A school-age child presents for a well-child visit with a hemoglobin level of 10 g/dL (100 g/L) and a body mass index of 15 kg/mm2. Which additional assessment should the nurse obtain to help identify a potential cause of these clinical manifestations?

Primary source of water.

Standard household income.

Family history of eating disorders.

Average daily intake of meals.

Answer and Explanation

The Correct Answer is D

A: Primary source of water. This assessment might be relevant if there is a concern about lead exposure or other contaminants in the water, which can contribute to anemia. Therefore, while important in certain contexts, it is not the most immediate assessment for these specific clinical manifestations.

B: Standard household income. Household income can influence access to nutritious food and overall health. Lower income can lead to food insecurity, poor diet quality, and subsequently, anemia and lower BMI due to inadequate nutrient intake. This can be an indirect but important factor to consider. However, it does not directly assess the child’s dietary intake or specific nutritional deficiencies.

C: Family history of eating disorders. Family history of eating disorders might provide insights into potential genetic or environmental predispositions to eating disorders. However, eating disorders are more commonly associated with adolescents and adults rather than school-age children.

D: Average daily intake of meals. This is the most directly relevant assessment. Analyzing the child's average daily intake of meals can provide immediate insights into potential nutritional deficiencies that might explain both the low hemoglobin level (anemia) and low BMI. Poor dietary intake, particularly of iron-rich foods, can lead to iron-deficiency anemia and inadequate caloric intake, affecting BMI. This assessment helps identify specific dietary issues that can be addressed directly to improve the child’s health.

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Correct Answer is B

Explanation

A. Bulges. Bulges might indicate abnormalities such as masses or hernias and are not considered normal findings.

B. Nontender. This is the expected finding in a healthy individual without thoracic abnormalities.

C. Tenderness. Tenderness might indicate inflammation, injury, or other underlying conditions and should be further assessed.

D. Thrill. Thrill refers to a vibrating sensation caused by turbulent blood flow and is not typically assessed during thoracic palpation.

A. Blood urea nitrogen (BUN). B. Glucose. C. White blood cell count (WBC). D. Hematocrit.

Correct Answer is D

Explanation

A. Blood urea nitrogen (BUN): Elevated BUN can indicate kidney problems, but it's not the primary test for melena (black, tarry stools) which suggests upper gastrointestinal bleeding.

B. Glucose: Glucose levels might be abnormal in some conditions that can cause bleeding, but it's not the most specific test for melena.

C. White blood cell count (WBC): WBC might be elevated in response to infection or inflammation, but it's not the most specific test for melena.

D. Hematocrit: Hematocrit measures the percentage of red blood cells in the blood. Melena can indicate significant blood loss, and monitoring hematocrit helps assess the severity of bleeding and potential need for blood transfusions.

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A school-age child presents for a well-child visit with a hemoglobin level of 10 g/dL (100 g/L) and a body mass index of 15 kg/mm2. Which additional assessment should the nurse obtain to help identify a potential cause of these clinical manifestations?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse completes palpation of the thoracic region on an adolescent client. Which finding is considered normal for this adolescent client?

Correct Answer is B

Explanation

The nurse observes that a client is experiencing melena. Which serum laboratory test should the nurse monitor in response to this finding?

Correct Answer is D

Explanation

In assessing a primigravida woman at 15 weeks gestation by dates, the nurse palpates the fundus at the umbilicus. Based on this assessment finding, it is most important for the nurse to obtain information about the occurrence of which condition?

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