A 14-year-old female is brought to the clinic by her mother, who is concerned that her daughter's shoulders appear uneven.

The adolescent denies pain but reports feeling self-conscious during gym class.

The nurse performs a forward bend test and notes an asymmetry in the rib cage.

The provider diagnoses idiopathic scoliosis.

The adolescent is prescribed a thoracolumbosacral orthosis (TLSO) brace.

Which nursing action is most appropriate in promoting adherence to treatment and psychosocial well-being?

Choice A rationale

Offering privacy and allowing gradual self-expression respects the adolescent's developmental stage, which often includes a need for autonomy and fear of judgment. Providing a non-threatening environment can reduce anxiety and build trust, fostering a sense of security that encourages the patient to open up when they feel ready, without feeling pressured or overwhelmed.

Choice B rationale

Encouraging immediate discussion with parents might be premature and perceived as a lack of understanding by the adolescent. Adolescents often value peer relationships and may find it difficult to express sensitive emotions to parents, especially after a traumatic event like an injury. This approach could increase their withdrawal and reluctance to communicate.

Choice C rationale

Focusing solely on physical care neglects the psychological and emotional needs of the adolescent, which are crucial for holistic recovery. Emotional distress can hinder physical healing and overall well-being. Avoiding emotional support can make the patient feel invalidated and isolated, potentially prolonging their withdrawal and emotional distress.

Choice D rationale

Assigning a withdrawn adolescent to a shared room without prior assessment or consent can exacerbate their anxiety and discomfort. While socialization is important, forcing it upon a patient who is already withdrawn can be counterproductive, potentially leading to increased stress and a further retreat into themselves rather than improving their social engagement.

Choice A rationale

While providing favorite foods can temporarily stimulate appetite, it does not address the underlying psychosocial issues contributing to nonorganic failure to thrive (NOFTT). NOFTT is often linked to impaired parent-child bonding and inadequate psychosocial stimulation, which manifest as poor feeding and developmental delays. A comprehensive approach is needed to resolve the root causes of the feeding difficulties.

Choice B rationale

Improving parental bonding and caloric intake is the most appropriate goal because nonorganic failure to thrive is primarily a result of inadequate nutritional intake often stemming from disturbed parent-child interactions. Enhanced bonding promotes a secure attachment, which is crucial for the child's emotional and physical development, leading to improved feeding behaviors and subsequent weight gain.

Choice C rationale

Increasing playtime with peers, while beneficial for social development, does not directly address the immediate and critical issues of malnutrition and impaired parent-child bonding in nonorganic failure to thrive. The primary concern in NOFTT is the child's physical health and the establishment of a nurturing environment to ensure adequate caloric intake and emotional security.

Choice D rationale

Encouraging the use of a pacifier for comfort might provide temporary solace but does not resolve the complex issues associated with nonorganic failure to thrive. The core problem is insufficient caloric intake and often, a lack of consistent, nurturing care. A pacifier may soothe, but it does not contribute to the essential nutritional and emotional repletion required for the child's growth and development.