A nurse in a clinic is assessing a 7-month-old infant. Which of the following indicates a need for further evaluation?

Choice A reason: This choice is incorrect because 1 cup of cooked rice provides more than 1 oz of grains. According to the U.S. Department of Agriculture (USDA), one-ounce equivalent of grains equals one slice of bread, one cup of ready-to-eat cereal, or half a cup of cooked rice, pasta, or cereal. Therefore, 1 cup of cooked rice provides about 2 oz of grains.

Choice B reason: This choice is incorrect because 1/2 slice of white bread provides less than 1 oz of grains. As explained above, one-ounce equivalent of grains equals one slice of bread, so 1/2 slice of white bread provides only 0.5 oz of grains.

Choice C reason: This choice is correct because 1 cup of ready-to-eat cereal flakes provides exactly 1 oz of grains. As explained above, the one-ounce equivalent of grains equals one cup of ready-to-eat cereal, so 1 cup of ready-to-eat cereal flakes provides 1 oz of grains.

Choice D reason: This choice is incorrect because 1/2 white flour tortilla provides less than 1 oz of grains. According to the USDA, one-ounce equivalent of grains equals one small tortilla (6 inches in diameter), so 1/2 white flour tortilla provides only about 0.4 oz of grains.

Choice A reason: This choice is incorrect because bradycardia is not a common finding in a child who is in a sickle cell crisis. Bradycardia is a condition in which the heart rate is slower than normal (less than 60 beats per minute). It may be caused by various factors such as hypothermia, hypothyroidism, or medication side effects, but it does not indicate a sickle cell crisis.

Choice B reason: This choice is incorrect because constipation is not a common finding in a child who is in a sickle cell crisis. Constipation is a condition in which the bowel movements are infrequent, hard, or difficult to pass. It may be caused by various factors such as dehydration, a low-fiber diet, or lack of physical activity, but it does not indicate a sickle cell crisis.

Choice C reason: This choice is correct because pain is a common finding in a child who is in a sickle cell crisis. Sickle cell crisis is a condition in which the red blood cells become sickle-shaped and clump together, blocking the blood flow and oxygen delivery to the organs and tissues. It may cause severe pain in the chest, abdomen, joints, or bones, as well as symptoms such as pallor, jaundice, fatigue, or shortness of breath.

Choice D reason: This choice is incorrect because high fever is not a specific finding in a child who is in a sickle cell crisis. High fever may indicate infection, inflammation, or dehydration, but it does not indicate sickle cell crisis. However, the infection can trigger or worsen the sickle cell crisis, so it should be treated promptly with antibiotics and fluids.