For a child admitted with primary medical needs, the admission assessment must include which of the following?

• A. A nurse's note
• B. A licensed physician's signed, written orders
• C. A social worker evaluation
• D. A pediatrician's generic summary

Answer: (B)

The main idea here is that when a child with primary medical needs is admitted, the care plan must be officially authorized by a physician. The admission assessment is not just a checklist of observations; it culminates in concrete orders that direct what will be done for the child right away. A licensed physician’s signed, written orders provide the legal authority for nursing staff to administer medications, order tests, start treatments, and implement the initial plan of care. Without those specific, documented orders, there would be no validated instructions for how to treat the child, which could lead to safety risks and gaps in care.

A nurse’s note is essential for documenting what happens during admission, but it does not establish the medical direction or authorize specific treatments. A social worker evaluation may address psychosocial factors, but it isn’t the required medical authorization for initiating care. A pediatrician’s generic summary wouldn’t carry the specific, actionable instructions that a physician’s signed orders provide.

So the best choice is the licensed physician’s signed, written orders because they authorize and guide the initial medical management of the child on admission.