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A nurse is caring for a 6-week-old infant admitted to the pediatric unit for evaluation of a suspected pyloric stenosis. Which of the following findings should the nurse expect?
- A. Projectile vomiting
- B. Metabolic acidosis
- C. Effortless regurgitation
- D. Distended abdomen
Correct Answer: A
Rationale: Projectile vomiting is a classic symptom of pyloric stenosis in infants. It typically occurs within 30 minutes of feeding and is forceful, often projecting several feet away from the infant. This occurs due to the obstruction at the pyloric sphincter, leading to the stomach forcefully emptying its contents. Metabolic acidosis is not a typical finding associated with pyloric stenosis. Pyloric stenosis leads to vomiting, which can result in dehydration and electrolyte imbalances, but it typically does not cause metabolic acidosis directly. Effortless regurgitation is not a characteristic finding of pyloric stenosis. In pyloric stenosis, vomiting is forceful and projectile, rather than a passive regurgitation of stomach contents. A distended abdomen can be a finding in pyloric stenosis. The obstruction at the pyloric sphincter can lead to gastric retention, causing the stomach to become distended over time. However, it's important to note that not all infants with pyloric stenosis will present with a visibly distended abdomen.
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A nurse is reinforcing teaching with a parent of an infant who has gastroesophageal reflux. Which of the following statements by the parent indicates an understanding of the teaching?
- A. I will have to feed my baby formula, rather than breast milk.
- B. I should move my baby into a side-lying position during sleep.
- C. My baby's formula can be thickened with oatmeal.
- D. I will keep my baby in an upright position after feedings.
Correct Answer: D
Rationale: I will have to feed my baby formula, rather than breast milk.' - This statement indicates a misunderstanding. Breast milk is generally preferred for infants with gastroesophageal reflux (GER) because it is more easily digested and less likely to exacerbate reflux symptoms compared to formula. Breastfeeding mothers may be encouraged to continue breastfeeding, and formula-fed infants may benefit from specialized formulas designed to reduce reflux symptoms. 'I should move my baby into a side-lying position during sleep.' - This statement indicates a misunderstanding. Placing an infant in a side-lying position during sleep is not recommended due to the risk of sudden infant death syndrome (SIDS). Instead, infants with GER should be placed on their back to sleep, as recommended by safe sleep guidelines. Elevating the head of the crib or bassinet slightly may also help reduce reflux symptoms during sleep. 'My baby's formula can be thickened with oatmeal.' - This statement indicates an understanding of the teaching. Thickening formula with oatmeal or rice cereal can help reduce gastroesophageal reflux (GER) symptoms in infants by making the formula heavier and less likely to reflux back into the esophagus. However, this should only be done under the guidance of a healthcare provider to ensure proper preparation and feeding technique. 'I will keep my baby in an upright position after feedings.' - This statement indicates an understanding of the teaching. Keeping the baby in an upright position after feedings can help reduce reflux symptoms by allowing gravity to keep the stomach contents down. Parents can hold the baby upright on their shoulder or in an infant seat for a period of time after feeding to minimize reflux episodes.
Bacterial infection caused by both staph and strept bacteria. Usually sign around mouth and nose, more common in children and the elderly.
- A. Eczema
- B. Vitiligo
- C. Angioedema
- D. Impetigo
Correct Answer: D
Rationale: Eczema: Eczema is a chronic skin condition characterized by inflammation, redness, and itching. It is not typically caused by bacterial infections and does not present with signs around the mouth and nose. Vitiligo: Vitiligo is a condition characterized by the loss of skin color in patches. It is not caused by bacterial infections and does not typically present with signs around the mouth and nose. Angioedema: Angioedema is swelling beneath the skin, often around the eyes and lips, and is commonly associated with allergic reactions or other triggers. It is not caused by bacterial infections. Impetigo: Impetigo is a bacterial skin infection caused by Staphylococcus aureus or Streptococcus pyogenes bacteria. It commonly presents with red sores or blisters around the mouth and nose, especially in children and the elderly. Therefore, option D, Impetigo, is the correct answer.
