Correct Answer: A

Rationale: Tachypnea, which refers to rapid breathing, is an early sign of congestive heart failure. In heart failure, the heart's inability to pump efficiently can lead to fluid accumulation in the lungs, causing the child to breathe faster to try to compensate for the decreased oxygen exchange. Bradycardia (slow heart rate) is not typically associated with congestive heart failure; instead, it may indicate a different issue. Inability to sweat is not a common early sign of congestive heart failure. Increased urinary output is not a typical early sign of congestive heart failure; instead, it may be a sign of other conditions like diabetes or kidney issues.

Correct Answer: D

Rationale: The correct answer is D: DTaP, IPV, MMR. Before starting kindergarten, the child should receive boosters of DTaP, IPV, and MMR to ensure ongoing protection against diphtheria, tetanus, pertussis, polio, measles, mumps, and rubella. Choice A is incorrect because it includes HepB instead of MMR. Choice B is incorrect as it includes HepB instead of MMR and DTaP instead of IPV. Choice C is incorrect as it includes Hib instead of IPV.

Correct Answer: B

Rationale: The correct answer is B: Obesity. Children with Down syndrome are at a higher risk of obesity due to various factors such as lower metabolic rate, hormonal imbalances, and reduced physical activity levels. Addressing healthy eating habits early can help prevent obesity in these children. Choice A (Rickets) is incorrect because rickets is primarily associated with vitamin D deficiency and is not a common nutritional problem in children with Down syndrome. Choice C (Anemia) is incorrect as anemia may not be a common nutritional problem specific to children with Down syndrome. Choice D (Rumination) is incorrect as rumination is a behavioral disorder characterized by repeated regurgitation of food and is not a common nutritional problem associated with Down syndrome.

Correct Answer: C

Rationale: The correct hematocrit range for a healthy 12-month-old infant is between 37% to 47%. At this age, this range reflects the normal blood volume and red blood cell (RBC) levels in infants. Choice A (19% to 32%) is too low for a healthy hematocrit level in a 12-month-old. Choice B (29% to 41%) is also below the typical range for a 12-month-old. Choice D (42% to 69%) includes an upper limit that is higher than expected for a healthy infant, making it an incorrect option.

Correct Answer: B

Rationale: Assessing the child's dietary intake is crucial in managing symptoms and ensuring proper nutrition in children with ADHD. Dietary factors can influence ADHD symptoms. While sleep patterns, academic performance, and behavior at home are important aspects to consider, dietary assessment plays a significant role in the management of ADHD.