In which situation should a nurse report child or vulnerable adult maltreatment?

A nurse should report child or vulnerable adult maltreatment when there are signs that suggest repeated or severe harm, particularly in a way that raises concern about ongoing abuse or neglect. In the case of a 7-year-old with various old and new bruises, the presence of multiple bruises of different ages can indicate a pattern of physical abuse rather than accidental injury. This is particularly significant given that children are more vulnerable and may not have the ability to protect themselves or communicate about their injuries.

The other scenarios, such as a child with a scraped knee from falling or a 2-year-old with a cold, do not typically indicate maltreatment; they describe common minor injuries or medical conditions that are not associated with abuse. Similarly, while an 80-year-old with minor bruises might raise some questions about their health or safety, the bruises alone, without further evidence suggesting abuse or neglect, do not meet the threshold for mandatory reporting. Therefore, the situation involving the 7-year-old with bruises is the most concerning and warrants immediate reporting to protect the child's well-being.