A weight-for-height z-score of -2.9 in a child indicates which condition?

NORCERT 8 Mains-2025

Child Health Nursing (Pediatrics)

Medium

Appeared in: NORCERT 8 Mains-2025

Explanation

Wasting is defined as low weight-for-height and indicates acute malnutrition.
According to WHO growth standards, moderate wasting is defined by a weight-for-height z-score that is between -2 and -3.
A z-score of -2.9 falls squarely within this range (-2.0 to -2.99), classifying it as moderate wasting.
This condition is also known as Moderate Acute Malnutrition (MAM).

Option A: Severe wasting, or Severe Acute Malnutrition (SAM), is diagnosed when the weight-for-height z-score is below -3. The score of -2.9 is not below -3.
Option C: Stunting is a measure of chronic malnutrition, not acute. It is identified by a low height-for-age z-score, not weight-for-height.
Option D: Underweight is a composite indicator measured by weight-for-age. It doesn't distinguish between a child who is wasted (thin) and a child who is stunted (short). Weight-for-height is a more specific measure of acute malnutrition.

Visual 1: Chart - A WHO growth chart for weight-for-height, visually demonstrating the cutoff lines for z-scores (-1, -2, -3) and where a value of -2.9 would be plotted in the 'moderate wasting' zone.
Visual 2: Infographic - An infographic comparing the definitions and key differences between wasting, stunting, and underweight, with icons representing each condition (a thin child, a short child, a small child).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of childhood malnutrition using WHO growth standards and z-scores as background academic context rather than a clinical decision trigger.
Accurately classifying the severity of malnutrition is critical for determining the correct management plan. Moderate Acute Malnutrition (MAM) is typically managed with supplementary feeding programs, while Severe Acute Malnutrition (SAM) requires more intensive therapeutic feeding and often inpatient care.
Nurses play a key role in anthropometric measurements (weight, height, MUAC) and plotting them on growth charts to identify malnutrition early.
Patient education for caregivers is crucial, focusing on appropriate feeding practices, hygiene, and seeking timely medical care for infections, which can precipitate wasting.

How to Approach the Question

First, identify the key components of the question: the indicator ('weight-for-height'), the measurement ('z-score'), and the value ('-2.9').
Recognize that 'weight-for-height' is the specific indicator used to assess wasting (acute malnutrition). This helps eliminate 'Stunting' (height-for-age) and 'Underweight' (weight-for-age) as primary answers.
Recall the standard WHO z-score classifications for the severity of wasting.
The critical cutoffs are -2 and -3. A score between -2 and -3 indicates moderate wasting, while a score below -3 indicates severe wasting.
Place the given value of -2.9 within these ranges. Since -2.9 is greater than -3 but less than -2, it falls into the 'moderate' category.
Select the option that matches this classification.

Concept Tested & Keywords

Concept Tested: Classification of childhood malnutrition using WHO growth standards and z-scores.
Stem keywords: weight-for-height, z-score, -2.9, child
Lead-in keywords: indicates which condition
Clinical cues: The specific indicator used is 'weight-for-height', which points towards assessing wasting.
Clinical cues: The value '-2.9' is critical for determining the severity of the condition.

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