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An 8-year-old has a body mass index (BMI) for age at the 90th percentile, but has no other risk factors. The nurse should:
- A. Refer for a weight management program.
- B. Prescribe a low-calorie diet.
- C. Order fasting glucose levels.
- D. Initiate daily exercise logs.
Correct Answer: A
Rationale: A BMI at the 90th percentile indicates overweight. A weight management program promotes healthy habits. Diet prescription, glucose testing, or exercise logs are premature without further risk assessment.
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Which statements by the mother of a toddler should lead the nurse to suspect that the child is at risk for iron deficiency anemia?
- A. He drinks over three cups of milk per day.
- B. I can't keep enough apple juice in the house; he must drink over 10 oz per day.
- C. He refuses to eat more than two different kinds of vegetables.
- D. He doesn't like meat; I don't think that he will eat small amounts of it.
- E. He sleeps 12 hours every night and takes a 2-hour nap.
Correct Answer: A,C,D
Rationale: Excess milk, limited vegetables, and low meat intake reduce iron intake, increasing anemia risk. Apple juice and sleep patterns are unrelated.
The father of a 16-month-old child calls the clinic because the child has a low-grade fever, cold symptoms, and a hoarse cough. Which of the following should the nurse suggest that the father do?
- A. Offer extra fluids frequently.
Correct Answer: A
Rationale: Offering extra fluids frequently helps keep the child hydrated and may soothe the throat, alleviating symptoms of croup.
After teaching a child with leukemia scheduled for a bone marrow aspiration about the procedure, the nurse determines that the teaching has been successful when the child identifies which of the following as the site for the aspiration?
- A. Right lateral side of the right wrist.
- B. Middle of the chest.
- C. Distal end of the thigh.
- D. Back of the hipbone.
Correct Answer: D
Rationale: Bone marrow aspiration is typically performed at the iliac crest (hipbone). Other sites are incorrect.
An adolescent with a history of losing weight and fatigue is admitted to the hospital with a diagnosis of stage I chronic renal failure. Based on these fi ndings, the nurse should:The chart shows:
- A. Continue monitoring intake and output.
- B. Notify the physician.
- C. Restrict the client’s fluids.
- D. Increase the client’s fluids.
Correct Answer: B
Rationale: The nurse would expect a person with a normal GFR to have approximately equal inputs and outputs. Chronic renal failure has fi ve stages. In stage I the glomerular fi ltration rate (GFR) is approximately ≥90 mL/minute/1.73 m2. In stage II the GFR decreases to approximately 60 to 89 mL/minute/1.73 m2. The decreased urine output may indicate worsening disease and should be reported. Assessing the client’s intake and output is still important, but notifying the provider is the priority. Fluids are restricted based on decreased sodium. Clients are encouraged to drink to thirst. Therefore, there is not enough information to suggest increasing or restricting fl uids.
To meet the developmental needs of an 8-year-old child who is confined to home with osteomyelitis, what should the nurse include in the care plan?
- A. Encouraging the child to communicate with schoolmates.
- B. Encouraging the parents to stay with the child.
- C. Allowing siblings to visit freely throughout the day.
- D. Talking to the child about his interests twice daily.
Correct Answer: A
Rationale: Encouraging communication with schoolmates supports social development and reduces isolation during home confinement.