A nurse is providing care to a child who has Down syndrome during a well-child checkup. Which of the following assessment findings requires immediate follow-up by the nurse?

Changes in feeding and bowel habits.

Presence of a single palmar crease on the child's hands.

Height and weight measurement below the 50th percentile for their age.

Evaluation of the caregiver's financial resources.

Answer and Explanation

The Correct Answer is A

A. Changes in feeding and bowel habits. In children with Down syndrome, sudden changes in feeding and bowel habits can indicate serious conditions such as gastrointestinal obstruction (e.g., Hirschsprung’s disease) or hypothyroidism. These conditions require immediate follow-up as they can lead to complications like malnutrition or bowel obstruction.

B. Presence of a single palmar crease on the child's hands. A single transverse palmar crease (simian crease) is a common physical feature in Down syndrome but is not an urgent concern. It does not require immediate medical intervention.

C. Height and weight measurement below the 50th percentile for their age. Children with Down syndrome often have shorter stature and lower weight percentiles due to their genetic condition. While growth monitoring is important, it is not an immediate concern unless severe failure to thrive is present.

D. Evaluation of the caregiver's financial resources. Assessing financial resources is important for long-term care planning, but it does not require urgent medical intervention. Immediate follow-up should prioritize health concerns affecting the child’s well-being.

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Correct Answer is A

Explanation

A. "Screening involves a combination of parent interviews, observations, and standardized developmental screening tools." The diagnosis of autism spectrum disorder (ASD) is based on behavioral assessments, including parent-reported history, clinical observations, and standardized screening tools such as the Modified Checklist for Autism in Toddlers (M-CHAT).

B. "ASD can be definitively diagnosed with a simple blood test, so we will schedule one for your child." There is no blood test or biomarker that can diagnose ASD. Diagnosis is based on behavioral and developmental criteria rather than laboratory tests.

C. "The screening process for ASD is usually completed in one visit to the healthcare provider." ASD screening and diagnosis require multiple evaluations over time, often involving developmental specialists, psychologists, and speech therapists to get a comprehensive understanding of the child’s behaviors.

D. "If your child makes eye contact with you, we can rule out autism spectrum disorder." While reduced eye contact is a common characteristic of ASD, some children with ASD do make eye contact, and the presence or absence of this behavior alone does not confirm or rule out the disorder.

A. Frequent assessments of blood glucose levels B. Routine monitoring of thyroid-stimulating hormone (TSH) levels C. Regular monitoring of blood pressure D. Continuous monitoring of body temperature

Correct Answer is B

Explanation

A. Frequent assessments of blood glucose levels. While hypothyroidism can affect metabolism, levothyroxine does not typically require frequent blood glucose monitoring unless the client has diabetes or another metabolic condition.

B. Routine monitoring of thyroid-stimulating hormone (TSH) levels. TSH is the primary indicator used to assess whether levothyroxine dosage is effective. Routine TSH monitoring ensures that thyroid hormone levels remain within the target range, preventing complications such as under-treatment (persistent hypothyroid symptoms) or over-treatment (hyperthyroid symptoms like palpitations and weight loss).

C. Regular monitoring of blood pressure. While thyroid dysfunction can affect blood pressure, routine BP monitoring is not the primary focus of hypothyroidism management unless the client has additional risk factors for hypertension.

D. Continuous monitoring of body temperature. Hypothyroidism can cause cold intolerance, but continuous body temperature monitoring is not necessary unless the client is at risk for severe hypothyroidism complications such as myxedema coma.

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A nurse is providing care to a child who has Down syndrome during a well-child checkup. Which of the following assessment findings requires immediate follow-up by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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