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The child exhibits advanced motor and language skills for their age: Children with Prader-Willi syndrome typically demonstrate developmental delays, including delayed motor milestones and speech development. Hypotonia and cognitive impairment contribute to slower skill acquisition rather than advanced abilities. This finding is inconsistent with the syndrome’s neurologic profile.

The child demonstrates a high level of energy and requires minimal sleep: Prader-Willi syndrome is associated with low energy levels, reduced stamina, and sleep disturbances such as excessive daytime sleepiness or sleep apnea. Increased energy and reduced sleep needs are not typical features. Fatigue is more commonly observed.

The child has a markedly increased muscle tone and strength: Hypotonia is a hallmark feature of Prader-Willi syndrome, particularly in infancy and early childhood. Decreased muscle tone contributes to feeding difficulties early in life and delayed motor development. Increased tone and strength do not align with the underlying neuromuscular findings.

"ACP helps clients decide the preferred location of death and advance directives.": While ACP may include discussions about goals of care and preferences, it is broader than end-of-life location alone. The primary focus is on documenting decision-making authority and treatment preferences should capacity be lost. Limiting ACP to location of death oversimplifies its scope.

"ACP is invalid if the client chooses curative treatment.": Advanced care planning remains appropriate regardless of whether the client is receiving curative, life-prolonging, or palliative treatment. ACP supports ongoing decision-making across the illness trajectory. Choosing curative treatment does not negate or invalidate ACP.

"ACP does not take into account the individual's cultural influences.": Cultural, spiritual, and personal values are central to advanced care planning discussions. ACP is designed to respect and incorporate these influences into healthcare decision-making. Excluding cultural considerations contradicts the foundational principles of ACP.

Organ donation can be considered before the client has died: Organ donation decisions are formally addressed after death or when death is imminent and criteria such as brain death are met. Premature consideration before death determination raises ethical and legal concerns. The process follows strict medical and legal protocols.

Organ donation is not regulated by any laws: Organ donation is governed by national and international laws and ethical guidelines to ensure consent, fairness, and safety. Regulatory frameworks define donor eligibility, procurement processes, and recipient allocation. Lack of regulation would risk ethical violations.

Organ donor status influences the course of a child's treatment: Medical care is provided based on the child’s clinical needs, independent of donor status. Treatment decisions are made to preserve life and function, not to facilitate organ procurement. Separating care from donation decisions protects patient rights.

"Applying a warm compress to our child's abdomen can help ease the pain.": Heat increases blood flow and may promote inflammation, which can worsen appendiceal swelling and increase the risk of rupture. Thermal applications to the abdomen are avoided when appendicitis is suspected. This intervention is contraindicated.

"Gently massaging our child's abdomen in a circular motion can help.": Abdominal massage increases pressure on inflamed tissues and can exacerbate pain or precipitate perforation. Manipulation of the abdomen is avoided in suspected appendicitis. Comfort measures should minimize, not increase, abdominal stimulation.

"We should encourage our child to lie flat on their back to rest.": Lying flat extends the abdomen and increases peritoneal stretch, which may intensify pain. Children with appendicitis often instinctively assume a flexed or side-lying position to reduce discomfort. Flat positioning does not promote pain relief.

Loose stool: Infant botulism more commonly presents with constipation due to decreased gastrointestinal motility from neuromuscular blockade. Botulinum toxin inhibits acetylcholine release, reducing smooth muscle activity in the gut. Loose stools are not a typical early manifestation.

Crying for long periods of time: Infant botulism is associated with a weak or diminished cry rather than excessive crying. Neuromuscular weakness limits vocal cord strength and respiratory effort. Prolonged crying is more suggestive of pain or discomfort from other causes.

Spasms involving the whole body: Botulism produces flaccid paralysis, not spasticity or muscle spasms. Increased muscle tone and generalized spasms are more consistent with conditions such as tetanus or seizure activity. This finding does not align with the toxin’s mechanism of action.

