The nurse is describing the maturation of various organ systems during toddlerhood to the parents. What would the nurse correctly include in this description?

A. A 7-year-old child who has diabetes insipidus and a urine specific gravity of 1.016: While diabetes insipidus requires monitoring and management, a urine specific gravity of 1.016 alone does not indicate acute distress or an emergency situation. The child may need adjustments in fluid intake or medication, but this can typically be addressed in a less urgent manner.

B. A 10-year-old child who has sickle cell anemia who reports severe chest pain: Severe chest pain in a child with sickle cell anemia could indicate a vaso-occlusive crisis affecting the chest, which is potentially life-threatening. Prompt assessment and intervention are necessary to

manage the pain and prevent complications, including acute chest syndrome or respiratory compromise.

C. A 1-year-old toddler who has roseola and a temperature of 39°C (102.2°F): Roseola is typically a benign viral illness characterized by fever and a rash. While a fever in a young child

requires monitoring and symptomatic management, it is not usually considered an emergency unless accompanied by other concerning symptoms such as dehydration or respiratory distress.

D. A 4-year-old child who has asthma and a PCO2 of 37 mm: While asthma exacerbations can be serious, a PCO2 level of 37 mm indicates normal carbon dioxide levels, which do not suggest acute respiratory distress or impending respiratory failure. However, if the child is experiencing severe respiratory distress, cyanosis, or altered mental status, immediate assessment and

intervention would be warranted.

A. Pulse rate is increased.

While there may be variations in pulse rate due to factors such as activity level and emotional state, a significant increase in pulse rate would not be a typical finding during an annual check- up for an 8-year-old child.

B. Breathing is diaphragmatic.

As children grow older, their respiratory patterns mature, and they develop diaphragmatic breathing, which is deeper and more efficient than the shallow breathing observed in infants. This change would be expected as the child gets older.

C. Secondary sex characteristics are present.

The development of secondary sex characteristics typically occurs during puberty, which begins around the ages of 9 to 13 in girls and 10 to 14 in boys. At 8 years old, it would be unlikely for significant secondary sex characteristics to be present.

D. Blood pressure has reached adult level.

Blood pressure in children gradually increases with age, but it does not reach adult levels until adolescence. At 8 years old, the child's blood pressure would still be within the pediatric range and would not resemble adult levels.