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.

Answer and Explanation

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..

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Correct Answer is C

Explanation

Choice A reason: Coffee-ground emesis is not the development that the nurse should monitor for. This is a sign of bleeding in the upper gastrointestinal tract, which can be caused by ulcers, gastritis, or esophageal varices. It is not related to the infant's condition, which is likely pyloric stenosis, a narrowing of the opening between the stomach and the small intestine.

Choice B reason: Frequent pauses are not the development that the nurse should monitor for. This is a normal behavior for infants during feeding, as they need to take breaks to breathe and swallow. It is not indicative of any problem or complication.

Choice C reason: Projectile vomiting is the development that the nurse should monitor for. This is a common symptom of pyloric stenosis, a condition that affects about 3 out of 1,000 infants. It occurs when the muscle at the end of the stomach becomes thickened and blocks the passage of food into the small intestine. This causes the infant to vomit forcefully after feeding, leading to dehydration, hunger, and weight loss. The olive-like mass in the upper right abdomen is the enlarged pylorus muscle that can be felt through the skin.

Choice D reason: Arched back is not the development that the nurse should monitor for. This is a sign of pain or discomfort in infants, which can have various causes, such as colic, reflux, or ear infection. It is not specific to pyloric stenosis, although the infant may arch their back due to the abdominal pain caused by the condition. .

A. Give prescribed intravenous antibiotics. B. Inquire about the client's last meal. C. Contact the healthcare provider. D. Document the client's relief of pain.

Correct Answer is C

Explanation

Choice A reason: Giving prescribed intravenous antibiotics is not the first action that the nurse should take. Antibiotics are used to treat the infection and inflammation caused by appendicitis, but they are not enough to prevent the complications of a ruptured appendix. The nurse should administer the antibiotics as ordered, but only after notifying the healthcare provider of the change in the child's condition.

Choice B reason: Inquiring about the client's last meal is not the first action that the nurse should take. The last meal may be relevant for the preparation of the surgery, but it is not urgent or related to the sudden relief of pain. The nurse should ask about the last meal as part of the preoperative assessment, but only after contacting the healthcare provider.

Choice C reason: Contacting the healthcare provider is the first action that the nurse should take. Sudden relief of pain in a child with appendicitis may indicate a perforation or rupture of the appendix, which is a life-threatening emergency. The nurse should immediately report this finding to the healthcare provider, who may order additional tests or expedite the surgery.

Choice D reason: Documenting the client's relief of pain is not the first action that the nurse should take. Documentation is an important part of nursing care, but it is not a priority in this situation. The nurse should document the child's pain level, vital signs, and interventions, but only after contacting the healthcare provider and taking appropriate actions.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for an infant admitted with dehydration, irritability, signs of extreme hunger, and a palpable olive-like mass in the upper right abdominal quadrant. When feeding the infant, the nurse should monitor for which development?

Correct Answer is C

Explanation

A 9-year-old admitted to the unit with severe abdominal pain and fever is diagnosed with appendicitis and is placed on the surgery schedule for an appendectomy. The child reports to the nurse of experiencing sudden relief in abdominal pain. Which action should the nurse take first?

Correct Answer is C

Explanation

An infant born 2 days ago has not passed a meconium stool and begins to vomit bilious secretions. Which action should the nurse take first?

A preschool-age boy in a daycare facility scratches his head frequently, and the nurse confirms the presence of head lice. The nurse washes the child's hair with permethrin shampoo and calls his parents. Which instruction should the nurse provide to the parents about treatment for head lice?

The nurse is providing discharge instructions to the caregiver of an infant with recurrent otitis media. Which statement made by the caregiver should the nurse recognize as needing additional education about minimizing subsequent infections?

A school-age child with nephrotic syndrome is receiving salt-poor human albumin IV. Which findings indicate to the nurse that the child is manifesting a therapeutic response?

The clinic nurse receives a call from a parent of a 10-year-old who reports that their child just returned from summer camp and has developed an expanding circular red rash on the arm. The parent asks the nurse which over-the-counter (OTC) product is safe to use. How should the nurse respond?

A 10-year-old boy has been seen frequently by the school nurse over the past three weeks after school begins in the fall. He reports headaches, stomach aches, and difficulty sleeping. Which intervention should the nurse implement?

An 8-year-old girl with precocious sexual development is being treated medically with injections of luteinizing hormone-releasing hormone (LHRH) to regulate the pituitary gland. Which statement by the parents indicates that they understand the treatment?