During a well-child physical, an adolescent female has a normal history and physical except for an excessive amount of tooth enamel erosion, a greater-than-normal number of filled cavities, and calluses on the back of her hand. Her body mass index is in the 50th to 75th percentile for her age. Which disorder is the nurse concerned about based on the assessment findings

Correct Answer: C

Rationale: The correct answer is C: Bulimia nervosa. The excessive tooth enamel erosion, filled cavities, and calluses on the back of the hand are indicative of self-induced vomiting, which is a common behavior in individuals with bulimia nervosa. The body mass index being in the 50th to 75th percentile suggests that the individual is not severely underweight, ruling out anorexia nervosa, kwashiorkor, and marasmus. Bulimia nervosa is characterized by episodes of binge eating followed by compensatory behaviors such as vomiting, which can lead to dental problems and calluses from inducing vomiting.

Correct Answer: B

Rationale: The correct answer is B: Record data on nurses’ notes. In this case, the infant's apical pulse of 166 beats/min is within the normal range for a 6-month-old during sleep. By recording this data on the nurses' notes, it ensures accurate documentation for future reference and monitoring. Administering oxygen (choice A) is not indicated as the pulse rate is normal. Reporting the data to the practitioner (choice C) is not necessary since the pulse rate is within the normal range. Placing the child in high Fowler position (choice D) is unrelated to the situation and not indicated based on the information provided.

Correct Answer: A

Rationale: The correct answer is A: Report findings to practitioner. A temperature of 38.4°C post-cardiac surgery may indicate infection, which requires prompt attention. Reporting to the practitioner allows for timely assessment and intervention. Choice B is incorrect as hypothermia blankets are used for low temperatures. Choice C is incorrect as it may exacerbate the fever. Choice D is incorrect as action is needed beyond just recording the temperature.

Correct Answer: C

Rationale: The correct answer is C: Circulatory stasis can lead to thrombus and embolus formation. Immobilization in children can lead to decreased muscle activity and venous return, increasing the risk of blood clots forming in the veins (thrombus) due to stagnant blood flow. These clots can dislodge and travel to the lungs causing a pulmonary embolism. Choices A, B, and D are incorrect because immobilization typically leads to a decrease in metabolic rate, worsens venous return due to lack of movement, and can result in bone demineralization rather than an increase in bone calcium.

Correct Answer: B

Rationale: The correct answer is B because macrophages do indeed derive from monocytes. Monocytes are circulating white blood cells that migrate into tissues and differentiate into macrophages. This process is well-documented in immunology. A: Macrophages are not granulocytes. Granulocytes are a different type of white blood cell characterized by the presence of granules in their cytoplasm. C: Macrophages are highly phagocytic cells, meaning they can engulf and digest foreign particles. Therefore, this statement is incorrect. D: Macrophages primarily reside in the tissues as part of the immune defense system, making this statement incorrect.