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A nurse is caring for a 4-month-old infant with thrush (candidiasis) who is breastfed.
- A. "Administer the prescribed nystatin (Mycostatin) for 2 to 3 days after the lesions disappear."'
- B. "Place the infant on a soy-based formula to supplement breastfeeding until thrush is resolved."'
- C. "Discontinue breastfeeding and resume 48 hr after the last lesion disappears."'
- D. "Scrape off the white patches of thrush from the oral mucous membrane with a tongue depressor."'
Correct Answer: A
Rationale: Correct Answer: A
Rationale: Nystatin is an antifungal medication commonly used to treat thrush in infants. It is safe for infants and effective against Candida. The treatment should be continued for 2 to 3 days after the lesions disappear to ensure complete eradication of the infection. Discontinuing the medication prematurely can lead to a recurrence of thrush.
Summary of other choices:
B: Switching to a soy-based formula is unnecessary and does not address the thrush infection directly.
C: Discontinuing breastfeeding is not necessary and can disrupt the infant's feeding routine.
D: Scraping off the white patches can cause trauma to the oral mucosa and should be avoided.
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A nurse is reinforcing teaching with the parents of an infant diagnosed with recurrent otitis media. Which of the following is appropriate teaching to include?
- A. Give the child an over-the-counter antihistamine when the symptoms begin.
- B. Hold the child in an upright position while feeding.
- C. Talk with the primary health care provider about performing a tonsillectomy.
- D. Apply a warm compress over the affected ear to provide comfort.
Correct Answer: B
Rationale: The correct answer is B: Hold the child in an upright position while feeding. This is important because feeding the infant in an upright position can help prevent reflux of milk into the Eustachian tube, reducing the risk of otitis media. This position helps to promote proper drainage and ventilation of the middle ear, decreasing the likelihood of infection.
Incorrect answers:
A: Giving the child an over-the-counter antihistamine is not appropriate for otitis media, as it is typically caused by bacterial infection, not allergies.
C: Tonsillectomy is not a first-line treatment for otitis media. It is usually considered if the child has recurrent tonsillitis, not otitis media.
D: Applying a warm compress over the affected ear may provide comfort but does not address the underlying cause or prevention of otitis media.
A nurse is planning discharge for a client who is 3 days postpartum. Which of the following non pharmacological interventions should the nurse include in the plan of care for lactation suppression?
- A. Place warm, moist packs on the breast.
- B. Apply cabbage leaves to the breast.
- C. Wear a loose-fitting bra.
- D. Put green tea bags on the breasts.
Correct Answer: B
Rationale: The correct answer is B: Apply cabbage leaves to the breast. Cabbage leaves have been shown to help with lactation suppression due to their anti-inflammatory properties. Placing cabbage leaves on the breasts can help reduce milk supply by decreasing blood flow to the area. This method is safe, inexpensive, and easily accessible.
Choice A (Place warm, moist packs on the breast) is incorrect as warmth can actually stimulate milk production. Choice C (Wear a loose-fitting bra) is also incorrect as it does not directly address lactation suppression. Choice D (Put green tea bags on the breasts) is not effective for lactation suppression and may not be safe for the newborn if ingested.
A client is admitted to the hospital with severe pregnancy-induced hypertension (PIH). The physician orders magnesium sulfate. Which nursing intervention is important when administering this drug?
- A. Assess blood pressure and respiratory rate every fifteen minutes
- B. Monitor blood glucose levels every eight hours
- C. Evaluate for orthostatic hypotension when getting the client up to walk
- D. Observe for premature labor every shift
Correct Answer: A
Rationale: The correct answer is A because magnesium sulfate is a central nervous system depressant used to prevent seizures in PIH. It can cause respiratory depression and hypotension. Assessing blood pressure and respiratory rate every fifteen minutes is crucial to monitor for signs of magnesium toxicity and ensure the client's safety. Monitoring blood glucose levels (B) is not directly related to magnesium sulfate administration. Evaluating for orthostatic hypotension (C) and observing for premature labor (D) are not specific to the administration of magnesium sulfate in treating PIH.
Which is a major difference in the clinical manifestation of adolescents with anorexia nervosa compared to bulimia?
- A. Binge eating
- B. Purging
- C. Body image distortion
- D. Decreased self esteem
Correct Answer: C
Rationale: The major difference between adolescents with anorexia nervosa and those with bulimia is body image distortion. Clients with anorexia see themselves as being overweight no matter how underweight they become. Clients with bulimia see their weight realistically but have psychological problems that manifest in an eating disorder. Both disorders may involve binge eating and purging, but body image perception is a distinguishing factor.
A client at 33 weeks gestation is admitted for suspected abruptio placenta. Which factor in the client's history supports this diagnosis? The client states that she:
- A. drinks two glasses of wine before dinner every night.
- B. has intermittent contractions that are relieved by walking.
- C. had intercourse with her partner last night.
- D. used crack an hour before the symptoms began.
Correct Answer: D
Rationale: The correct answer is D: used crack an hour before the symptoms began. Abruptio placenta is a condition where the placenta prematurely separates from the uterine wall. Substance abuse, such as crack cocaine, can lead to vasoconstriction and increased risk of abruptio placenta due to compromised blood flow to the placenta. This can result in fetal distress and maternal bleeding. The other choices (A, B, C) do not directly correlate with abruptio placenta. Intermittent contractions relieved by walking are more suggestive of Braxton Hicks contractions, intercourse is not a known risk factor for abruptio placenta, and drinking wine does not typically cause this condition.