A nurse in a well-child clinic is collecting data from four clients. Which of the following findings should the nurse report to the provider as a potential indication of child maltreatment?

The correct answer is choiceb. Perceives death as a punishment.

Choice A rationale:

Preschool-aged children generally do not understand that death is permanent.They often view death as temporary or reversible, similar to what they see in cartoons.

Choice B rationale:

Preschoolers may perceive death as a punishment for something they did or thought.This age group often feels guilt and shame, believing their actions or thoughts caused the illness or death.

Choice C rationale:

Worrying about physical body changes is more typical in older children who have a better understanding of the physical aspects of illness and death.

Choice D rationale:

Feelings of isolation are more common in older children and adolescents who are more aware of social dynamics and the implications of their illness.

Choice A rationale:
Lethargy, or extreme fatigue and sluggishness, is a characteristic symptom of hypothyroidism. Hypothyroidism occurs due to an underactive thyroid gland, which leads to a decrease in metabolic activity and energy levels. Children with hypothyroidism often exhibit lethargy, weakness, and a lack of interest in activities. This is due to the reduced metabolic rate and overall slowing down of bodily functions.
Choice B rationale:
Diarrhea is not a common finding associated with hypothyroidism. In fact, hypothyroidism tends to slow down gastrointestinal motility, leading to constipation rather than diarrhea. Therefore, diarrhea is not expected as a symptom in a child with hypothyroidism.
Choice C rationale:
Tachycardia, an elevated heart rate, is not typically associated with hypothyroidism. Instead, hypothyroidism often leads to bradycardia (a slower-than-normal heart rate) due to the overall slowing of the body's metabolic processes.
Choice D rationale:
Hirsutism, which refers to excessive hair growth in areas where hair growth is typically seen in males, is not a common finding in hypothyroidism. Hirsutism is more commonly associated with hormonal imbalances such as polycystic ovary syndrome (PCOS) rather than hypothyroidism.