A nurse is collecting data from a client who reports feeling stress. Which of the following should the nurse identify as an external stressor?

A) Ensure that the client gave informed consent: Obtaining informed consent is a critical nursing responsibility prior to any procedure, including an esophagogastroduodenoscopy (EGD). The nurse should verify that the client understands the purpose, risks, and potential outcomes of the procedure. This ensures that the client has voluntarily agreed to undergo the procedure after being fully informed.

B) Administer an oral contrast solution: An esophagogastroduodenoscopy (EGD) does not require the administration of an oral contrast solution. The procedure involves the use of a flexible endoscope to visualize the esophagus, stomach, and duodenum, and is typically performed without contrast agents. Oral contrast is more commonly used in imaging studies such as CT scans or fluoroscopy, not in endoscopy.

C) Inform the client the procedure will take 60 min: The duration of an esophagogastroduodenoscopy typically ranges from 15 to 30 minutes, not 60 minutes. The nurse should inform the client about the usual time frame for the procedure, but stating 60 minutes could be an overestimate. Providing accurate information about the length of the procedure helps manage client expectations.

D) Ensure that the client's bladder is full: The procedure is focused on the upper gastrointestinal tract, so bladder fullness is not necessary for an esophagogastroduodenoscopy. The client should be positioned appropriately, usually in a left lateral position, but there is no need for the bladder to be full. The nurse should ensure that the client follows the pre-procedure guidelines, such as fasting, to reduce the risk of complications.

A) "I should position the car seat's retainer clip at the level of my baby's belly button.": This statement is incorrect. The retainer clip of the car seat should be positioned at the level of the baby's armpits, not the belly button. Proper placement of the retainer clip ensures the safety harness fits securely across the baby's chest, reducing the risk of injury during a crash.

B) "I should keep my baby rear-facing in the car seat until she is 2 years old.": This statement is correct and aligns with current guidelines from organizations such as the American Academy of Pediatrics (AAP). Infants and toddlers should remain in a rear-facing car seat until they are at least 2 years old or until they reach the maximum height or weight limit allowed by the car seat manufacturer for rear-facing use. Rear-facing is the safest position for infants and provides the best protection for their developing head, neck, and spine.

C) "I should enable the airbag when my baby is in the front seat of the car.": This statement is incorrect. Infants and young children should never ride in the front seat of a car with an active airbag, as airbags can cause serious injury or death in the event of a collision. Children should always be placed in the back seat, ideally in a rear-facing car seat, to minimize risk.

D) "I should place my baby in the car seat at a 90-degree angle.": This statement is incorrect. A car seat should be installed at a slight recline to ensure that the baby's airway remains open and to prevent their head from falling forward. A 45-degree angle is typically recommended for newborns, although this can vary based on the specific car seat model and the baby's size.