The parent of a child diagnosed with Juvenile Idiopathic Arthritis asks about exercises that would be good for the child.
Which of the following would promote mobility.

Choice A rationale

Deferring the explanation to the healthcare provider avoids the nurse's professional responsibility to communicate the legal requirements and ethical obligations related to child welfare. Nurses are independent reporters in most jurisdictions, and while the provider may follow up, the nurse must directly address the parent's immediate concern regarding their own action, citing the legal mandate.

Choice B rationale

While calling a supervisor may be a step in the facility's internal protocol, the nurse has a direct responsibility to communicate the reason for the mandatory reporting to the parent in a professional and non-accusatory manner. Directly stating the legal requirement is the most appropriate and professional boundary-maintaining response in this highly sensitive and legally mandated situation.

Choice C rationale

This response inappropriately shifts the responsibility for contacting the authorities solely to the supervisor, which can be inaccurate and fails to explain the fundamental reason for the nurse's initial action. The nurse initiated the action based on reasonable suspicion and a direct legal requirement, which is the necessary information to convey to the parent.

Choice D rationale

In all states and provinces, nurses are designated as mandatory reporters, meaning they are legally required to report any reasonable suspicion of child abuse or neglect to the appropriate child protective services or law enforcement. This response is appropriate because it is factual, non-judgmental, professional, and clearly explains that the action was a non-negotiable legal obligation rather than a personal decision.

Choice A rationale

Vigorous exercise is strongly contraindicated in a child with Kawasaki Disease, especially in the acute phase. The primary risk associated with this vasculitis is the potential development of coronary artery aneurysms. Physical exertion increases cardiac workload, which could potentially worsen myocardial ischemia or increase the risk of serious coronary complications.

Choice B rationale

Keeping the child NPO (nothing by mouth) is generally not indicated for routine comfort measures in Kawasaki Disease unless a specific invasive procedure or life-threatening complication, such as severe cardiac failure requiring intubation, is anticipated. Adequate hydration is crucial to prevent dehydration from fever and to maintain fluid balance, which is achieved through oral intake or intravenous fluids.

Choice C rationale

Administering aspirin is a critical part of the medical management for Kawasaki Disease and serves a dual purpose. High-dose aspirin is given for its anti-inflammatory properties to reduce fever and systemic inflammation. Later, low-dose aspirin is continued for its anti-platelet effects to prevent the formation of blood clots, especially in the setting of coronary artery aneurysms.

Choice D rationale

Splinting extremities for contractures is not a typical intervention for the acute phase of Kawasaki Disease. Joint pain (arthralgia) and stiffness may occur, but contractures are not a primary or immediate complication. To promote comfort, the nurse should instead handle the extremities gently and provide passive range of motion to prevent further joint stiffness.