A 9-year-old boy presents with signs suggesting abuse. Which should the school nurse consider?

A 9-year-old boy presents with signs suggesting abuse. Which should the school nurse consider?

• A. Sexual abuse
• B. Obesity
• C. Vision problems
• D. Diabetes

Answer: (A)

When signs point to possible harm to a child, sexual abuse must be considered because it is often not disclosed and may present through a cluster of cues such as sudden behavioral changes (withdrawal, anxiety, fear around certain people), age-inappropriate sexual knowledge or behavior, and any physical findings in the genital or anal areas. The school nurse should take these indicators seriously, provide a safe, nonjudgmental space, and follow mandatory reporting procedures to protect the child. While obesity, vision problems, or diabetes are important health issues, they do not explain the abuse‑related signals described and are not the focus of this scenario.

When signs point to possible harm to a child, sexual abuse must be considered because it is often not disclosed and may present through a cluster of cues such as sudden behavioral changes (withdrawal, anxiety, fear around certain people), age-inappropriate sexual knowledge or behavior, and any physical findings in the genital or anal areas. The school nurse should take these indicators seriously, provide a safe, nonjudgmental space, and follow mandatory reporting procedures to protect the child. While obesity, vision problems, or diabetes are important health issues, they do not explain the abuse‑related signals described and are not the focus of this scenario.