The twelve-year-old boy has fractured his arm because of a fall from his bike. After the injury has been casted, the nurse knows it is most important to perform all of the following assessments on the area distal to the injury except:

Correct Answer: B

Rationale: Assessing the radial and ulnar pulses is crucial in evaluating the circulation of blood to the hand. However, in this scenario of a fractured arm, the injury is distal to the hand (further away from the body). It is more critical to check capillary refill, finger movement, and skin integrity in the area distal to the injury to ensure there is no compromise to the blood flow, nerve function, or skin integrity following the injury. Checking the radial and ulnar pulse would be more relevant if the injury was closer to the wrist area, as it would directly impact these pulses.

Correct Answer: C

Rationale: Osteogenesis imperfecta, also known as brittle bone disease, is a genetic disorder that affects collagen production, leading to brittle and easily fractured bones. In addition to bone fragility, individuals with osteogenesis imperfecta may also experience teeth abnormalities such as dentinogenesis imperfecta (discolored and weakened teeth) and ligament laxity due to the improper development of connective tissues. This incomplete development of teeth, bones, and ligaments is a characteristic feature of osteogenesis imperfecta, making it the correct choice in this scenario. Congenital hip dysplasia, Duchenne's muscular dystrophy, and osteomyelitis do not typically involve the same constellation of symptoms related to teeth, bones, and ligaments seen in osteogenesis imperfecta.

Correct Answer: B

Rationale: In the context of a pediatric patient diagnosed with gastroesophageal reflux (GER), the inappropriate nursing diagnosis among the options provided is B) Impaired oral mucous membrane. This is because GER primarily involves the reflux of gastric contents into the esophagus and potentially the mouth, rather than directly affecting the oral mucous membranes. A) Risk for aspiration is a relevant nursing diagnosis for a patient with GER, as the refluxed gastric contents can potentially be aspirated into the lungs, leading to respiratory complications. C) Deficient fluid volume is also a pertinent nursing diagnosis due to the potential for frequent regurgitation and vomiting in patients with GER, which can lead to dehydration and electrolyte imbalances. D) Imbalanced nutrition: Less than body requirements is another appropriate nursing diagnosis because GER can lead to feeding difficulties, poor weight gain, and inadequate nutrient intake in pediatric patients. Educationally, understanding the rationale behind selecting the correct nursing diagnosis in a specific clinical scenario like GER helps nurses provide targeted and effective care to pediatric patients. By analyzing each option critically, nurses can develop clinical reasoning skills and make informed decisions to optimize patient outcomes.

Correct Answer: B

Rationale: Sibling of Baby Angie who died of SIDS is the least probable to develop sudden infant death syndrome (SIDS) among the given choices. This is because siblings of infants who have died of SIDS are at a higher risk themselves due to potential genetic or environmental factors. Research suggests that siblings of infants who died of SIDS are at an increased risk compared to the general population, indicating a possible genetic predisposition or shared environmental influences. It is crucial for parents and caregivers of these siblings to take extra precautions and follow safe sleep practices to reduce the risk of SIDS.

Correct Answer: D

Rationale: Idiopathic thrombocytopenic purpura (ITP) is a condition characterized by a low platelet count, leading to an increased risk of bleeding and easy bruising. Platelets are responsible for blood clotting and when their count is low, it can result in purpura (bruising) due to small blood vessels leaking blood into the skin. For this reason, the most common finding in ITP is bruising rather than blood clots, pallor, or dry membranes.