Three children in a family, ages 7 months, 4 years, and 9 years, have been tested for lead poisoning. The two younger children’s tests reflect elevated lead levels, and they will be undergoing treatment. The children’s mother questions why her younger children’s tests were elevated but her older child’s was not. What response by the nurse is most correct?

Your older child has a stronger liver and kidneys, which have helped her to better rid her body of the lead

Some children are better able to metabolize toxins such as lead after exposure

It is likely your older child may have had elevated levels earlier in life but has gotten over the condition

Younger children are often impacted because their play behaviors place them on the floor and they often put things into their mouths

Answer and Explanation

The Correct Answer is D

Choice A reason: Liver and kidney function do not significantly differ in lead metabolism between young and older children. Lead is stored in bones and tissues, and all children are susceptible to toxicity. The older child’s lower exposure, not stronger organs, explains the difference, making this an incorrect explanation.

Choice B reason: There is no evidence that some children metabolize lead better after exposure. Lead absorption and toxicity depend on exposure, not individual metabolic differences. Younger children’s behaviors increase exposure risk, making this a vague and scientifically inaccurate explanation for the observed difference in lead levels.

Choice C reason: Assuming the older child had elevated lead levels earlier without evidence is speculative. Lead levels persist without intervention, and the older child’s normal levels likely reflect lower exposure due to behavior, not recovery, making this an incorrect and unsupported explanation for the mother.

Choice D reason: Younger children (7 months, 4 years) engage in floor play and hand-to-mouth behaviors, increasing ingestion of lead from dust or objects in contaminated environments. Older children (9 years) are less likely to exhibit these behaviors, reducing exposure, making this the correct and most accurate explanation.

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Free Nursing Study Resources

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

Explanation

Choice A reason: High-fiber foods prevent constipation, which can exacerbate urinary tract infections by causing urinary stasis. A diet rich in fiber promotes regular bowel movements, reducing pressure on the bladder and urethra, which helps flush bacteria from the urinary tract, making this a correct and essential home care strategy.

Choice B reason: Encouraging frequent urination (every few hours) helps flush bacteria from the urinary tract, reducing the risk of bacterial proliferation in the bladder. This practice prevents urine stasis, a key factor in recurrent urinary tract infections, making it an appropriate and effective home care instruction for the child.

Choice C reason: Daily bubble baths are not recommended for children with urinary tract infections, as they can irritate the urethra and introduce bacteria, worsening the infection. Plain water baths are preferred to maintain hygiene without causing irritation, making this statement incorrect for proper home care management.

Choice D reason: Increasing fluid intake promotes urine production, which helps flush bacteria from the urinary tract, reducing infection severity and recurrence risk. Adequate hydration dilutes urine, decreasing irritation and bacterial growth, making this a critical home care instruction for managing urinary tract infections effectively in children.

Choice E reason: Wiping back to front can introduce fecal bacteria into the urethra, increasing the risk of urinary tract infections, especially in females. Proper hygiene involves wiping front to back to prevent bacterial transfer, making this statement incorrect and harmful for home care management of the condition.

A. Estrogen level to assess fertility B. Vision and hearing screening to detect vision and hearing impairments C. Spine radiographs to assess for scoliosis D. Echocardiogram to detect cardiac defects E. Thyroid hormone level to detect thyroid disease

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

Explanation

Choice A reason: Estrogen level testing is not routinely ordered for Trisomy 21 patients. While fertility concerns may arise in females with Down syndrome, estrogen levels are not a standard screening test. Common tests focus on congenital anomalies and developmental issues, such as cardiac, thyroid, and musculoskeletal abnormalities, making this choice inappropriate.

Choice B reason: Vision and hearing screenings are critical for Trisomy 21 patients due to a high prevalence of sensory impairments. Approximately 50% have hearing loss, often conductive, and 60-75% have vision issues like cataracts or refractive errors. Early detection ensures interventions to support development, making this a standard and necessary test.

Choice C reason: Spine radiographs are commonly ordered for Trisomy 21 patients to assess for scoliosis and atlantoaxial instability, which occur in about 10-15% of individuals. These musculoskeletal abnormalities can lead to neurological complications if undetected. Regular screening ensures timely intervention, making this a standard test for managing Down syndrome complications.

Choice D reason: Echocardiograms are essential for Trisomy 21 patients, as 40-50% have congenital heart defects, such as atrioventricular septal defects or ventricular septal defects. Early detection is critical to manage cardiac complications that can affect growth and survival, making this a routine test in Down syndrome care protocols.

Choice E reason: Thyroid hormone level testing is standard for Trisomy 21 patients due to a high risk of hypothyroidism (15-20% prevalence). Thyroid dysfunction can exacerbate developmental delays and metabolic issues. Regular screening ensures early treatment, but it was not selected as one of the three most common tests in this context.

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Naxlex Comprehensive Predictor Exams

A clinic nurse has provided instructions to the mother of a 6-year-old female with a urinary tract infection. Which statements by the mother indicate understanding of home care? (Select all that apply)

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

Explanation

Which of the following are common tests ordered for patients with Trisomy 21? (Select all that apply)

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

Explanation

Which statement would warrant immediate concern from a nurse caring for a patient with diagnosed appendicitis awaiting surgery?

Which approaches would be best for a nurse to use when attempting to do a physical assessment on a 2-year-old child? (Select all that apply)

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A nurse is caring for a visually impaired 10-year-old child. The nursing intervention with the highest priority during the admission process would be:

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Which diagnostic test is both diagnostic and therapeutic for intussusception?

The nurse is assessing a 6-year-old child with glomerulonephritis. Which finding should the nurse respond to first?

A nurse is assessing a 3-month-old infant in the emergency department. The caregiver reports that the baby “rolled off the couch” and has bruising on the ear and cheek. Based on the TEN-4-FACESp bruising screening tool, what is the priority nursing action?