The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the nurse include? (Select all that apply.)

The correct answer is choice A: Signs of stress.

Choice A rationale:

Children often express stress through physical complaints such as stomach pains, headaches, and fatigue. The 9-year-old's complaints of stomach pains, along with the description of aggressive and stubborn behavior, are indicative of stress. Stressors can include academic pressures, family issues, social challenges, or other emotional factors.

Choice B rationale:

Developmental delay refers to a situation where a child's developmental milestones are significantly delayed compared to their peers. This doesn't align with the presented symptoms of stomach pains, aggression, and stubbornness. These symptoms are more indicative of emotional or psychological distress.

Choice C rationale:

While a physical problem could potentially cause emotional stress, the scenario doesn't provide enough information to directly conclude that a physical problem is the primary trigger. Stomach pains could indeed result from emotional stress, and it's important to consider the child's overall well-being.

Choice D rationale:

Lack of adjustment to the school environment can lead to behavioral and emotional challenges, but it's not the most direct explanation for the symptoms described in the scenario. The combination of stomach pains and behavioral changes suggests a more immediate emotional trigger, which is often stress-related.

The correct answer is choice D: Sex can be presented as a normal part of growth and development.

Choice A rationale:

Children in 5th grade are generally around 10 to 11 years old, which means they are approaching puberty and experiencing physical changes. While it might be tempting to think that they are too young for sex education, it's important to acknowledge that they are at an age where their bodies are undergoing significant transformations. Providing them with age-appropriate sex education can empower them to understand these changes and navigate them safely.

Choice B rationale:

Correct terminology should not be reserved solely for older children. Using accurate and age-appropriate terminology when discussing topics related to sex and development is crucial. Children in 5th grade are capable of understanding basic anatomical terms and concepts, which can help them better comprehend their own bodies and the changes they are experiencing.

Choice C rationale:

Encouraging children to ask questions is an essential part of sex education. s reflect curiosity and a desire to learn. Discouraging questions can lead to misinformation and misunderstandings. Open dialogue about sex and development can help dispel myths and promote healthy attitudes toward these topics.

Choice D rationale:

Presenting sex as a normal part of growth and development is the foundation of comprehensive and age-appropriate sex education. Children in 5th grade are entering a stage of life where they might start experiencing sexual curiosity and have questions about their bodies. Addressing these questions in a respectful and factual manner can help them develop a healthy understanding of their own sexuality and promote safe behaviors.