Nokea
A mother brings her 3-month-old infant to the clinic because the baby does not sleep through the night. Which finding is most significant in planning care for this family?
- A. The mother states the baby is irritable during feedings.
- B. The mother is a single parent and lives with her parents.
- C. The infant's formula has been changed twice.
- D. The diaper area shows severe skin breakdown.
Correct Answer: D
Rationale: Severe skin breakdown can cause discomfort, disrupting sleep, and requires immediate intervention to improve the infant's comfort.
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The nurse is preparing to administer medications for an eight-month-old infant with heart failure. The infant has a blood pressure of 114/66 mm Hg, apical pulse of 88 beats/minute, and respirations of 30 breaths/minute. Which medication should the nurse withhold until the healthcare provider is notified?
- A. Digoxin.
- B. Furosemide.
- C. Hydralazine.
- D. Enalapril.
Correct Answer: A
Rationale: Digoxin should be withheld if the apical pulse is below 90 beats/minute in infants, as it may indicate toxicity.
A child receives a prescription for loratadine 5 mg by mouth once day. The bottle is labelled 'Loratadine for Oral Suspension, USP 5 mg per 5 mL.' How many teaspoons should the nurse instruct the parent to administer with each dose?
- A. 1 teaspoon
Correct Answer: A
Rationale: 5 mg of loratadine corresponds to 5 mL (1 teaspoon) of the suspension, as per the concentration provided.
The parents of a newborn infant with hypospadias are concerned about when the surgical correction should occur. Which information should the nurse provide?
- A. Repair should be done before the child is potty-trained.
- B. The urethral repair should be done after sexual maturity.
- C. Surgery should be done by one month to prevent bladder infections.
- D. Delaying the repair until school age reduces castration fears.
Correct Answer: A
Rationale: Repair before potty-training (6-12 months) prevents urinary dysfunction and psychosocial issues.
Which snack selected by a school-aged child with gastroesophageal reflux indicates to the nurse that the child understands the dietary restrictions?
- A. Sugar cookies.
- B. Pizza.
- C. Tacos.
- D. Chocolate milkshake.
Correct Answer: A
Rationale: Sugar cookies are low-fat and low-sugar, suitable for gastroesophageal reflux, unlike high-fat or acidic options.
The nurse is providing teaching to a school-age child with left femoral osteomyelitis and the child's parent prior to discharge. Which instruction should the nurse provide related to the initial phase of treatment?
- A. Administer topical antibiotic therapy daily.
- B. Provide passive range of motion exercises.
- C. Ensure no weight bearing on the affected extremity.
- D. Schedule ice pack applications to the infected area.
Correct Answer: C
Rationale: No weight bearing on the affected extremity prevents further damage during the initial treatment phase of osteomyelitis.