During a well-child visit with a 4-year-old girl the nurse notes that the parents speaks harshly to ...

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Explanation:
1. Since the child is only 4 years old, it would be difficult to ask the parent to leave the room. If the nurse wants to speak alone with the child, it would be best to escort the child to another area and speak briefly with the child.
2. Referring to counseling without a discussion with the parent is not appropriate.
3. The nurse should not ask the child if she is unhappy with the parent.
4. The best approach to this encounter would be for the nurse to discuss concerns with the parent privately, since the nurse wants to help the parent develop a good relationship with the child. The child should not be a part of this conversation.