during a well child checkup the parent of a 5 year old child reports the child seems much smaller than the 2 older siblings did at this same age a rev
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Nursing Elites

ATI RN

RN Nursing Care of Children 2019 With NGN

1. During a well-child checkup, the parent of a 5-year-old child reports the child seems much smaller than the 2 older siblings did at this same age. A review of the medical record reveals that the child is 44 inches tall and weighs 42 pounds. What information should be included in the response by the nurse?

Correct answer: D

Rationale: The correct answer is D. The child is slightly taller than average, but the weight is within normal limits. This information should be reassuring to the parent and provides insights into normal growth patterns. Choice A is incorrect as it inaccurately states that the child is taller than other children this age. Choice B is incorrect because the child's weight is actually within normal limits. Choice C is incorrect as it inaccurately states that the child is shorter in stature than other children this age.

2. The nurse is providing education to the parent of a child with Beta-thalassemia. Which risk factors about the condition should the nurse include in the teaching?

Correct answer: D

Rationale: The correct answer is D: Chronic hypoxia and iron overload. Children with Beta-thalassemia often suffer from chronic hypoxia due to ineffective erythropoiesis and require frequent blood transfusions, leading to iron overload. These complications must be managed to prevent organ damage. Choices A, B, and C are incorrect. Hypertrophy of the thyroid, polycythemia vera, and thrombocytopenia are not direct risk factors associated with Beta-thalassemia. Therefore, they should not be included in the teaching regarding this condition.

3. At which age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?

Correct answer: B

Rationale: Infants typically begin to smile in response to pleasurable stimuli by 2 months, which is an early sign of social interaction and emotional development.

4. Which type of breath sound is normally heard over the entire surface of the lungs except for the upper intrascapular area and the area beneath the manubrium?

Correct answer: A

Rationale: Vesicular breath sounds are normally heard over most of the lung fields, except near the trachea and main bronchi, where bronchial or bronchovesicular sounds may be heard.

5. The parents of a child with acute postinfectious glomerulonephritis (APIGN) ask how they will know that the condition is improving. How should the nurse respond?

Correct answer: A

Rationale: Improvement in APIGN is indicated by an increase in urine output and a change in urine color from brown (due to hematuria) to a more normal appearance. This reflects a reduction in glomerular inflammation and improved kidney function. Choice B is incorrect because resting more comfortably is not a direct indicator of kidney function improvement. Choice C is incorrect because a decrease in appetite is not typically associated with improvement in APIGN. Choice D is incorrect because an increased BUN value would suggest worsening kidney function rather than improvement.

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