A nurse is collecting data from the guardian of a toddler during a well-child visit. The guardian expresses concern to the nurse because his child has a poor appetite, but drinks a quart of milk each day. The nurse should identify that this practice places the toddler at risk for which of the following conditions?

Celiac disease

Lactose intolerance

Acute renal failure

Iron-deficiency anemia

Answer and Explanation

The Correct Answer is D

A. Celiac disease: Celiac disease is an autoimmune disorder triggered by gluten ingestion that damages the small intestine and impairs nutrient absorption. While it can cause poor appetite and growth issues, high milk intake alone does not cause or increase the risk for celiac disease. Diagnosis is based on genetic susceptibility and gluten exposure, not dietary patterns.

B. Lactose intolerance: Lactose intolerance results from deficiency of lactase, leading to diarrhea, bloating, and abdominal discomfort after dairy consumption. Drinking large amounts of milk may exacerbate symptoms if the child is lactose intolerant, but intolerance is not caused solely by high milk intake.

C. Acute renal failure: Acute renal failure is typically caused by severe dehydration, infection, toxins, or obstruction and is not related to high milk intake in a toddler. Daily consumption of milk, even in large quantities, does not precipitate acute renal failure in a healthy child.

D. Iron-deficiency anemia: Excessive milk intake can displace iron-rich foods from the toddler’s diet and interfere with iron absorption, increasing the risk for iron-deficiency anemia. Milk is low in iron, and consuming more than 24 ounces per day can contribute to inadequate dietary iron intake and subsequent anemia in toddlers.

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. Itching has subsided: While reduced pruritus indicates healing and comfort improvement, it does not correlate with viral shedding or contagiousness. Children with varicella can still transmit the virus until all lesions are fully crusted, regardless of the presence or absence of itching.

B. All vesicles have crusted over: Varicella (chickenpox) is contagious from 1–2 days before the rash appears until all lesions have formed crusts. Crusting of vesicles indicates that viral shedding has ended, and the child is no longer infectious. This is the primary clinical indicator used to determine when isolation precautions can safely be discontinued.

C. Temperature is less than 37.8° C (100° F): Fever reduction signals improvement in systemic infection and overall health but does not reflect cessation of viral shedding. Children may remain contagious despite a normal temperature until the lesions crust over.

D. The antibiotics regimen is complete: Antibiotics are not effective against varicella, a viral infection, and completing an antibiotic course does not influence contagiousness. Transmission risk is determined by lesion status, not antibiotic therapy.

A. The client spends most of their day sleeping. B. The client is easily distracted by external stimuli. C. The client withdraws from group activities. D. The client will only eat finger foods.

Correct Answer is B

Explanation

A. The client spends most of their day sleeping: Excessive sleep is more characteristic of depressive episodes in bipolar disorder. While fatigue can contribute to risk in some contexts, it does not directly indicate increased injury risk from manic behaviors.

B. The client is easily distracted by external stimuli: Distractibility is a hallmark of mania and can lead to impulsive or unsafe actions, such as leaving dangerous objects within reach, wandering, or starting multiple activities at once. This significantly increases the client’s risk for injury.

C. The client withdraws from group activities: Social withdrawal is more associated with depressive states. While it may affect engagement or mood, it does not inherently increase risk for injury due to manic behavior.

D. The client will only eat finger foods: Preferring finger foods may indicate impulsivity or hyperactivity but does not directly correlate with a substantial risk for injury. Safety risks are more closely tied to distractibility, poor judgment, and impulsive actions during mania.

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Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching about infection control with the guardian of a school-age child who has varicella. The nurse should inform the guardian that which of the following findings is an indication that the child is no longer contagious?

Correct Answer is B

Explanation

A nurse is collecting data from a client who has bipolar disorder. The nurse should identify that which of the following findings places the client at an increased risk for injury due to mania?

Correct Answer is B

Explanation

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