A 15-year-old is newly diagnosed with scoliosis and refuses to wear the prescribed brace due to embarrassment.
What is the best nursing intervention?
Emphasize the importance of treatment compliance.
Tell the adolescent their peers will not notice.
Involve the adolescent in selecting brace customization options.
Explain the risks of noncompliance.
The Correct Answer is C
Choice A rationale
Emphasizing compliance without addressing the underlying emotional distress of an adolescent regarding body image can be counterproductive. Adherence to medical regimens, especially those affecting appearance, is significantly influenced by psychosocial factors and perceived stigma. A confrontational approach often increases resistance, hindering long-term treatment success.
Choice B rationale
Dismissing an adolescent's concern about peer perception trivializes their developmental stage, where social acceptance and body image are paramount. Telling them peers will not notice is often untrue and undermines trust, as adolescents are highly attuned to social cues and peer judgment, which can lead to further noncompliance.
Choice C rationale
Involving the adolescent in brace customization promotes autonomy and ownership over their treatment, significantly increasing compliance. This approach addresses the emotional impact of body image concerns by allowing for personalization, which can mitigate feelings of embarrassment and enhance self-esteem during a critical developmental period.
Choice D rationale
While explaining risks is important for informed consent, focusing solely on negative consequences without offering solutions or addressing emotional barriers can instill fear without promoting adherence. This approach can also lead to resentment or a feeling of being lectured, further alienating the adolescent from treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Juvenile Idiopathic Arthritis is a chronic autoimmune inflammatory condition affecting joints in children, often leading to pain, swelling, and stiffness. It does not primarily affect proximal muscle strength or neuromuscular coordination in a way that would manifest as a Gowers sign. The underlying pathology involves synovial inflammation rather than primary muscle weakness.
Choice B rationale
Multiple Sclerosis is a demyelinating disease of the central nervous system, predominantly affecting adults, though rare in children. While it can cause muscle weakness and gait disturbances due to impaired nerve conduction, a positive Gowers sign is not a characteristic or primary indicator of this condition. Its presentation is typically varied and includes sensory deficits, visual disturbances, and ataxia.
Choice C rationale
Osteosarcoma is a malignant bone tumor, primarily affecting long bones, common in adolescents. Its primary manifestations include localized pain, swelling, and sometimes a palpable mass. It causes structural damage to the bone and surrounding tissues but does not directly lead to the proximal muscle weakness and compensatory maneuvers seen with a Gowers sign.
Choice D rationale
Muscular dystrophy, particularly Duchenne muscular dystrophy (DMD), is a genetic disorder characterized by progressive degeneration of muscle fibers, leading to increasing muscle weakness. The Gowers sign is a classic indicator of proximal muscle weakness, where the child uses their hands to "walk up" their legs to stand from a seated position, due to weakness of the gluteal and quadriceps muscles. This sign is highly specific to conditions like DMD where progressive proximal muscle weakness is a hallmark.
Correct Answer is A
Explanation
Choice A rationale
NSAIDs (Nonsteroidal Anti-inflammatory Drugs) are commonly the first-line treatment for juvenile idiopathic arthritis (JIA). They work by inhibiting cyclooxygenase enzymes (COX-1 and COX-2), thereby reducing the production of prostaglandins, which are inflammatory mediators responsible for pain, swelling, and stiffness in the joints.
Choice B rationale
Antifungal medications are used to treat fungal infections. JIA is an autoimmune inflammatory condition, not caused by fungal pathogens. Therefore, antifungal medications have no therapeutic role in the management of juvenile idiopathic arthritis.
Choice C rationale
Antibiotics are specifically designed to combat bacterial infections. JIA is an autoimmune disease where the body's immune system mistakenly attacks its own tissues, primarily joints. It is not caused by bacteria, so antibiotics are ineffective for its treatment.
Choice D rationale
Antiviral medications are used to treat viral infections. JIA is not caused by viral pathogens but rather by an autoimmune dysfunction. Therefore, antiviral medications do not play a role in the primary management of juvenile idiopathic arthritis.
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