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A child with a diagnosis of nephrotic syndrome is being discharged. What dietary instructions should the nurse provide?
- A. Encourage a high-protein diet
- B. Avoid foods high in salt
- C. Encourage a low-sodium diet
- D. Encourage a low-protein diet
Correct Answer: B
Rationale: For a child with nephrotic syndrome, it is important to avoid foods high in salt. This instruction helps manage symptoms and prevent complications associated with the condition. High salt intake can lead to fluid retention and worsen edema, which are common issues in nephrotic syndrome. Encouraging a low-sodium diet is crucial to maintaining fluid balance and reducing strain on the kidneys. Choices A, C, and D are incorrect because a high-protein diet can further stress the kidneys, while a low-protein diet may not be necessary unless specifically advised by the healthcare provider. Encouraging a low-sodium diet is more appropriate for managing nephrotic syndrome.
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A 2-week-old infant is admitted with a tentative diagnosis of a ventricular septal defect. The parents report that their baby has had difficulty feeding since coming home after birth. What should the nurse consider before responding?
- A. Feeding problems are common in neonates.
- B. Inadequate sucking is not significant unless cyanosis is present.
- C. Ineffective sucking and swallowing may be early indications of a heart defect.
- D. Many neonates retain mucus, which can interfere with feeding for several weeks.
Correct Answer: C
Rationale: Ineffective sucking and swallowing can be early signs of a heart defect like a ventricular septal defect. This is crucial information for the nurse to consider as it aligns with the infant's tentative diagnosis. Choice A is too general and does not provide specific relevance to the situation. Choice B is incorrect as inadequate sucking can indeed be significant, especially in the context of a potential heart defect. Choice D is not directly related to the potential heart defect and feeding difficulties mentioned in the scenario.
In planning care for a 7-year-old boy with diabetes insipidus, what is the priority nursing diagnosis?
- A. Deficient fluid volume related to dehydration
- B. Excess fluid volume related to edema
- C. Deficient knowledge related to fluid intake regimen
- D. Imbalanced nutrition, more than body requirements related to excess weight
Correct Answer: A
Rationale: The priority nursing diagnosis for a 7-year-old boy with diabetes insipidus is deficient fluid volume related to dehydration. Diabetes insipidus leads to excessive urination and fluid loss, which can result in dehydration. This diagnosis should take precedence as restoring fluid balance is crucial in managing this condition. Choices B, C, and D are less of a priority in this case. Excess fluid volume related to edema is not typically associated with diabetes insipidus. Deficient knowledge about fluid intake and imbalanced nutrition related to excess weight may be important but addressing the dehydration and fluid volume deficit is the most critical aspect in the immediate care of a child with diabetes insipidus.
A 2-week-old infant is admitted with a tentative diagnosis of a ventricular septal defect. The parents report that their baby has had difficulty feeding since coming home after birth. What should the nurse consider before responding?
- A. Feeding problems are common in neonates.
- B. Inadequate sucking is not significant in the absence of cyanosis.
- C. Ineffective sucking and swallowing may be early indications of a heart defect.
- D. Many neonates retain mucus, which may interfere with feeding for several weeks.
Correct Answer: C
Rationale: In this scenario, the nurse should consider that ineffective sucking and swallowing in a 2-week-old infant could be early signs of a heart defect such as a ventricular septal defect. This is crucial information as it can guide further assessment and management. Choice A is incorrect because while feeding problems can be common in neonates, in this case, the specific context of a suspected heart defect should be prioritized. Choice B is incorrect as inadequate sucking can indeed be significant, especially when considering potential underlying heart issues, regardless of the presence of cyanosis. Choice D is incorrect as while mucus retention can affect feeding, in this case, the focus should be on the possibility of a heart defect rather than a temporary issue like mucus interference.
A nurse is assessing a 3-month-old infant with suspected pyloric stenosis. What clinical manifestation is the nurse likely to observe?
- A. Projectile vomiting
- B. Diarrhea
- C. Constipation
- D. Abdominal distension
Correct Answer: A
Rationale: Projectile vomiting is the hallmark clinical manifestation of pyloric stenosis in infants. In pyloric stenosis, the muscle surrounding the opening between the stomach and the small intestine thickens, leading to obstruction. This obstruction causes forceful, projectile vomiting, which is typically non-bilious (does not contain bile) and occurs after feedings. Choices B, C, and D are incorrect because diarrhea, constipation, and abdominal distension are not typical symptoms of pyloric stenosis.
A 12-month-old infant has become immunosuppressed during a course of chemotherapy. When preparing the parents for the infant's discharge, what information should the nurse give concerning the measles, mumps, and rubella (MMR) immunization?
- A. It should not be given until the infant reaches 2 years of age.
- B. Infants who are receiving chemotherapy should not be given these vaccines.
- C. It should be given to protect the infant from contracting any of these diseases.
- D. The parents should discuss this with their health care provider at the next visit.
Correct Answer: B
Rationale: The correct answer is B. Live vaccines like MMR should not be given to immunosuppressed infants because their weakened immune systems may not handle the vaccine safely. Choice A is incorrect as delaying the MMR vaccine until the infant reaches 2 years of age does not address the issue of immunosuppression. Choice C is incorrect because administering live vaccines to an immunosuppressed individual could lead to serious complications. Choice D is incorrect as immediate action is required to prevent potential harm to the immunosuppressed infant.