The nurse is conducting physical assessments for a group of children at a local wellness clinic. Which child requires further evaluation?
An eight-year-old child who weighs 60 pounds, rides a bike without training wheels, and is an active swimmer.
A three-year-old child who weighs 28 pounds, requires help with feeding, dislikes most foods, and refuses to drink milk.
A six-month-old who weighs 16 pounds, continues to breastfeed, has started solid foods, and is beginning to crawl.
A four-year-old child who weighs 40 pounds, eats from the same plate every meal, and is occasionally a picky eater.
The Correct Answer is B
Choice A rationale
An eight-year-old child who weighs 60 pounds, rides a bike without training wheels, and is an active swimmer is showing appropriate developmental milestones for their age. Riding a bike and swimming are complex activities that require good motor coordination and balance. These activities also indicate that the child is physically active, which is beneficial for overall health.
Choice B rationale
A three-year-old child who weighs 28 pounds, requires help with feeding, dislikes most foods, and refuses to drink milk may be showing signs of a feeding disorder or picky eating, which can lead to nutritional deficiencies and impact growth and development. This child requires further evaluation to determine the cause of these feeding difficulties and to develop a plan to address them.
Choice C rationale
A six-month-old who weighs 16 pounds, continues to breastfeed, has started solid foods, and is beginning to crawl is showing appropriate developmental milestones for their age. The World Health Organization recommends exclusive breastfeeding for the first six months of life, followed by the introduction of appropriate complementary foods. Crawling is also a typical developmental milestone that usually appears between 6 and 10 months of age.
Choice D rationale
A four-year-old child who weighs 40 pounds, eats from the same plate every meal, and is occasionally a picky eater is within normal behavior for their age. It’s common for
preschoolers to have food preferences and to want routines, such as using the same plate. Picky eating is also a common behavior at this age and usually isn’t a cause for concern unless it leads to nutritional deficiencies or other health problems.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
A 12-month-old with a weak cry, pale complexion, decreased breath sounds, retractions, and an oxygen saturation of 93% is showing signs of severe respiratory distress. The weak cry and pale complexion suggest poor oxygenation and possible hypoxia. Decreased breath sounds and retractions indicate the child is struggling to breathe. An oxygen saturation of 93% is below the normal range for infants, further indicating respiratory distress. This child should be prioritized for treatment.
Choice B rationale
A 5-year-old speaking in full sentences, pink complexion, bilateral wheezing, and an oxygen saturation of 93% is showing signs of respiratory distress, but not as severe as Choice A12. The ability to speak in full sentences and having a pink complexion suggest that the child is getting
enough oxygen. However, bilateral wheezing indicates some airway obstruction. An oxygen saturation of 93% is on the lower end of the normal range for children this age.
Choice C rationale
A 16-year-old speaking in short phrases, wheezing, sitting upright, and an oxygen saturation of 93% is also showing signs of respiratory distress. Speaking in short phrases and sitting upright are signs that the teenager is working harder to breathe. Wheezing indicates airway obstruction. An oxygen saturation of 93% is on the lower end of the normal range for teenagers.
Choice D rationale
A 9-year-old who is quiet, pale, sitting on his father’s lap, bilateral wheezing, and an oxygen saturation of 93% is showing signs of respiratory distress. Being quiet and pale can indicate poor oxygenation. Bilateral wheezing suggests airway obstruction. An oxygen saturation of 93% is below the normal range for children this age. However, this child’s symptoms are not as severe as those of the 12-month-old in Choice A.
Correct Answer is ["B","C","D"]
Explanation
Choice A rationale
Providing a detailed technical explanation using medical terminology is not an appropriate action when obtaining informed consent for a child. Medical terminology can be complex and difficult for non-medical professionals to understand. Therefore, it is important to explain the information in a way that is easy for the parents and the child (if appropriate) to understand.
Choice B rationale
Ensuring the parents were not pressured to give consent and the consent forms were provided is an appropriate action when obtaining informed consent for a child. It is important that the decision to consent is made freely and without coercion.
Choice C rationale
Explaining the potential adverse effects and benefits is an appropriate action when obtaining informed consent for a child. Parents must be fully informed about the potential risks and benefits of a procedure or treatment to make an informed decision.
Choice D rationale
Providing alternative options for treatment and explaining the possible risks of negative outcomes is an appropriate action when obtaining informed consent for a child. Parents should be aware of all available treatment options and their potential outcomes to make an informed decision.
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