A nurse is caring for a child who has tinea pedis. The child's parent asks the nurse what this infection is commonly called. The nurse should respond with which of the following common names?
- A. Shingles
- B. Athlete's foot
- C. Fever blister
- D. Pinworms
Correct Answer: B
Rationale: Shingles: This is a viral infection caused by the varicella-zoster virus, which also causes chickenpox. It typically manifests as a painful rash that develops into fluid-filled blisters. Athlete's foot: This is a fungal infection of the skin on the feet, particularly between the toes. It causes itching, burning, and cracked, flaking skin. Fever blister: Also known as a cold sore, this is a viral infection caused by the herpes simplex virus. It typically appears as a cluster of small, fluid-filled blisters on or around the lips. Pinworms: This is a parasitic infection caused by tiny, white worms that infect the intestines. It commonly causes anal itching, particularly at night, due to the female worms laying eggs around the anal area.
A nurse is reinforcing teaching with the parents of a preschooler who has atopic dermatitis. Which of the following information should the nurse include?
- A. You will need to take the entire prescription of antibiotics even if your symptoms improve.
- B. The doctor will remove the lesions with liquid nitrogen.
- C. The doctor might recommend an antihistamine to help control your symptoms.
- D. You can relieve your child's discomfort by applying warm compresses to the lesions.
Correct Answer: C
Rationale: You will need to take the entire prescription of antibiotics even if your symptoms improve.' Atopic dermatitis is not typically treated with antibiotics, as it is not caused by a bacterial infection. Therefore, this statement is not relevant and would not be included in the teaching. 'The doctor will remove the lesions with liquid nitrogen.' Liquid nitrogen is not typically used to remove lesions associated with atopic dermatitis. Atopic dermatitis lesions are usually managed with topical treatments and other measures to reduce inflammation and itching. Therefore, this statement is not accurate and would not be included in the teaching. 'The doctor might recommend an antihistamine to help control your symptoms.' Antihistamines may be prescribed to help relieve itching associated with atopic dermatitis. Itching is a common symptom of atopic dermatitis, and antihistamines can help reduce this symptom. Therefore, this statement is relevant and would be included in the teaching. 'You can relieve your child's discomfort by applying warm compresses to the lesions.' Warm compresses can exacerbate itching associated with atopic dermatitis by increasing blood flow.
A nurse is caring for a child who has acute diarrhea and reports that he is thirsty. Which of the following fluids should the nurse give the child?
- A. Broth
- B. Apple juice
- C. Cherry gelatin
- D. Pedialyte
Correct Answer: D
Rationale: Broth: Broth is not typically recommended for children with acute diarrhea because it lacks the necessary electrolytes to adequately replace those lost through diarrhea. While it can help provide some fluids, it may not be sufficient for rehydration and could potentially worsen dehydration if electrolytes are not adequately replaced. Apple juice: While apple juice may seem like a hydrating option, it is not the best choice for children with acute diarrhea. Apple juice contains a high amount of sugar, which can draw water into the intestines and worsen diarrhea. Additionally, it lacks the necessary electrolytes needed for rehydration. Cherry gelatin: Cherry gelatin is not recommended for rehydrating a child with acute diarrhea. Like apple juice, it contains sugar, which can exacerbate diarrhea by drawing water into the intestines. Gelatin also lacks the electrolytes needed to replace those lost through diarrhea. Pedialyte: Pedialyte is the preferred choice for rehydrating a child with acute diarrhea. It is specifically formulated to replace lost fluids and electrolytes and is less likely to worsen diarrhea compared to sugary beverages like juice or gelatin. Pedialyte helps prevent dehydration by providing a balanced mixture of water, sugar, and electrolytes, making it an effective choice for managing diarrhea in children.