At hemophilia camp several children with injuries arrive at the clinic at the same time. Which of the following children require the most immediate care?

A child that was playing soccer when he collided with another child and now has a swollen knee

A child that was running and fell forward with abrasions on both arms

A child that stepped on a nail that has a puncture wound on the foot

A child that was running around the pool and fell and hit his head

Answer and Explanation

The Correct Answer is D

A. While hemarthrosis (bleeding into joints) is common in hemophilia and requires prompt factor replacement and assessment, it is not immediately life-threatening unless associated with vascular compromise or severe pain that threatens circulation.

B. Minor abrasions are low-risk injuries. They may require cleaning and monitoring for infection, but they do not pose an immediate threat to life or major function.

C. Puncture wounds carry a risk for tetanus and infection, but they are not immediately life-threatening unless signs of severe infection or vascular compromise appear. Prompt cleaning, tetanus prophylaxis, and factor coverage are important, but urgency is lower than for head trauma.

D. Head trauma in a child with hemophilia is an emergency. Even a minor impact can cause intracranial hemorrhage, which may be rapidly life-threatening. Symptoms such as vomiting, lethargy, headache, or neurological changes require immediate assessment, factor replacement, and emergency intervention. Hemophilia increases the risk of severe bleeding even without external signs.

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Correct Answer is B

Explanation

A. A BMI at or above the 90th percentile is generally considered overweight, not obese. Using the 90th percentile as a cutoff would overestimate the number of children classified as obese, potentially leading to unnecessary interventions. The 90th percentile does not align with established CDC guidelines for obesity screening in children.

B. According to CDC growth charts, a child is considered obese if their BMI is equal to or greater than the 95th percentile for age and sex. This classification is evidence-based and correlates with increased risk for cardiometabolic complications (type 2 diabetes, hypertension, dyslipidemia) and psychosocial issues such as low self-esteem and bullying. It serves as a key threshold for initiating clinical assessment and targeted interventions, including nutrition counseling, increased physical activity, and behavioral support.

C. A BMI at the 70th percentile is within the normal weight range for children of the same age and sex. Children in this percentile are not considered overweight or obese and typically do not require weight-related interventions beyond routine healthy lifestyle guidance. Labeling a child with a BMI at the 70th percentile as obese would be inaccurate and could contribute to unnecessary anxiety or inappropriate treatment.

D. A BMI between the 85th and 94th percentile is classified as overweight, not obese. This distinction is important because children who are overweight may benefit from preventive lifestyle interventions, whereas children at or above the 95th percentile may require more intensive assessment and management. Misclassifying overweight children as obese could lead to inappropriate labeling or interventions.

A. "It is likely your infant will need minimally invasive surgery once the infant reaches 6 months of age." B. "Treatment focuses on making sure to place your baby on his back for most of the time he is in the crib." C. "Your infant may need to wear a helmet for most hours of the day." D. "Your infant will need to be hospitalized to have surgery to completely correct this problem."

Correct Answer is C

Explanation

A. Minimally invasive surgery is not the standard treatment for plagiocephaly. Surgical intervention is typically reserved for rare, severe, or syndromic cases where conservative measures fail or cranial deformities are extreme. Most infants respond well to non-surgical interventions if identified early.
B. Placing an infant on their back is critical for SIDS prevention, but strict supine positioning can contribute to positional plagiocephaly. Therefore, treatment focuses on repositioning the infant during awake periods, encouraging tummy time, and limiting prolonged supine positioning when the infant is awake and supervised, to promote symmetrical skull growth.
C. Helmet therapy, also called cranial orthosis, is considered the most effective intervention for moderate to severe plagiocephaly. The helmet works by gently guiding skull growth as the infant’s skull is still malleable, usually between 4–12 months of age. Infants typically wear the helmet for 23 hours a day, with adjustments made every few weeks by a specialist to ensure proper fit and effectiveness. This therapy is non-invasive, reduces cranial asymmetry, and avoids the need for surgery in most cases. Parents are also instructed on monitoring skin integrity, proper cleaning, and follow-up appointments to track progress.
D. Hospitalization and surgery are unnecessary for standard positional plagiocephaly. Surgical correction is extremely rare and only indicated for congenital cranial malformations or syndromes that do not respond to conservative management.

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At hemophilia camp several children with injuries arrive at the clinic at the same time. Which of the following children require the most immediate care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is conducting a class on obesity for the parents of school-aged children. The parents have correct understanding of the information if they state. "A child with a BMI greater than the percentile is considered obese."

Correct Answer is B

Explanation

An infant is diagnosed with plagiocephaly. When teaching the parents about treatment which information would the nurse likely include?

Correct Answer is C

Explanation

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