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 C

Explanation

A. A bubbling sound heard during inspiration and expiration in the central airways: This description is accurate. Crackles (also called rales) are often heard in conditions like pulmonary edema or pneumonia.

B. A crowing noise heard during inspiration over the trachea: This description refers to stridor, not crackles. Stridor occurs due to upper airway obstruction.

C. Popping, non-musical sounds heard in the lung bases, usually during inspiration: This description is accurate for crackles. They occur due to fluid or secretions in the alveoli.

D. Superficial squeaking or grating sounds heard during inspiration and expiration: This description refers to wheezes, not crackles. Wheezes are associated with narrowed airways.

A. Eats less salt-cured meats. B. Participates in healing rituals. C. Uses herbal remedies. D. Meditates in sweat lodges.

Correct Answer is C

Explanation

A. Eats less salt-cured meats: Reducing the intake of salt-cured meats is generally a positive behaviour, especially for someone with hypertension. This behaviour aligns with dietary recommendations for managing high blood pressure.

B. Participates in healing rituals: Healing rituals are part of many cultural practices and can provide emotional and spiritual support. However, without further information, it's unclear if these rituals interfere with the prescribed treatment. This may warrant additional assessment to ensure they complement the medical regimen.

C. Uses herbal remedies: The use of herbal remedies could potentially interact with prescribed antihypertensive medications. This behaviour requires careful assessment to ensure there are no harmful interactions or adverse effects on the treatment plan.

D. Meditates in sweat lodges: Sweat lodges are a traditional practice for many Native Americans, providing physical and spiritual cleansing. However, the high temperatures and dehydration risks associated with sweat lodges could adversely affect blood pressure control and overall cardiovascular health. This behaviour requires further evaluation to ensure it is safe for the client with hypertension.

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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

The nurse hears crackles when auscultating a client's lung sounds. Which is an accurate description of the sound of crackles?

Correct Answer is C

Explanation

An older Native-American client with hypertension presents to an outpatient clinic for follow-up evaluation after initiation of treatment with oral antihypertensive medications. Report of which client behavior requires additional assessment by the nurse?

Correct Answer is C

Explanation

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