Delayed motor skills: Thyroid hormone deficiency can impair muscle tone and coordination, leading to delayed gross and fine motor development. Motor delays are common but may improve with treatment initiation. They are not the most severe long-term consequence if the condition remains untreated.

Delayed social interactions: Social development may be affected secondary to overall developmental delay, but it is not the primary or most critical impact of untreated congenital hypothyroidism. Social deficits often reflect underlying cognitive impairment rather than isolated thyroid effects. Early hormone replacement can mitigate these concerns.

Delayed language development: Language delay is frequently observed due to impaired neurologic maturation and slowed cognitive processing. While significant, language skills are influenced by broader cognitive function. Addressing thyroid deficiency early helps prevent long-term speech and language deficits.

High levels of cerebrospinal fluid (CSF): Spina bifida is a neural tube defect involving incomplete closure of the vertebral column rather than abnormal CSF production. Elevated CSF levels are not a defining feature and are not used as a screening indicator. CSF abnormalities are more relevant to hydrocephalus assessment.

Increased intracranial pressure (ICP): Elevated ICP may occur secondary to associated conditions such as hydrocephalus, but it is not an initial or direct sign of spina bifida. The defect itself is identified by spinal and cutaneous findings. ICP changes develop later if complications arise.

Indications of infection: Infection is a potential complication if neural tissue is exposed, but it is not an initial indicator prompting suspicion of spina bifida. Early recognition relies on visible spinal or skin markers. Infection suggests a secondary problem rather than the congenital defect.

"A provider will explain the changes you may see in your child's body after they have died.": Nurses are often the primary professionals who prepare families for expected postmortem changes such as skin cooling, color changes, and cessation of breathing. Limiting this role to a provider is inaccurate and may delay timely, compassionate education.

"A nurse must obtain locks of hair from the deceased child.": Creating keepsakes such as locks of hair is optional and should be guided by family preference and cultural considerations. It is never mandatory and should only be offered sensitively. Presenting this as a requirement may be distressing to families.

"Warming blankets can minimize the body changes in deceased children.": After death, physiologic changes such as cooling and mottling are expected and cannot be prevented with warming measures. Applying warming blankets may create false expectations or confusion. Comfort measures are directed toward the family rather than altering postmortem changes.

Eye Movement Desensitization and Reprocessing (EMDR): EMDR is primarily used for trauma-related disorders such as post-traumatic stress disorder. While parental stress is significant, EMDR targets unresolved traumatic memories rather than ongoing caregiver burden. It is not the most appropriate first-line intervention for caregiver stress related to chronic childhood conditions.

Acceptance and Commitment Therapy (ACT): ACT focuses on psychological flexibility and values-based coping and can be beneficial for chronic stress. However, evidence supporting its routine use for parental burnout in caregivers of children with autism is less established than other therapies. It is typically adjunctive rather than first-line.

Play Therapy and Art Therapy: These therapies are primarily designed for children to express emotions and improve communication skills. While helpful for pediatric clients, they are not intended to address parental stress or burnout. Their focus does not align with the parents’ coping needs.

"Formula feeding is easier and will let you get more rest, so it's definitely the better option now.": This statement introduces personal judgment and implies superiority of one feeding method over another. It may invalidate the mother’s autonomy and oversimplifies infant feeding decisions. Nursing communication should remain neutral and supportive rather than directive or comparative.

"Since formula feeding is not as beneficial as breastfeeding, you should only use it as a last resort.": This statement is judgmental and may increase parental guilt or distress. While breastfeeding has immunologic benefits, formula feeding can fully support normal growth when used correctly. Nursing support should focus on safe feeding practices rather than persuasion.

"Breastfeeding provides better immunity, so I strongly recommend you reconsider and continue breastfeeding.": This response disregards the mother’s decision and undermines autonomy. Pressuring the parent may damage trust and does not address the immediate need for education on formula use. Supportive counseling should align with the family’s chosen feeding method.