Nokea
The nurse is teaching a parent of a 6-month-old infant with gastroesophageal reflux (GER) before discharge. What instructions should the nurse include?
- A. Elevate the head of the bed in the crib to a 90-degree angle while the infant is sleeping.
- B. Hold the infant in the prone position after a feeding.
- C. Discontinue breastfeeding so that a formula and rice cereal mixture can be used.
- D. Prescribed cimetidine (Tagamet) should be given 30 minutes before feedings.
Correct Answer: D
Rationale: Cimetidine is an H2 blocker that reduces stomach acid, helping manage GER. Holding the infant in the prone position is not recommended due to the risk of SIDS. Breastfeeding should not be discontinued unless advised by a physician. Elevating the head to 90 degrees is excessive.
You may also like to solve these questions
Which sign is indicative of developmental dysplasia of the hip in infants?
- A. Ortolani sign
- B. Romberg sign
- C. Trendelenburg sign
- D. Gower's sign
Correct Answer: A
Rationale: The Ortolani sign is a specific maneuver used during physical examination to detect hip instability or dislocation in infants. A positive Ortolani sign, where the hip is felt to slip back into the socket, is indicative of developmental dysplasia of the hip, a condition that can lead to long-term disability if not treated early. Romberg sign is used to assess sensory ataxia, Trendelenburg sign indicates weakness of the hip abductor muscles, and Gower's sign is seen in children with proximal muscle weakness climbing up their own body from a supine position due to conditions like muscular dystrophy.
The nurse observes that a newborn is having problems after birth. What should indicate a tracheoesophageal fistula?
- A. Jitteriness
- B. Meconium ileus
- C. Excessive frothy saliva
- D. Increased need for sleep
Correct Answer: C
Rationale: Excessive frothy saliva is a hallmark sign of tracheoesophageal fistula. The abnormal connection between the esophagus and trachea causes difficulty in swallowing, leading to an accumulation of saliva in the mouth. This symptom is crucial for early identification and management of tracheoesophageal fistula. Choices A, B, and D are incorrect as they are not specific indicators of tracheoesophageal fistula.
What is the primary goal in the treatment of a child with nephrotic syndrome?
- A. Decrease urine output
- B. Increase serum albumin
- C. Reduce proteinuria
- D. Increase blood pressure
Correct Answer: C
Rationale: The primary goal in treating nephrotic syndrome in children is to reduce proteinuria. Nephrotic syndrome is characterized by proteinuria, leading to hypoalbuminemia and edema. By reducing proteinuria, kidney damage can be minimized, and symptoms can be managed effectively. Decreasing urine output (Choice A) is not the primary goal, as it does not address the underlying issue of protein loss. Increasing serum albumin (Choice B) is a consequence of reducing proteinuria rather than the primary goal. Increasing blood pressure (Choice D) is not a goal in treating nephrotic syndrome and may even be contraindicated to prevent further kidney damage.
Which condition is most commonly associated with a 'sunset sign' in infants?
- A. Hydrocephalus
- B. Meningitis
- C. Cerebral palsy
- D. Encephalitis
Correct Answer: A
Rationale: The 'sunset sign,' characterized by downward-driven eyes, is most commonly associated with hydrocephalus. This condition causes increased intracranial pressure, leading to the eyes appearing to be forced downward. Meningitis (choice B) typically presents with symptoms such as fever, headache, and a stiff neck, but not the 'sunset sign.' Cerebral palsy (choice C) is a group of disorders affecting movement and muscle coordination, not directly related to the 'sunset sign.' Encephalitis (choice D) is inflammation of the brain, which can cause symptoms like fever, headache, and confusion, but not the specific downward eye gaze seen in the 'sunset sign.'
Which factor is most likely to cause a "brittle" diabetic state in a child with type 1 diabetes?
- A. Noncompliance with diet
- B. Insulin resistance
- C. Frequent infections
- D. Hypothyroidism
Correct Answer: C
Rationale: Frequent infections can destabilize blood sugar levels, leading to a "brittle" diabetic state in children with type 1 diabetes. Infections increase metabolic demands and can result in significant blood glucose fluctuations, requiring careful monitoring and adjustment of insulin therapy. Noncompliance with diet may affect blood sugar control but is not the primary cause of a "brittle" state. Insulin resistance is more common in type 2 diabetes rather than type 1. Hypothyroidism can impact metabolism but is not directly linked to the development of a "brittle" diabetic state in type 1 diabetes.