Nokea
A 1-year-old child is on a pure vegetarian (vegan) diet. This diet requires supplementation with what?
- A. Niacin
- B. Folic acid
- C. Vitamins D and B12
- D. Vitamins C and E
Correct Answer: C
Rationale: Pure vegetarian (vegan) diets eliminate any food of animal origin, including milk and eggs. These diets require supplementation with many vitamins, especially vitamin B6, vitamin B12, riboflavin, vitamin D, iron, and zinc. Niacin, folic acid, and vitamins C and E are readily obtainable from foods of vegetable origin.
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The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for their children. Which is most likely lacking in their particular diet?
- A. Fat
- B. Protein
- C. Vitamins C and A
- D. Iron and calcium
Correct Answer: D
Rationale: Deficiencies can occur when various substances in the diet interact with minerals. For example, iron, zinc, and calcium can form insoluble complexes with phytates or oxalates (substances found in plant proteins), which impair the bioavailability of the mineral. This type of interaction is important in vegetarian diets because plant foods such as soy are high in phytates. Fat and vitamins C and A are readily available from vegetable sources. Plant proteins are available.
The nurse is interviewing the parents of a 4-month-old boy brought to the hospital emergency department. The infant is dead, and no attempt at resuscitation is made. The parents state that the baby was found in his crib with a blanket over his head, lying face down in bloody fluid from his nose and mouth. The nurse might initially suspect his death was caused by what?
- A. Suffocation
- B. Child abuse
- C. Infantile apnea
- D. Sudden infant death syndrome (SIDS)
Correct Answer: D
Rationale: The description of how the child was found in the crib is suggestive of SIDS. The nurse is careful to tell the parents that a diagnosis cannot be confirmed until an autopsy is performed.
A new parent asks the nurse, How can diaper rash be prevented? What should the nurse recommend?
- A. Wash the infant with soap before applying a thin layer of oil.
- B. Clean the infant with soap and water every time diaper is changed.
- C. Wipe stool from the skin using water and a mild cleanser.
- D. When changing the diaper, wipe the buttocks with oil and powder the creases.
Correct Answer: C
Rationale: Change the diaper as soon as it becomes soiled. Gently wipe stool from the skin with water and mild soap. The skin should be thoroughly dried after washing. Applying oil does not create an effective barrier. Over washing the skin should be avoided, especially with perfumed soaps or commercial wipes, which may be irritating. Baby powder should not be used because of the danger of aspiration.
What may a clinical manifestation of failure to thrive (FTT) in a 13-month-old include?
- A. Irregularity in activities of daily living
- B. Preferring solid food to milk or formula
- C. Weight that is at or below the 10th percentile
- D. Appropriate achievement of developmental landmarks
Correct Answer: A
Rationale: One of the clinical manifestations of children with FTT is irregularity or low rhythmicity in activities of daily living. Children with FTT often refuse to switch from liquids to solid foods. Weight below the fifth percentile is indicative of FTT. Developmental delays, including social, motor, adaptive, and language, exist.
The nurse is teaching a parent with a 2-month-old infant who has been diagnosed with colic about ways to relieve colic. Which statement by the parent indicates the need for additional teaching?
- A. I should let my infant cry for at least 30 minutes before I respond.
- B. I will swaddle my infant tightly with a soft blanket.
- C. I should massage my infants abdomen whenever possible.
- D. I will place my infant in an upright seat after feeding.
Correct Answer: A
Rationale: Because the infant has been diagnosed with colic, the parent should respond to the infant immediately or any type of interventions to relieve colic may not be effective. Also, the infant may develop a mistrust of the world if his or her needs are not met. The parent should swaddle the baby tightly with a soft blanket, massage the babys abdomen, and place the infant in an upright seat after a feeding to help relieve colic.