A nurse is caring for a child in the emergency department.

Drag 1 condition and 1 client finding to fill in each blank in the following sentence.

The client is most at risk for developing
_
due to

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"E","dropdown-group-2":"C"}

Rationale for correct choices

• Peritonitis: The child exhibits classic signs of an inflamed and potentially perforated appendix, including worsening abdominal pain, right lower quadrant tenderness, firm and distended abdomen, hypoactive bowel sounds, fever, and elevated WBC and CRP. These signs indicate localized inflammation that can progress to peritonitis if untreated.

• Perforated appendix: The child’s sudden improvement in pain followed by worsening distention and hypoactive bowel sounds suggests a possible appendix perforation. Laboratory findings of leukocytosis and elevated inflammatory markers support significant infection. Perforation allows intestinal contents to enter the peritoneal cavity, directly causing peritonitis.

Rationale for incorrect choices

• Pneumonia: The child has occasional expiratory wheezing, but lung sounds are not abnormal and oxygen saturation is normal. There are no signs of cough, increased respiratory rate, or infiltrates on imaging that would suggest pneumonia. Respiratory involvement is minor and does not account for the acute abdominal findings.

• Dehydration: While nausea, vomiting, and NPO status may contribute to fluid loss, the child’s vital signs do not indicate severe dehydration. Blood pressure is within normal range and perfusion appears adequate. Dehydration is a secondary concern and not the most immediate risk compared with peritonitis.

• Ileus: Hypoactive bowel sounds could suggest an ileus; however, the firm, distended abdomen and systemic inflammatory markers point toward an acute surgical complication rather than simple postoperative or functional ileus. The underlying cause is likely perforation, making ileus a secondary manifestation.

• Anxiety: The child expresses fear, but anxiety is not the primary clinical concern driving risk. Psychological distress is present but does not explain the acute abdominal findings or the elevated WBC and CRP. Anxiety management is supportive rather than emergent.

• Client statement: Statements of pain or fear provide important subjective data but do not identify the physiological cause of risk. While the child reports worsening symptoms, the primary risk arises from the anatomical and infectious changes due to appendix perforation.

• Bowel sounds: Hypoactive bowel sounds indicate reduced intestinal activity but are a secondary finding. They reflect the impact of peritoneal inflammation rather than the underlying cause, which is the perforated appendix. Monitoring bowel sounds helps assess progression but does not define the main risk.

• Lung sounds: Lung sounds are clear, indicating no pulmonary complication. The respiratory system is not involved in the current risk profile. Focus should remain on the abdominal pathology causing systemic inflammation.

• Nausea and vomiting: These symptoms are expected with appendicitis and contribute to discomfort and fluid imbalance but are not the primary factor placing the child at highest risk. The risk stems from anatomical perforation leading to peritoneal contamination.

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Correct Answer is B

Explanation

A. 3 months: At 3 months, infants typically have a smaller head circumference, weigh less (around 12–13 lb), have fewer teeth, and have not yet demonstrated standing or significant weight-bearing when held. The developmental milestones observed in this infant exceed those expected at 3 months.

B. 6 months: The infant’s weight (14.5 lb), height (24 inches), presence of two lower central incisors, ability to bear weight when held in a standing position, hold a bottle, and exhibit a social smile align with typical developmental milestones for a 6-month-old. Neurologic reflexes such as Moro and tonic neck reflexes usually disappear by this age.

C. 9 months: By 9 months, infants are usually able to sit without support, may begin crawling, and have more teeth. The inability to sit unsupported indicates the infant is younger than 9 months.

D. 12 months: At 12 months, infants generally are able to stand independently, may begin walking, and have more advanced fine motor skills and additional teeth. The developmental abilities and physical measurements of this infant suggest she is younger than 12 months.

A. The client needs assistance with learning to eat with the opposite hand. B. The client will require a wheelchair for use in the home. C. The client needs assistance with paying medical bills. D. The client will require a prescription for home on therapy

Correct Answer is C

Explanation

A. The client needs assistance with learning to eat with the opposite hand: This is an aspect of rehabilitation and occupational therapy, focusing on adaptive techniques for daily living. It is not within the social worker’s primary role, so this information should be directed to therapy services.

B. The client will require a wheelchair for use in the home: Equipment needs such as wheelchairs are usually coordinated through physical therapy or case management. While the social worker may assist with resources, the primary focus is on functional mobility, which is addressed by therapy services.

C. The client needs assistance with paying medical bills: Financial assistance, insurance navigation, and access to community resources are within the social worker’s scope of practice. Reporting this need ensures the client receives support for managing medical expenses and continuity of care at home.

D. The client will require a prescription for home therapy: Prescriptions for home health services fall under the provider’s and therapy team’s responsibilities. The social worker may support logistics, but the primary coordination of therapy prescriptions is not their role.

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A nurse is caring for a child in the emergency department. Drag 1 condition and 1 client finding to fill in each blank in the following sentence. The client is most at risk for developing _________ due to ________

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Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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A nurse is caring for a child in the emergency department.

Drag 1 condition and 1 client finding to fill in each blank in the following sentence.

The client is most at risk for developing
_
due to