A 10-year-old girl has come to the clinic with her mother for a routine health care maintenance visit. During the assessment, the nurse attempts to communicate with the youngster but notes the girl avoids eye contact, appears to slouch in the chair, and talks in a whisper. Many times, she looks at her mother before answering?

What should the nurse consider as potential reasons for this type of communication?
How should the nurse proceed with this child?
Identify nursing diagnoses that would be appropriate in this situation.

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