A nurse is caring for a 5-year-old child in the acute care setting.

exhibits

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Child remains in bed. Child uncooperative and agitated, Refusing PO fluids. Child reports chest pain and joint pain as a 4 on the Faces Scale. Nasal flaring and moderate subcostal and substernal retractions are noted. Bilateral, moderate inspiratory and expiratory wheezes noted upon auscultation. Voided 200 mL of clear yellow urine

Child reports chest pain and joint pain as a 4 on the Faces Scale.

Nasal flaring and moderate subcostal and substernal retractions are noted.

Bilateral

moderate inspiratory and expiratory wheezes noted upon auscultation.

Answer and Explanation

The Correct Answer is ["A","B","C","D"]

These findings indicate that the child is experiencing significant pain, which is concerning, especially considering the history of sickle cell anemia and the recent increase in pain despite previous management with acetaminophen. Chest pain could also be indicative of a vaso-occlusive crisis or a respiratory complication.

Nasal flaring and moderate subcostal and substernal retractions are noted:

Nasal flaring and retractions suggest increased work of breathing, which could indicate respiratory distress. In a child with sickle cell anemia, respiratory complications like acute chest syndrome are a significant concern during a vaso-occlusive crisis.

Bilateral, moderate inspiratory and expiratory wheezes noted upon auscultation:

Wheezing indicates airway obstruction or inflammation, which could be due to asthma exacerbation, infection, or acute chest syndrome, all of which are common complications in children with sickle cell disease.

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Correct Answer is B

Explanation

A. The calorie needs of toddlers vary depending on factors such as age, weight, height, activity level, and metabolism. 3,000 calories per day is likely to be excessive for most toddlers.
B. Although calorie intake is important for growth and development, the emphasis should be on the nutritional quality of the foods rather than solely on the quantity of calories consumed. Providing nutrient-rich foods ensures that the toddler receives essential vitamins, minerals, and other nutrients necessary for growth and development.
C. Vitamin supplementation may be necessary for some toddlers but it should be done under the guidance of a healthcare provider to ensure appropriate dosing and to avoid potential overdose or adverse effects.
D. An increased appetite alone does not guarantee adequate nutrition if the quality of the foods consumed is poor.

A. Neuroblastoma B. Ewing sarcoma C. Osteosarcoma D. Wilms' tumor

Correct Answer is D

Explanation

A. Neuroblastoma is a type of cancer that arises from immature nerve cells and commonly affects infants and young children. While it can occur in the abdomen, it is not primarily a renal tumor.
B. Ewing sarcoma is a type of bone cancer that primarily affects children and adolescents. It typically arises in the bones of the pelvis, legs, arms, ribs, or spine. While it can involve the abdominal area if it metastasizes (spreads), it is not primarily an intra-abdominal tumor.
C. Osteosarcoma commonly arises in the long bones of the arms and legs. While it can spread to other parts of the body, including the abdomen, it is primarily a bone tumor.
D. Wilms' tumor, also known as nephroblastoma, is the most common malignant renal (kidney) tumor of childhood. It typically occurs in children around 2 to 5 years old and is often detected as a firm, non- tender abdominal mass.

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Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching about nutritional considerations with the parents of a toddler. Which of the following statements by the parents indicates an understanding of the teaching?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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