The emergency department nurse is caring for a 6-year-old child with a fractured forearm and suspects the injury is the result of abuse. Which x-ray finding would confirm the suspicions for the nurse?

Correct Answer: B

Rationale: The correct answer is B: A spiral fracture. Spiral fractures are often associated with twisting injuries, which are commonly seen in cases of child abuse. The spiral nature of the fracture indicates a rotational force applied to the bone, consistent with non-accidental trauma. A: A single transverse fracture is not specific to abuse and can occur from accidental falls. C: A greenstick fracture is an incomplete fracture commonly seen in children due to their bone structure, not necessarily indicative of abuse. D: A comminuted fracture, while severe, does not specifically point towards abuse as it can result from high-impact accidents. In summary, the presence of a spiral fracture in a young child raises suspicion of non-accidental trauma due to its characteristic mechanism of injury.

Correct Answer: B

Rationale: The correct answer is B because consistently turning up the volume on the television suggests the client is having difficulty hearing. This behavior indicates a potential hearing loss as the individual may not be able to hear the TV at normal volume levels. Cleaning ears daily (A) is a routine hygiene practice and does not necessarily indicate hearing loss. Ear pain when yawning (C) could be related to ear infections or eustachian tube dysfunction, not specifically hearing loss. Dizziness upon standing (D) is more indicative of orthostatic hypotension or inner ear issues, not necessarily hearing loss.

Correct Answer: B

Rationale: The correct answer is B because recommending an over-the-counter scopolamine patch is an appropriate intervention for preventing motion sickness during a cruise. Scopolamine is a common medication used to alleviate symptoms of motion sickness by affecting the vestibular system. It is often recommended for individuals going on cruises or experiencing other forms of motion sickness. Choice A is incorrect because making an appointment with the healthcare provider may not be necessary for a common issue like motion sickness and could delay the client's access to immediate relief. Choice C is incorrect as discouraging the client from taking the trip does not address the client's concern about motion sickness and is not a practical solution. Choice D is incorrect as instructing the client to lie down does not address motion sickness and may not be effective in preventing or alleviating symptoms.

Correct Answer: C

Rationale: The correct answer is C: Perform a bedside glucose check. This is the priority intervention as the client's symptoms suggest hypoglycemia, common in pancreatic islet tumors. Checking glucose levels will confirm this and guide appropriate treatment. Starting an IV with D5W (A) may be needed for severe cases, but confirming hypoglycemia is crucial first. Notifying the health-care provider (B) may delay immediate action. Giving orange juice (D) may help raise blood sugar, but confirming hypoglycemia is necessary before providing any treatment.

Correct Answer: B

Rationale: The correct answer is B: Body image disturbance. This is crucial for a female client with Cushing's syndrome due to physical changes like weight gain, facial fullness, and stretch marks. Addressing body image issues can improve self-esteem and overall well-being. A: Altered glucose metabolism is a physiological concern, not a psychosocial one. C: Risk for suicide is not directly associated with Cushing's syndrome. D: Impaired wound healing is also a physiological issue, not a psychosocial problem.