A nurse is caring for a 4-month-old infant in the outpatient setting.

Exhibits

Which of the following should the nurse identify as unexpected findings? Click to highlight the findings that require follow-up. To deselect a finding, click on the finding again.

Body system	Findings
Vital Signs	Temperature 36.9°C (98.4° F) Heart rate 162/min Respiratory rate 28/min Oxygen saturation 97% on room air
Gastrointestinal	Also spits up after every feeding, sometimes forcefully. Infant is formula fed and recently began refusing some feedings. Bowel sounds normoactive. Small, soft, midline bulge observed on abdomen between xyphoid process and umbilicus. Weight 5,925 g (13 lb 1 oz). Parents report birth weight was 4,196 g (9 lb 4 oz).

A nurse is providing discharge teaching to the parent of a 5-year-old child who has leukemia and is receiving chemotherapy. Which of the following statements by the parent indicates an understanding of the teaching?

A nurse is planning care for a child who has cerebral palsy and is experiencing muscle spasms. Which of the following medications should the nurse expect to administer?

A nurse is caring for a 4-month-old infant in the outpatient setting.

For each assessment finding, click to specify if the finding is consistent with hypertrophic pyloric stenosis or gastroesophageal reflux. Each finding may support more than one disease process.

A nurse is caring for a 4-month-old infant.

Complete the diagram by dragging from the choices below to specify what condition the infant is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the infant's progress.

A nurse is creating a plan of care for a school-age child who is postoperative following a tonsillectomy. Which of the following interventions should the nurse include?

A nurse is preparing to obtain a blood sample for an Hgb from a child who has hemophilia. Which of the following actions should the nurse plan to take?

A nurse is providing teaching about food choices to the parent of a school-age child who has celiac disease. Which of the following statements by the parent indicates an understanding of the teaching?

A nurse is planning care for an adolescent client who has sickle cell anemia and is experiencing a vaso-occlusive crisis. Which of the following interventions is the nurse's priority?

A nurse is planning care for a child who is postoperative following a below-the-knee amputation. Which of the following interventions should the nurse include in the plan of care?

A nurse is performing an initial physical examination on a child. The nurse should recognize that which of the following manifestations indicates a possible brain tumor?

Select all that apply.