A nurse is reinforcing teaching with an adolescent who has type 1 diabetes mellitus. Which of the following statements by the adolescent indicates an understanding of the teaching?

Choice A reason:

Insomnia may not be an expected finding in a school-age child with a newly diagnosed brain tumor. While sleep disturbances can occur due to various medical conditions, insomnia is not a common presenting symptom of brain tumors in this age group. Thus, it is less likely to be the correct answer.

Choice B reason:

A negative Babinski sign would actually be a normal finding in a school-age child. The Babinski sign is a neurological test that becomes positive in certain conditions, but a negative result is expected in a healthy child. Therefore, this finding is not indicative of a brain tumor and is not the correct choice.

Choice C reason:

Increased appetite is also an unlikely finding in a child with a newly diagnosed brain tumor. Brain tumors can lead to various neurological symptoms, but an increased appetite is not a characteristic feature. Thus, this choice is less likely to be correct.

Choice D reason:

Incoordination is a more expected finding in a school-age child with a newly diagnosed brain tumor. Brain tumors can affect motor skills and coordination due to their location and impact on the brain's functions. Children may experience difficulties with balance, coordination, and fine motor skills. Therefore, this choice is the most likely correct answer.

Choice A reason:

The Visual Analog Scale (VAS) is a pain rating scale that involves a straight line with one end representing "no pain” and the other end representing "worst pain imaginable.” The individual marks a point on the line to indicate their pain level. This scale may not be suitable for a 3-year-old child as it requires a certain level of cognitive and numerical understanding to make a meaningful assessment, which a young child may not possess.

Choice B reason:

The FACES pain rating scale is a visual tool that uses a series of facial expressions ranging from smiling to crying to help individuals, especially children, express their pain level. A 3-year-old child can easily point to the facial expression that best matches their pain experience, making it a suitable choice for this age group.

Choice C reason:

The Word-Graphic Scale is a pain rating scale that combines verbal descriptors with a visual representation of the pain intensity. It may include words like "no pain,” "mild pain,” "moderate pain,” and "severe pain” along with corresponding symbols. While it can be used with children, a 3-year-old might have difficulty grasping the abstract nature of the scale and correlating words with pain levels.

Choice D reason:

The Numeric Rating Scale (NRS) requires the individual to rate their pain level on a scale from 0 to 10, with 0 being "no pain” and 10 being "worst pain.” Similar to the Visual Analog Scale, this scale might not be suitable for a 3-year-old child who may not fully understand abstract numerical concepts.