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.

Answer and Explanation

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.

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Correct Answer is ["B","C","D"]

Explanation

Choice A rationale

While maintaining a cool, dry environment can be comfortable for the child, it is not specifically related to tracheostomy care. Humidity can actually be beneficial for a child with a tracheostomy, as it helps to keep the airway moist and prevent mucus from becoming too thick.

Choice B rationale

Having emergency tracheostomy equipment available at all times is crucial. This should include a spare tracheostomy tube of the same size and one size smaller, suction equipment, and a bag-valve-mask device. In case of a problem with the tracheostomy tube (such as blockage or accidental dislodgement), it is important to have the necessary equipment immediately available.

Choice C rationale

Changing the tracheostomy tube at the ordered frequency is important to prevent blockage and infection. The frequency will depend on various factors, including the type of tracheostomy tube and the child’s specific condition.

Choice D rationale

Monitoring the thickness and color of secretions can help to detect infections or other complications. Changes in secretions can be an early sign of problems such as tracheitis or pneumonia.

A. Inability to pick up crackers with thumb and forefinger. B. Playing with a toy for only a few minutes. C. Ability to crawl on all fours supported on hands and knees. D. Inability to pull self to a standing position.

Correct Answer is A

Explanation

Choice A rationale

By 9 months, most babies have developed the fine motor skills necessary to pick up small objects, like crackers, with their thumb and forefinger. This is known as the pincer grasp. If a 9- month-old child is unable to do this, it could be a sign of a developmental delay.

Choice B rationale

It’s normal for babies at this age to have a short attention span. They often play with a toy for only a few minutes before moving on to something else. Therefore, this behavior is not typically a cause for concern.

Choice C rationale

The ability to crawl on all fours supported on hands and knees is a typical developmental milestone for a 9-month-old child. Therefore, this behavior is expected and does not indicate a developmental delay.

Choice D rationale

While some 9-month-old babies may be able to pull themselves to a standing position, not all babies develop this skill at the same time. Therefore, the inability to do this is not necessarily a cause for concern.

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The nurse is conducting physical assessments for a group of children at a local wellness clinic. Which child requires further evaluation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When teaching home tracheotomy care to caregivers of a child with a tracheostomy tube, which of the following topics are essential to include in teaching? Select all that apply.

Correct Answer is ["B","C","D"]

Explanation

The nurse is caring for a 9-month-old child.The nurse assesses the baby and finds all of the following data.Which finding is of MOST concern and leads the nurse to consider a possible referral to Early intervention for developmental delay?

Correct Answer is A

Explanation

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