The nurse is caring for a 14-year-old client diagnosed with celiac disease. The nurse knows that the client understands the diet instructions when they request which of the following meals?
Low-fat yogurt with blueberries and granola
Cheese, banana slices, rice cakes, and whole milk
Eggs, bacon, rye toast, and lactose-free milk
Egg, cheese, and sausage wrapped in a flour tortilla
The Correct Answer is B
Rationale:
A. Granola often contains gluten, so this meal would not be suitable for someone with celiac disease.
B. Cheese, banana slices, rice cakes, and whole milk are gluten-free and appropriate for a child with celiac disease.
C. Rye toast contains gluten, which is contraindicated for someone with celiac disease.
D. Flour tortillas generally contain gluten, so this meal is not appropriate for someone with celiac disease.
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Correct Answer is D
Explanation
Rationale:
A. Urinary and bowel continence is expected by age 4, so this does not warrant further investigation.
B. Tying shoes is a skill typically developed later, around 5-6 years of age, so not being able to do so at age 4 is not concerning.
C. Having an imaginary friend is common in children around this age and is not a cause for concern.
D. Speaking in 2-3 word sentences is typical for a younger child, around 2 years of age. By age 4, a child should be able to speak in more complex sentences, so this finding warrants further investigation.
Correct Answer is D
Explanation
Rationale:
A. While explaining discharge instructions is important, it is not the immediate priority following cast application.
B. Educating the client to elevate the leg is important to reduce swelling, but it is not the first priority.
C. Administering pain relief is necessary, but assessing circulation, sensation, and movement is more critical to identify any early signs of complications.
D. Performing a neurovascular assessment is the priority action because it ensures that there is no compromise to blood flow, sensation, or movement in the affected limb, which could indicate complications such as compartment syndrome.