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?

Choice A rationale

Active peer interaction generally indicates healthy social development and positive self-esteem in adolescents. Engagement with peers often provides opportunities for validation, belonging, and the development of social skills, all of which contribute positively to an individual's self-perception and confidence, rather than signaling struggles with self-esteem.

Choice B rationale

Isolation and negative body image are significant warning signs of self-esteem issues. Isolation indicates a withdrawal from social engagement, potentially due to feelings of inadequacy or fear of judgment. A negative body image reflects dissatisfaction with one's physical appearance, often leading to feelings of shame, anxiety, and low self-worth, which are central to poor self-esteem.

Choice C rationale

Choosing healthy foods is typically associated with positive health behaviors and a sense of self-care, which can be indicative of a healthy self-image and good self-esteem. Individuals with high self-esteem are more likely to prioritize their well-being and make choices that benefit their physical and mental health.

Choice D rationale

Frequent tantrums are more characteristic of younger children struggling with emotional regulation rather than adolescents with self-esteem issues. While adolescents can exhibit emotional outbursts, prolonged and frequent tantrums are less specific to self-esteem and more indicative of broader emotional or behavioral dysregulation issues in this age group.

Choice A rationale

Consumption of alcohol during pregnancy is contraindicated due to its teratogenic effects, which can lead to Fetal Alcohol Spectrum Disorders (FASDs). No amount of alcohol is considered safe during pregnancy, as it can cross the placenta and directly harm fetal development, affecting multiple organ systems.

Choice B rationale

Albacore tuna has higher mercury levels compared to other fish due to its longer lifespan and position in the food chain. High mercury intake during pregnancy can negatively impact fetal neurological development. Pregnant clients are advised to limit albacore tuna to 6 ounces per week, but some guidelines suggest even less or alternative fish.

Choice C rationale

Switching to whole milk provides increased caloric and fat intake, which is beneficial during pregnancy to support fetal growth and maternal energy needs. Whole milk also provides essential fat-soluble vitamins like A and D, and calcium, crucial for fetal bone development, in higher quantities than skim milk.

Choice D rationale

While moderate caffeine intake (generally less than 200 mg per day) is considered acceptable by some organizations during pregnancy, 600 milligrams daily significantly exceeds this recommendation. High caffeine intake is associated with risks such as miscarriage, preterm birth, and low birth weight due to its vasoconstrictive effects.