A nurse is teaching adolescent boys about pubertal changes. The first sign of pubertal change seen with boys is

In a teaching plan for the mother of an 11-year-old boy with ulcerative colitis, the nurse should stress the importance of coping with stress and avoiding triggers. Ulcerative colitis is a chronic inflammatory bowel disease that can be influenced by various factors, including stress and triggers. Helping the child and the family develop effective stress management strategies and identifying and avoiding triggers can help in reducing the frequency and severity of ulcerative colitis flare-ups.

preventing the spread of illness to others in (option B) is incorrect because it, is not the primary focus of teaching for ulcerative colitis. Ulcerative colitis is not an infectious condition that can be spread to others.

, nutritional guidance and supportive intake of sodas in (option C) is incorrect because it, is an important aspect of managing ulcerative colitis. However, it should be addressed in conjunction with a comprehensive nutritional plan that considers the individual needs and tolerances of the child. The mention of supportive intake of sodas may not be appropriate, as carbonated beverages can potentially aggravate symptoms in some individuals with ulcerative colitis.

teaching daily use of enemas in (option D) is incorrect because it, is not typically a part of routine care for ulcerative colitis in children. The use of enemas may be considered in specific situations or as part of an individualized treatment plan under the guidance of healthcare providers, but it is not a general teaching point for all children with ulcerative colitis.

When the skin surface is caked with desquamated skin and sebaceous secretions after the removal of a cast, the nurse should suggest washing the area with warm water and soap. This will help to gently cleanse the skin and remove the accumulated material without causing unnecessary trauma or irritation.

Option A, applying powder to absorb the material, may not effectively remove the caked material and could potentially lead to further clumping or discomfort.

Option B, vigorously scrubbing the leg, can be harsh on the skin and may cause skin irritation, redness, or even abrasions. It is important to be gentle and avoid excessive scrubbing, especially on the fragile and recently exposed skin.

Option C, carefully picking the material off the leg, can increase the risk of skin injury or introduce bacteria into the skin. Picking at the skin should be avoided to prevent further damage or infection.

Therefore, option D, washing the area with warm water and soap, is the most appropriate and gentle method to remove the caked material from the skin surface