A 9-year-old boy discusses sex with accurate vocabulary. What is the appropriate nursing response?

• A. Ask the child whether he was sexually abused.
• B. Ascertain what the child understands about sex.
• C. Inquire where the child got this important information.
• D. Involve the child in teaching sex information to peers.

Answer: (B)

When a child speaks about sex with accurate vocabulary, the appropriate approach is to assess what he understands about the topic. This directly respects the child’s developmental level, validates his curiosity, and helps you tailor information appropriately. Start with open-ended questions to learn what the child thinks sex is, what he has heard, and what meanings he ascribes to it. For example, you can ask what he believes happens during sex, where he learned about it, and what questions he has. This helps you identify any misinformation, gauge his level of understanding, and determine what information to provide next in plain, developmentally appropriate terms.

If there are safety concerns or indicators of possible abuse, those need to be explored with sensitivity and appropriate protocols, but the first step is to clarify his current knowledge. Asking where he got the information or involving him in teaching others isn’t suitable as an initial response and can create discomfort or misinformation. Focus on understanding his perspective first, then share accurate information and establish a safe, open communication pattern for future discussions.