A parent brings their 2-year-old son in for a well visit. The nurse assesses his growth since the last appointment. Which finding should concern the nurse?

Correct Answer: D

Rationale: The correct answer is D. A total weight gain of 15 lb in one year for a 2-year-old is excessive and may indicate an underlying issue such as a metabolic disorder or overfeeding. This rapid weight gain can put the child at risk for health problems. Choices A, B, and C are not typically concerning findings in a 2-year-old. A prominent abdomen can be normal at this age due to a toddler's slightly protruding belly, a forward curve of the spine at the sacral area is a typical finding in young children, and an increase in height of 5 inches in a year is within the expected range of growth for a 2-year-old.

Correct Answer: C

Rationale: The correct answer is C. By age 5, children should be able to state their name and address. If a child cannot do this, it may indicate a developmental delay that requires further assessment. Choices A, B, and D do not indicate a need for further education as they reflect typical developmental milestones for preschool-age children, such as gradually improving counting skills, asking many questions, and improving speech clarity over time.

Correct Answer: D

Rationale: The correct answer is D: Rules. When discussing play in school-aged children, rules are essential as they help in structuring games and social interactions. Rules provide a framework for play, ensuring fairness and cooperation among children. Choice A, recreation, is too broad and doesn't specifically address the importance of rules in play. Choice B, ritualism, is unrelated to the concept of play in school-aged children. Choice C, physical activity, is important for overall health but doesn't capture the specific aspect of rules that are crucial in the play of school-aged children.

Correct Answer: C

Rationale: In this scenario, option C, "We will be sure to give our infant at least 8 oz of juice every day," indicates a need for further teaching. Juice is not recommended for infants due to its high sugar content, which can contribute to further weight loss in a child with failure to thrive. It provides empty calories and can displace more nutrient-dense foods needed for growth. Option A is correct because using a 24-kcal/oz formula can help increase the caloric intake of the infant, which is crucial in managing failure to thrive. Option B is also correct as following formula preparation instructions ensures the infant receives the necessary nutrients. Option D is incorrect as feeding the infant according to a written schedule is important for establishing routine and ensuring adequate intake. However, the specific content of the schedule would need to align with the infant's nutritional needs. Educationally, this question highlights the importance of appropriate feeding practices in infants with failure to thrive. It emphasizes the significance of providing nutrient-dense foods, following guidelines for formula preparation, and avoiding sugary beverages like juice in this population.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) All of the above. Failure to thrive (FTT) in infants is a serious condition characterized by inadequate weight gain and growth. Infants with FTT may exhibit signs such as fear of strangers, minimal smiling, and avoidance of eye contact. These behavioral and social cues can be indicative of underlying issues affecting the infant's growth and development. Option A) Fear of strangers is relevant because infants with FTT may display heightened anxiety and fear around unfamiliar individuals due to the lack of consistent nurturing and attachment. Option B) Minimal smiling is significant as infants typically smile in response to positive interactions and stimuli. In cases of FTT, the infant's limited engagement and lack of joy may signal underlying concerns impacting their emotional well-being. Option C) Avoidance of eye contact is also pertinent as it can indicate difficulties in forming secure attachments and bonding with caregivers, which are crucial for healthy social and emotional development in infants. Educationally, understanding the assessment findings associated with FTT is vital for nurses caring for pediatric patients. Recognizing these behavioral cues can prompt early intervention and appropriate support services to address the underlying factors contributing to FTT in infants. By identifying and addressing these signs early, healthcare providers can work towards promoting optimal growth, development, and well-being in infants at risk for FTT.