護理師評估一位疑似受虐的兒童，哪項發現應優先通報？
A nurse is assessing a child suspected of being physically abused. Which finding should the nurse prioritize reporting?
- AA small scrape on the child's knee from falling兒童膝蓋有一處因跌倒造成的輕微擦傷
- BThe child is shy and avoids eye contact with strangers兒童害羞且避免與陌生人眼神接觸
- CBruises in various stages of healing on the torso✓ 正解軀幹處有多種不同癒合階段的瘀傷
- DThe child cries when the parents leave the room父母離開房間時兒童會哭泣
在兒童虐待評估中，『不同癒合階段的瘀傷』（Bruises in various stages of healing）是高度懷疑反覆受虐的關鍵指標。正常的兒童活動（如跌倒）通常在膝蓋、手肘等骨頭突出處造成單一傷口，而軀幹（Torso）、背部或臀部的瘀傷極不尋常。護理師作為法定通報者（Mandated Reporter），一旦有『合理懷疑』（Reasonable Suspicion）即須通報，不需確鑿證據。其他選項如分離焦慮、膝蓋擦傷或害羞，多屬於正常發展範疇或常見意外，不具備受虐的特異性。
Bruises in various stages of healing on the torso are a critical indicator of physical abuse and must be prioritized for reporting. Unlike accidental injuries which typically occur on bony prominences, multiple bruises in different healing phases suggest repeated trauma. As a mandated reporter, the nurse must report reasonable suspicion of abuse immediately.
在美國，護理師是 Mandated Reporter，法律責任極重，『合理懷疑』即須通報；台灣雖也有法定通報義務（24小時內），但在臨床判定上常較為保守，有時會先由社工再次確認才正式進入通報流程。