The mother of a 6-year-old girl is concerned about her child's obesity. The child's weight plots at the 75th percentile, and height at the 25th percentile. The child's body mass index (BMI) is at the 85th percentile for age and gender. Which intervention(s) should the nurse implement? Select all that apply.
Obtain the child's 3-day diet history based on the mother's input.
Explain that the child is likely to grow into her weight.
Tell the mother that girls hit their growth spurt before boys so eating more is expected.
Inquire as to whether or not the school has a physical education program.
Determine the child's usual physical activity pattern.
Correct Answer : A,E
Choice A reason: Obtaining the child's 3-day diet history based on the mother's input is a useful intervention to assess the child's nutritional intake and identify any unhealthy eating habits or patterns. The nurse can use the diet history to provide individualized and evidence-based dietary advice and counseling to the mother and the child, such as reducing the intake of sugar-sweetened beverages, increasing the intake of fruits and vegetables, and limiting the portion sizes.
Choice B reason: Explaining that the child is likely to grow into her weight is not a helpful intervention and may be misleading or harmful. It may give the mother and the child a false sense of reassurance and discourage them from making any lifestyle changes. It may also ignore the potential health risks and psychosocial consequences of childhood obesity, such as diabetes, hypertension, low self-esteem, and bullying.
Choice C reason: Telling the mother that girls hit their growth spurt before boys so eating more is expected is not a valid intervention and may be inaccurate or inappropriate. It may imply that the child's obesity is normal or inevitable, which is not true. It may also overlook the fact that the child's weight and height are disproportionate and do not match the growth charts for her age and gender.
Choice D reason: Inquiring as to whether or not the school has a physical education program is not a sufficient intervention and may be irrelevant or ineffective. It may not address the child's specific physical activity needs and preferences, or the barriers and facilitators to physical activity in the home and community settings. It may also shift the responsibility and accountability from the mother and the child to the school.
Choice E reason: Determining the child's usual physical activity pattern is a beneficial intervention to evaluate the child's energy expenditure and identify any sedentary behaviors or activities. The nurse can use the physical activity pattern to provide individualized and evidence-based physical activity recommendations and guidance to the mother and the child, such as increasing the frequency, intensity, and duration of moderate to vigorous physical activity, reducing the screen time, and engaging in fun and enjoyable physical activities..
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Starting the daughter on birth control pills is not necessary and may interfere with the LHRH treatment. LHRH injections suppress the production of sex hormones and prevent ovulation and menstruation. Birth control pills contain synthetic hormones that may have unwanted side effects and may not be effective in preventing pregnancy in girls with precocious puberty.
Choice B reason: Encouraging the daughter to dress in clothing that suits her sexual maturity level is not advisable and may cause psychological distress. Girls with precocious puberty may feel self-conscious and embarrassed about their early physical development and may face teasing or bullying from their peers. Dressing in clothing that accentuates their sexual maturity may make them feel more uncomfortable and isolated. They should be allowed to dress in clothing that matches their age and emotional development.
Choice C reason: The daughter will not be on this hormone treatment the rest of her life. LHRH injections are usually given until the age of normal puberty, around 11 or 12 years old. Then, the treatment is stopped and the natural puberty process resumes. The injections are meant to delay puberty, not stop it permanently.
Choice D reason: Sexual maturity differences between the daughter and her peers will disappear within a few years is the correct statement that shows understanding of the treatment. LHRH injections slow down the growth and development of the sex organs and secondary sexual characteristics, such as breasts and pubic hair. This allows the girl to grow at a normal rate and reach her full adult height potential. It also reduces the social and emotional problems that may arise from being sexually mature too early. Once the treatment is stopped, the girl will go through puberty at the same time as her peers and the differences will no longer be noticeable.
Correct Answer is D
Explanation
Choice A reason: Obtaining a swab of secretions from the penis and urethra is not the appropriate action to take in this situation. This may be done to test for sexually transmitted infections (STIs), such as chlamydia or gonorrhea, that can cause epididymitis, an inflammation of the tube that carries sperm from the testicle. However, epididymitis usually causes gradual pain and swelling, not sudden and severe, and is unlikely to be triggered by a physical activity. Moreover, obtaining a swab may be painful and unnecessary for the adolescent.
Choice B reason: Collecting a sterile urine sample for culture and sensitivity is not the appropriate action to take in this situation. This may be done to test for urinary tract infections (UTIs) or kidney stones that can cause testicular pain. However, UTIs and kidney stones usually cause other symptoms, such as burning or difficulty urinating, blood in the urine, or lower back pain. They are also unlikely to be triggered by a physical activity. Moreover, collecting a urine sample may be difficult and uncomfortable for the adolescent.
Choice C reason: Providing the adolescent with a urinal for urinary hesitancy is not the appropriate action to take in this situation. Urinary hesitancy is the difficulty or delay in starting or maintaining a urine stream. It can be caused by various factors, such as anxiety, medication, prostate problems, or nerve damage. It is not a common symptom of testicular pain and is not related to the cause of the pain. Moreover, providing a urinal may be embarrassing and unnecessary for the adolescent. ⁷
Choice D reason: Reporting the findings immediately to the healthcare provider is the appropriate action to take in this situation. Sudden and severe testicular pain and swelling can be a sign of testicular torsion, a medical emergency that occurs when the testicle twists and cuts off its blood supply. Testicular torsion can be caused by trauma, strenuous exercise, or cold temperature. It can lead to permanent damage or loss of the testicle if not treated promptly. The adolescent needs urgent evaluation and possible surgery to untwist the testicle and restore blood flow.
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