A school-age client is recovering after abdominal surgery. The nurse is planning care for the return of bowel function. Which intervention should be included in the client’s plan of care?

Correct Answer: D

Rationale: The correct answer is D - Ambulate 3-4 times a day. Ambulation helps stimulate peristalsis and aids in the return of bowel function after abdominal surgery. Walking promotes movement in the abdomen, preventing complications like ileus. Fowler's position (choice A) may help with breathing but does not directly impact bowel function. Choosing a low-fat diet (choice B) is important for overall health but does not directly promote bowel function. Having a commode at the bedside (choice C) is convenient but does not actively facilitate the return of bowel function like ambulation does.

Correct Answer: D

Rationale: The correct answer is D: Use a nightlight in the child’s room. This answer is correct because a nightlight can provide a sense of security for the child and help alleviate any fear of the dark, which is a common issue for young children. It can also help the child feel more comfortable and relaxed, promoting better sleep. Choice A is incorrect as always sleeping in a quiet, darkened room may not address the child's fear of the dark. Choice B is incorrect as high-carbohydrate snacks before bedtime can actually disrupt sleep. Choice C is incorrect as eliminating the afternoon nap may lead to overtiredness, making it harder for the child to fall asleep at night.

Correct Answer: C

Rationale: The correct answer is C: Appropriate weight gain for age. In congestive heart failure, decreasing the demands on the heart is crucial. Appropriate weight gain indicates good cardiac output and effective management of fluid retention. Irritability (choice A) can be a sign of distress, capillary refill of more than 5 seconds (choice B) indicates poor perfusion, and positioning in high Fowler position (choice D) is more related to respiratory support rather than decreasing demands on the heart.

Correct Answer: A

Rationale: The correct answer is A: Immediately bring the child to clinic for evaluation. Given the child's medical history of a repaired ventricular septal defect (VSD) and presenting symptoms of decreased appetite, fever, and muscle/joint aches, there is concern for a possible infection or cardiac-related issue. It is crucial to promptly assess the child's condition due to the potential risks associated with cardiac conditions and infections in this population. Delaying evaluation could lead to serious complications. Choices B and C are incorrect because waiting until next week or simply treating symptoms with acetaminophen may result in a missed opportunity to address a potentially serious issue. Choice D is incorrect as it dismisses the child's symptoms as manipulation, which is not a responsible or evidence-based approach to healthcare.

Correct Answer: A

Rationale: The correct answer is A: Provide adequate hydration. Hypercalcemia in an immobilized child can be managed by ensuring adequate hydration to help promote renal excretion of excess calcium. Hydration helps prevent further calcium buildup in the blood and reduces the risk of complications. It is crucial to maintain a good fluid balance to support the kidneys in eliminating excess calcium. Changing position frequently (choice B) may help prevent complications related to immobility but does not directly address hypercalcemia. Encouraging a diet high in calcium (choice C) is contraindicated in hypercalcemia as it can exacerbate the condition. Providing a diet high in calories for healing (choice D) is important for overall nutrition but does not specifically target the management of hypercalcemia in an immobilized child.