A school-age child presents for a well-child visit with a hemoglobin level of 10 g/dL (100 g/L) and a body mass index of 15 kg/mm2. Which additional assessment should the nurse obtain to help identify a potential cause of these clinical manifestations?

Primary source of water.

Standard household income.

Family history of eating disorders.

Average daily intake of meals.

Answer and Explanation

The Correct Answer is D

A: Primary source of water. This assessment might be relevant if there is a concern about lead exposure or other contaminants in the water, which can contribute to anemia. Therefore, while important in certain contexts, it is not the most immediate assessment for these specific clinical manifestations.

B: Standard household income. Household income can influence access to nutritious food and overall health. Lower income can lead to food insecurity, poor diet quality, and subsequently, anemia and lower BMI due to inadequate nutrient intake. This can be an indirect but important factor to consider. However, it does not directly assess the child’s dietary intake or specific nutritional deficiencies.

C: Family history of eating disorders. Family history of eating disorders might provide insights into potential genetic or environmental predispositions to eating disorders. However, eating disorders are more commonly associated with adolescents and adults rather than school-age children.

D: Average daily intake of meals. This is the most directly relevant assessment. Analyzing the child's average daily intake of meals can provide immediate insights into potential nutritional deficiencies that might explain both the low hemoglobin level (anemia) and low BMI. Poor dietary intake, particularly of iron-rich foods, can lead to iron-deficiency anemia and inadequate caloric intake, affecting BMI. This assessment helps identify specific dietary issues that can be addressed directly to improve the child’s health.

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Correct Answer is B

Explanation

A. Multiple maculopapular pustules over forehead and chin on an adolescent student: These pustules could be indicative of an infectious process, such as acne or impetigo. While not necessarily an emergency, it’s important to assess and potentially treat these skin lesions promptly. The school nurse should report this to the healthcare provider for further evaluation.

B. Red, swollen, painful nodule located on the upper back of a school-aged student: This finding raises concern for an abscess or localized infection. The pain, redness, and swelling suggest an inflammatory process. The nurse should promptly report this to the healthcare provider for assessment and appropriate management.

C. Small, white flecks on the hair shafts throughout the scalp on a school-aged child: These white flecks are likely nits (lice eggs). While not an emergency, they do require attention. The nurse should inform the parents or guardians and recommend appropriate treatment. However, this finding does not necessitate immediate reporting to the healthcare provider.

D. Bilateral patellar abrasions with eschar formation on a preschool-aged student: Abrasions with eschar (dead tissue) formation can indicate a deeper injury. The nurse should report this to the healthcare provider promptly for assessment and wound care recommendations.

A. Tell the client the medication needs more time to work. B. Reassess the client and the level of pain. C. Ask the unlicensed assistive personnel (UAP) to offer a backrub to the client. D. Encourage the client to focus on taking deep breaths.

Correct Answer is B

Explanation

A. Telling the client the medication needs more time: While true for some medications, it's important to assess the severity of the pain to determine if further action is needed.

B. Reassessing the client's pain: This is the most crucial step. Reassessment helps determine the effectiveness of the medication and identify any potential issues.

C. Asking UAP to offer a backrub: While comfort measures can be helpful, delegation to an UAP should only occur after a nurse assessment and with clear instructions. In this case, pain management is the priority.

D. Encouraging deep breaths: Distraction techniques can be a complementary approach, but reassessing the pain level is the most urgent step.

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A school-age child presents for a well-child visit with a hemoglobin level of 10 g/dL (100 g/L) and a body mass index of 15 kg/mm2. Which additional assessment should the nurse obtain to help identify a potential cause of these clinical manifestations?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which finding, obtained during a skin assessment of a student, should the school nurse report to the healthcare provider?

Correct Answer is B

Explanation

A client is complaining of severe pain after being medicated one hour ago with hydrocodone with acetaminophen one tablet orally. Which intervention should the nurse implement next?

Correct Answer is B

Explanation

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