| Course | NU 632 Healthcare of Infants, Children and Adolescents |
|---|---|
| Unit | Unit 8 |
| Paper type | Mandated reporting record |
| Length | About 860 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MSN Family Nurse Practitioner |
| Updated | October 2026 |
Free sample paper for NU 632 Unit 8
Mandated Reporting Record: Bruising Found on a 5-Month-Old at a Well-Child Visit
Student Name
Department of Nursing, Herzing University
NU 632: Healthcare of Infants, Children and Adolescents
Instructor Name
March 11, 2026
Mandated Reporting Record: Bruising Found on a 5-Month-Old at a Well-Child Visit
Encounter
Composite patient built for teaching. Date and time: March 11, 10:15 to 11:20. Setting: primary care clinic, California. Patient: female infant, 5 months 2 weeks, attending a scheduled well-child visit. Present: the infant's mother, age 24, and the infant's maternal aunt, age 30. The infant's father was not present. Reason for visit: routine 4-to-6-month well visit, delayed by two weeks at the family's request.
Findings, Described Physically
General: alert infant, tracking faces, smiling, feeding from a bottle during the visit without distress; weight at the 40th percentile, consistent with prior visits. Skin, examined with the infant undressed and the mother present: (1) left ear: a blue-purple bruise on the upper outer rim of the ear, about 1.5 cm by 0.8 cm, with no break in the skin; (2) left cheek: a faint yellow-green area about 2 cm in diameter along the jaw line; (3) upper right arm, inner aspect: three oval purple bruises about 0.5 to 0.8 cm each, arranged in a row about 1 cm apart. Photographs of each area were taken with a measuring scale in view, with the mother's verbal consent, and stored in the record's secure media section. No bruises on the buttocks, legs, abdomen, or back. No swelling of the scalp; anterior fontanelle soft and flat. No bleeding from the mouth; the frenulum is intact. Movement of all four limbs full and symmetric, with no apparent pain on handling of the arms or legs. The infant is not yet rolling over and is not cruising or crawling, per the mother's report and observation during the visit.
Bruising in an infant who is not yet mobile, and bruising of the ear, are findings that published guidance identifies as warranting evaluation for physical abuse (Christian & Committee on Child Abuse and Neglect, 2015; Pierce et al., 2021). This record describes what was observed and does not state a cause.
Explanations Given, Recorded Without Commentary
Asked open-endedly, "Can you tell me about these marks?" the mother said: "She bumps into the side of her crib. And my sister's little boy grabs her arm when he plays with her." Asked who cares for the infant, the mother said she, the infant's father, and her sister share care; the father cares for the infant alone on weekday evenings while the mother works. The aunt said: "I haven't seen her get hurt." No leading questions were asked. The infant is preverbal.
History
Prior records: at the two-month visit, a small bruise on the infant's forehead was documented, with the explanation that the infant rolled against a car seat buckle; no further action was taken at that time. No previous reports are known to the clinic. The infant was born at term after an uncomplicated pregnancy. No family history of bleeding disorders is reported. No prior emergency department visits are recorded in the health information exchange.
Reporting Threshold in This Jurisdiction
Under California's Child Abuse and Neglect Reporting Act, a health care provider acting in a professional capacity must report when they know or reasonably suspect that a child has been the victim of abuse or neglect (California Penal Code § 11166). The threshold is reasonable suspicion, not certainty; the reporter is not required to investigate or to determine the cause. Given multiple bruises in a nonmobile infant, including bruising of the ear, with a prior facial bruise and explanations that do not account for the pattern, the threshold is met.
The Report
Telephone report made at 11:05 to the county child protective services hotline, report taken by an intake worker who provided a reference number, recorded in the confidential section of the record. The written report on the state form was submitted electronically at 14:30 the same day, within the 36 hours the statute requires. The clinic's social worker was informed. The mother was told, before the family left, that the clinician is required by law to report injuries like these in a baby this young to child protective services, that this does not mean anyone has concluded what happened, and that the next step is further evaluation. She was not told details of the report content beyond this.
Medical Evaluation Arranged
Bruising in a young infant can be the first visible sign of more serious injury, and such sentinel injuries often precede more severe abuse (Sheets et al., 2013). After discussion with the child abuse pediatrics consultant by phone, the infant was referred the same day to the children's hospital emergency department for a skeletal survey, head imaging as indicated, and laboratory studies to evaluate for bleeding disorders, as recommended in the evaluation of suspected physical abuse (Christian & Committee on Child Abuse and Neglect, 2015). The mother agreed and transported the infant with her sister; the intake worker was informed of the plan and destination. The emergency department was called before the family left the clinic.
Follow-Up
Follow-up call to the emergency department at 17:00 confirmed arrival. The clinic will obtain the results and the child protective services disposition as permitted, and the infant's next well visit is scheduled in three weeks, with the clinician who saw her today.
References
Cal. Penal Code § 11166 (2024).
