The nurse explains that Bryant's traction is reserved for children who weigh less than how many pounds?

Choice A reason: Phenytoin can be taken with or without food, as food does not significantly affect its absorption. Taking it on an empty stomach is not necessary and may cause gastrointestinal upset, making this an incorrect teaching point for long-term use.
Choice B reason: Insomnia is not a common side effect of phenytoin. Common neurological effects include dizziness, ataxia, or sedation due to its action on sodium channels, stabilizing neuronal membranes. Teaching about insomnia is irrelevant and does not address key management concerns.
Choice C reason: Phenytoin commonly causes gingival hyperplasia due to fibroblast proliferation in gum tissue. Regular gum massage and good oral hygiene can reduce this risk by promoting circulation and preventing tissue overgrowth, making this a critical teaching point for long-term use.
Choice D reason: Blood pressure monitoring is not a primary concern with phenytoin, which primarily affects the central nervous system and liver. While rare cardiovascular effects may occur, gingival hyperplasia and blood level monitoring are more significant for long-term management.

Choice A reason: The forward bend test is the standard for scoliosis screening, revealing spinal asymmetry (rib hump) due to lateral curvature. It detects abnormal spinal alignment in preadolescents, when growth spurts exacerbate scoliosis, allowing early intervention to prevent progression.
Choice B reason: Observing gait (heel-to-toe walking) assesses neurological or musculoskeletal function but not spinal curvature. Scoliosis primarily affects spinal alignment, not gait, unless severe, making this less effective for detecting the lateral curvature characteristic of scoliosis.
Choice C reason: Flexing the knees to check knee height assesses leg length discrepancy, not spinal curvature. Scoliosis involves lateral spinal deviation, and knee height is unrelated to detecting the spinal asymmetry critical for diagnosis.
Choice D reason: Observing shoulders and hips while clothed is less effective, as clothing obscures subtle asymmetries. The forward bend test, performed without clothing, better reveals spinal curvature or rib hump, the hallmark signs of scoliosis in preadolescents.