A nurse is assessing a client who has been taking oral contraceptives for the past 6 months. Which of the following findings should the nurse immediately report to the provider?

Choice A reason: Playing with a jump rope requires advanced coordination, typical of older children, not 30-month-olds, who engage in simpler play like trucks. Assuming jump rope is appropriate risks overestimating development, potentially frustrating the child, critical to avoid in supporting age-appropriate activities for toddlers.

Choice B reason: Playing with a large plastic truck is developmentally appropriate for a 30-month-old, supporting gross motor and imaginative play, critical for cognitive and physical development. This activity aligns with toddler abilities, essential for fostering engagement, creativity, and motor skills in early childhood care settings.

Choice C reason: Imaginary friends typically emerge around 3-4 years, not at 30 months, when simpler play like trucks is common. Assuming imaginary play is expected risks misjudging development, potentially overlooking age-appropriate activities, critical to prevent in supporting toddler engagement and growth.

Choice D reason: Dress-up play is more typical for preschoolers (3-5 years), requiring advanced imagination beyond 30-month-olds, who prefer trucks. Assuming dress-up is appropriate risks developmental mismatch, potentially reducing engagement, critical to avoid in ensuring age-appropriate activities for toddlers in care settings.

Choice A reason: A semi-sitting position for meals is impractical in a hip spica cast, risking discomfort or aspiration; turning every 2 hours prevents pressure injuries. Assuming semi-sitting is correct risks complications, critical to avoid in ensuring safe positioning and care for children in spica casts.

Choice B reason: Maintaining dependent lower extremities increases edema risk in a hip spica cast; turning every 2 hours promotes circulation. Assuming dependent positioning is correct risks swelling, critical to prevent in ensuring proper cast care and comfort for children with hip spica casts.

Choice C reason: A bedside commode is unsuitable for a hip spica cast, which covers the pelvis; bedpans are used. Turning every 2 hours is key. Assuming a commode is appropriate risks impracticality, critical to avoid in ensuring proper toileting and care in spica cast management.

Choice D reason: Turning every 2 hours prevents pressure ulcers and promotes circulation in a child with a hip spica cast, critical for skin integrity and comfort. This ensures proper cast care, reducing complications, supporting healing, and maintaining safety in pediatric orthopedic management.