He cried initially. He has seemed fine other than not moving his left arm. On exam, he has a nursemaid’s elbow of the left arm. When asked by the nurse when alone whether somebody hurt him, the child replies “no.” Which of the following factors makes this injury most suspicious for child abuse?

A. The mother is single and thus is at increased risk for abusing her child.

B. The history of tripping off a curb is not within a 16-month-old child’s developmental abilities.

C. The mother delayed seeking care for the child soon after the injury.

D. The child’s response when asked by the nurse when alone whether somebody hurt him.

E. The child appears very fearful and cries when even experienced pediatricians try to examine him.

Answer: C

Five types of history should raise the suspicion of child abuse. These include (1) a child with a serious injury and no history of trauma offered; ...

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