The practical nurse (PN) is caring for a school-age child whose parent reports concern about the child's weight and obesity status.
Which historical finding should the PN recognize as potentially contributing to early obesity?
Consumption of whole milk as a toddler.
Dedicated breastfeeding for 6 months.
Exclusive soy-based formula for the first year of life.
Introduction of fortified cereal before 4 months of age.
The Correct Answer is D
Choice A rationale
Consumption of whole milk as a toddler is generally appropriate for growth and development, providing essential fats and nutrients. Unless consumed in excessive quantities or as part of an overall diet high in calories without sufficient physical activity, it is not typically identified as a primary singular contributor to early obesity.
Choice B rationale
Dedicated breastfeeding for 6 months is protective against childhood obesity. Breast milk provides optimal nutrition and growth-promoting factors, and breastfeeding is associated with better self-regulation of caloric intake by infants, potentially reducing the risk of later obesity compared to formula feeding.
Choice C rationale
Exclusive soy-based formula for the first year, while an alternative for specific dietary needs, does not inherently contribute to early obesity more than other formulas. The caloric density and nutritional composition of standard infant formulas are regulated and designed to support healthy growth, making it unlikely to be a primary cause of obesity.
Choice D rationale
Introducing solid foods, such as fortified cereal, before 4 months of age is associated with an increased risk of obesity. Infants lack the necessary gastrointestinal and renal maturity to process solids effectively before this age, and early introduction can lead to excessive caloric intake, disruption of feeding cues, and altered gut microbiome development, predisposing to weight gain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
A heart rate of 60 beats/minute for a 9-month-old infant is significantly below the normal physiological range (90-140 beats/minute). Digoxin primarily acts to slow the heart rate and increase contractility, but such a low rate indicates severe bradycardia, a potentially dangerous adverse effect of digoxin toxicity due to excessive parasympathetic stimulation and impaired atrioventricular conduction.
Choice B rationale
A heart rate of 120 beats/minute is within the normal resting range for a 9-month-old infant, which typically falls between 90-140 beats/minute. Digoxin’s therapeutic effect in infants with cardiac conditions often aims to bring the heart rate to a more efficient and less tachycardic rate, thereby improving cardiac output without causing bradycardia.
Choice C rationale
A heart rate of 80 beats/minute is below the typical normal range for a 9-month-old infant (90-140 beats/minute). While digoxin can decrease heart rate, 80 beats/minute suggests an excessive therapeutic effect, potentially indicating mild bradycardia which could compromise cardiac output and tissue perfusion.
Choice D rationale
A heart rate of 180 beats/minute is significantly above the normal physiological range for a 9-month-old infant (90-140 beats/minute). This elevated rate indicates persistent tachycardia, suggesting that the digoxin has not achieved its therapeutic effect of slowing the heart rate, or that the underlying cardiac issue is not adequately controlled.
Correct Answer is D
Explanation
Choice A rationale
Cheese is a good source of calcium and protein, but it is not a primary source of iron. Iron is essential for hemoglobin synthesis, and the client's hemoglobin and hematocrit levels are below normal ranges [Hemoglobin, pregnant female > 11 g/dL ( > 110 g/L); Hematocrit, pregnant female > 33% ( > 0.33 volume fraction)], indicating iron deficiency anemia.
Choice B rationale
Cauliflower is a cruciferous vegetable rich in vitamin C and fiber, but its iron content is relatively low. While vitamin C aids in iron absorption, cauliflower itself does not provide a significant amount of dietary iron to effectively address the client's anemic status.
Choice C rationale
Carrots are well-known for their beta-carotene content, a precursor to vitamin A, and provide fiber. However, carrots are not a significant source of iron. To combat iron deficiency anemia during pregnancy, foods rich in heme iron or non-heme iron with good bioavailability are required.
Choice D rationale
Chicken, particularly the dark meat, is a good source of heme iron, which is more readily absorbed by the body compared to non-heme iron found in plant-based foods. Given the client's anemic status, increasing dietary intake of iron-rich foods like chicken is crucial for improving hemoglobin and hematocrit levels.
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