HESI Registered Nurse EXIT Practice Exam

Upon entering the room, how would the nurse expect a 6 month-old child with nonorganic failure-to-thrive (NOFTT) to appear?

1. Irritable and "colicky" with no attempts to pull to standing

2. Alert, laughing and playing with a rattle, sitting with support

3. Skin color dusky with poor skin turgor over abdomen

4. Pale, thin arms and legs, uninterested in surroundings

The correct answer is: Pale, thin arms and legs, uninterested in surroundings

A 6-month-old child with nonorganic failure-to-thrive (NOFTT) is expected to show signs of nutritional neglect which directly affects their physical appearance and behavior. Such a child would typically present as pale and thin, with notably underdeveloped arms and legs due to malnutrition. The lack of adequate nutrition can lead to an overall lack of energy and interest in their surroundings, which is reflected in a diminished response to stimuli. The physical characteristics of being thin and pale are particularly significant indicators of NOFTT, as the child's growth and development are being adversely affected. Additionally, the disinterest in their environment aligns with the behavioral manifestations of a child suffering from inadequate emotional or physical care, which is central to the diagnosis of nonorganic failure-to-thrive. Other appearances typically seen in healthy infants, such as being alert, engaging in play, or having good skin turgor, would not be present in this scenario, as the condition results from environmental factors rather than organic causes.