A nurse is providing discharge instructions to a parent and their school-age child who has juvenile idiopathic arthritis.

Which of the following instructions should the nurse include?

Encourage the child to take a 45-minute nap daily.

Administer prednisone on an alternate-day schedule.

Allow the child to stay at home on days when their joints are painful.

Apply cool compresses for 20 minutes every hour.

Answer and Explanation

The Correct Answer is B

Prednisone is a type of steroid medicine that helps decrease severe inﬂammation and is usually given for a short time while other medicines are started that can take longer to be eﬀective.
Choice A is not an answer because there is no information available that suggests taking a 45-minute nap daily would be beneﬁcial for a child with juvenile idiopathic arthritis.
Choice C is not an answer because it may not be necessary for the child to stay at home on days when their joints are painful.
Choice D is not an answer because applying cool compresses for 20 minutes every hour may not be the most eﬀective way to manage pain and inﬂammation.

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Correct Answer is A

Explanation

The correct answer is Choice A.

Choice A rationale: Encouraging the infant to stand in the crib while in a cast for developmental dysplasia of the hip (DDH) supports gross motor development and maintains neuromuscular stimulation. Standing promotes proprioceptive input, strengthens postural muscles, and supports bone mineralization through weight-bearing. Infants in hip spica casts or orthotic devices can safely stand with supervision, preserving developmental milestones. Normal serum calcium ranges from 8.5 to 10.5 mg/dL, and mechanical loading enhances osteoblastic activity and skeletal growth.

Choice B rationale: While electronic toys offer sensory stimulation, they do not adequately support gross motor development in infants with DDH. At 10 months, infants require opportunities for vertical positioning and weight-bearing to stimulate vestibular and musculoskeletal systems. Passive play with electronic toys may delay motor milestones such as cruising and standing. Developmental progress depends on integrated sensory-motor experiences, and reliance on sedentary toys may limit engagement of core and lower limb musculature.

Choice C rationale: Latex balloons pose a significant safety hazard due to the risk of aspiration and suffocation. When burst, latex fragments can occlude the airway, especially in infants with underdeveloped protective reflexes. The tracheal diameter in infants averages 4 to 5 mm, making obstruction by balloon fragments potentially fatal. Additionally, latex exposure may trigger allergic reactions, particularly in atopic individuals. The American Academy of Pediatrics strongly advises against latex balloon use in children under 8 years.

Choice D rationale: Prompt diaper changes are essential for skin integrity, especially under a cast where moisture retention can lead to maceration and infection. However, this action does not directly promote growth and development. It is a hygiene measure that prevents irritant contact dermatitis and secondary infections such as Candida albicans. Normal skin pH ranges from 4.5 to 5.5, and prolonged exposure to urine and feces elevates pH, disrupting the acid mantle. While necessary, it lacks developmental stimulation.

A. "Our baby will sleep in our bed because I am breastfeeding.". B. "We will remove blankets and toys from the crib.". C. "We will give my baby a pacifier during naps and at bedtime.". D. "We will place my baby on her back when sleeping.".

Correct Answer is A

Explanation

“Our baby will sleep in our bed because I am breastfeeding.” Sharing a bed with a baby increases the risk of SIDS1.
Choice B is not the answer because removing blankets and toys from the crib is a recommended way to reduce the risk of SIDS2.
Choice C is not the answer because giving a baby a paciﬁer during naps and at bedtime can help reduce the risk of SIDS.
Choice D is not the answer because placing a baby on their back when sleeping is one of the most important measures to help protect against SIDS1.

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A nurse is providing discharge instructions to a parent and their school-age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include?

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A nurse is providing discharge instructions to a parent and their school-age child who has juvenile idiopathic arthritis.

Which of the following instructions should the nurse include?