Christian, C. W., & Committee on Child Abuse and Neglect. (2015). The evaluation of suspected child physical abuse. Pediatrics, 135(5), e1337-e1354. https://doi.org/10.1542/peds.2015-0356
Pierce, M. C., Kaczor, K., Lorenz, D. J., Bertocci, G., Fingarson, A. K., Makoroff, K., Berger, R. P., Bennett, B., Magana, J., Staley, S., Ramaiah, V., Fortin, K., Currie, M., Herman, B. E., Herr, S., Hymel, K. P., Jenny, C., Sheehan, K., Zuckerbraun, N., ... Leventhal, J. M. (2021). Validation of a clinical decision rule to predict abuse in young children based on bruising characteristics. JAMA Network Open, 4(4), Article e215832. https://doi.org/10.1001/jamanetworkopen.2021.5832
Sheets, L. K., Leach, M. E., Koszewski, I. J., Lessmeier, A. M., Nugent, M., & Simpson, P. (2013). Sentinel injuries in infants evaluated for child physical abuse. Pediatrics, 131(4), 701-707. https://doi.org/10.1542/peds.2012-2780
The Herzing NU 632 Unit 8 instructions
The Unit 8 assignment asks you to document a suspected child maltreatment encounter and the mandated report that follows. Expect to record the encounter details, then describe findings physically and precisely, with size, location, color and shape, without labeling them as abuse. Explanations given by caregivers should be quoted exactly. Relevant history, including prior injuries, belongs in the record. Many sections ask you to state the reporting threshold in your state and to document the report itself: time, agency, recipient and reference number. Medical evaluation for occult injury in young children is commonly required. Follow-up steps close the record. Cite the state statute and AAP guidance in APA 7, using legal citation format for statutes. Use a composite infant and family. The tone throughout should be factual and neutral.
How this NU 632 Unit 8 example is built
The record opens with the date, times, setting and who was present. Findings are described one by one, giving each bruise's location, measured size and color, along with the infant's growth, alertness and feeding during the visit. The explanations section quotes the mother's open-ended answer about the marks and records it without comment. The history section notes a previously documented forehead bruise and its explanation. The threshold section explains that California law requires a report on reasonable suspicion, not proof. The report is documented with the time of the call, the hotline, the intake worker and the reference number, and notes that the written follow-up report was sent within the required timeframe. The evaluation section arranges same-day emergency assessment for imaging and laboratory tests, and follow-up confirms arrival and the plan for results.
Where the points sit in the NU 632 Unit 8 rubric
Herzing rubrics for a mandated reporting record typically score objective documentation of findings, recording of explanations, history, application of the legal threshold, documentation of the report, medical evaluation and follow-up. Objective documentation is graded most strictly; findings must be described physically without conclusions. Explanation points require exact quotes without interpretation. For the threshold line, the state's reasonable suspicion standard must be summarized correctly. Report documentation is credited when time, agency, recipient and reference number appear. Medical evaluation points go to recognizing sentinel injuries and arranging appropriate workup. Follow-up earns credit when results and the agency's response are tracked. Evidence and writing points require the statute in legal citation format, AAP guidance in APA style and a neutral, factual tone.
NU 632 Unit 8 help: mistakes that cost points
Reporting records most often lose points when the writer states a conclusion, such as "findings consistent with abuse," instead of describing what was seen. Students also paraphrase caregiver explanations, which loses accuracy and can introduce bias. Bruise descriptions without size, color or location are common. Many papers believe proof is needed before reporting, when the standard is reasonable suspicion. The report itself is often documented without time or reference number. Another gap is missing medical evaluation, though bruising in a non-mobile infant can signal serious hidden injury. Follow-up is frequently omitted. Finally, avoid language that judges the family; a neutral record protects the child, the family and the clinician.
Get a NU 632 Unit 8 example written to your instructions
Send the Unit 8 instructions and the rubric from your NU 632 classroom, plus the scenario and your jurisdiction. We write a custom example that records observation rather than conclusion, states the threshold correctly and documents the report, returned in 24 to 48 hours. The first custom sample is free.
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NU 632 Unit 8 questions, answered
Why avoid writing conclusions in the record?
Because your observation is the durable part and your inference is not. A note describing a finding by site, size, shape and color remains useful to an investigator months later; one recording that a finding was consistent with a particular cause substitutes an opinion for the description and can be challenged. Describe fully, interpret sparingly, and let the investigation do its work.
What is the reporting threshold?
Reasonable suspicion in most jurisdictions, not certainty and not proof. The obligation is triggered by a level of concern well below what a clinician might want before acting, and waiting for confirmation is both a misreading of the duty and a delay that matters. State the standard your jurisdiction applies and why the circumstances meet it.
How should the child's own account be recorded?
Verbatim, in quotation marks, without leading questions having been asked. Open prompts preserve the account; specific questions can shape it and compromise its later use. Record what you asked as well as what they answered, and resist the urge to tidy their words into clinical phrasing, because the exact language is part of what makes the record valuable.
Where can I find a free NU 632 Unit 8 sample paper?
This page presents the full NU 632 Unit 8 reporting record free, with the physical findings, quoted explanations, the California threshold, the documented report, the medical evaluation and follow-up. If your case is in another state or involves an older child, ask for a custom record, written free and normally sent within 48 hours.
When must a nurse practitioner make a child abuse report?
When there is reasonable suspicion of abuse or neglect based on what is seen or heard in professional practice, not proof. State laws set the details, including who to call and deadlines for written follow-up reports.