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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.
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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.
An infant has been diagnosed with an allergy to milk. In teaching the parent how to meet the infants nutritional needs, the nurse states that
- A. Most children will grow out of the allergy.
- B. All dairy products must be eliminated from the childs diet.
- C. It is important to have the entire family follow the special diet.
- D. Antihistamines can be used so the child can have milk products.
Correct Answer: A
Rationale: Approximately 80% of children with cows milk allergy develop tolerance by the fifth birthday. The child can have eggs. Any food that has milk as a component or filler is eliminated. These foods include processed meats, salad dressings, soups, and milk chocolate. Having the entire family follow the special diet would provide support for the child, but the nutritional needs of other family members must be addressed. Antihistamines are not used for food allergies.
What is an important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS)?
- A. Discourage the parents from making a last visit with the infant.
- B. Make a follow-up home visit to the parents as soon as possible after the childs death.
- C. Explain how SIDS could have been predicted and prevented.
- D. Interview the parents in depth concerning the circumstances surrounding the childs death.
Correct Answer: B
Rationale: A competent, qualified professional should visit the family at home as soon as possible after the death. Printed information about SIDS should be provided to the family. Parents should be allowed and encouraged to make a last visit with their child. SIDS cannot always be prevented or predicted, but parents can take steps to reduce the risk (e.g., supine sleeping, removing blankets and pillows from the crib, and not smoking). Discussions about the cause only increase parental guilt. The parents should be asked only factual questions to determine the cause of death.
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.
The parent of an infant with colic tells the nurse, All this baby does is scream at me; it is a constant worry. What is the nurses best action?
- A. Encourage the parent to verbalize feelings.
- B. Encourage the parent not to worry so much.
- C. Assess the parent for other signs of inadequate parenting.
- D. Reassure the parent that colic rarely lasts past age 9 months.
Correct Answer: A
Rationale: Colic is multifactorial, and no single treatment is effective for all infants. The parent is verbalizing concern and worry. The nurse should allow the parent to put these feelings into words. An empathetic, gentle, and reassuring attitude, in addition to suggestions about remedies, will help alleviate the parents anxiety. The nurse should reassure the parent that he or she is not doing anything wrong. The infant with colic is experiencing spasmodic pain that is manifested by loud crying, in some cases up to 3 hours each day. Telling the parent that it will eventually go away does not help him or her through the current situation.