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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.
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The nurse is teaching a parent with a 2-month-old infant who has been diagnosed with colic about ways to relieve colic. Which statement by the parent indicates the need for additional teaching?
- A. I should let my infant cry for at least 30 minutes before I respond.
- B. I will swaddle my infant tightly with a soft blanket.
- C. I should massage my infants abdomen whenever possible.
- D. I will place my infant in an upright seat after feeding.
Correct Answer: A
Rationale: Because the infant has been diagnosed with colic, the parent should respond to the infant immediately or any type of interventions to relieve colic may not be effective. Also, the infant may develop a mistrust of the world if his or her needs are not met. The parent should swaddle the baby tightly with a soft blanket, massage the babys abdomen, and place the infant in an upright seat after a feeding to help relieve colic.
Where do eczematous lesions most commonly occur in an infant?
- A. Abdomen, cheeks, and scalp
- B. Buttocks, abdomen, and scalp
- C. Back and flexor surfaces of the arms and legs
- D. Cheeks and extensor surfaces of the arms and legs
Correct Answer: D
Rationale: The lesions of atopic dermatitis are generalized in infants. They are most common on the cheeks, scalp, trunk, and extensor surfaces of the extremities. The abdomen and buttocks are not common sites of lesions. The back and flexor surfaces are not usually involved.
The nurse is examining an infant, age 10 months, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions. What is the most likely cause?
- A. Impetigo
- B. Urine and feces
- C. Candida albicans infection
- D. Infrequent diapering
Correct Answer: C
Rationale: C. albicans infection produces perianal inflammation and a maculopapular rash with satellite lesions that may cross the inguinal folds. Impetigo is a bacterial infection that spreads peripherally in sharply marginated, irregular outlines. Eruptions involving the skin in contact with the diaper but sparing the folds are likely to be caused by chemical irritation, especially urine and feces, and may be related to infrequent diapering.
Which statement best describes colic?
- A. Periods of abdominal pain resulting in weight loss
- B. Usually the result of poor or inadequate mothering
- C. Periods of abdominal pain and crying occurring in infants older than age 6 months
- D. A paroxysmal abdominal pain or cramping manifested by episodes of loud crying
Correct Answer: D
Rationale: Colic is described as paroxysmal abdominal pain or cramping that is manifested by loud crying and drawing up the legs to the abdomen. Weight loss is not part of the clinical picture. There are many theories about the cause of colic. Emotional stress or tension between the parent and child is one component. This is not consistent throughout all cases. Colic is most common in infants younger than 3 months of age.
The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is often prone (face down) while awake. The nurses response should be based on remembering what?
- A. This is acceptable to encourage head control and turning over.
- B. This is acceptable to encourage fine motor development.
- C. This is unacceptable because of the risk of sudden infant death syndrome (SIDS).
- D. This is unacceptable because it does not encourage achievement of developmental milestones.
Correct Answer: A
Rationale: These parents are implementing the guidelines to reduce the risk of SIDS. Infants should sleep on their backs to reduce the risk of SIDS and then be placed on their abdomens when awake to enhance achievement of milestones such as head control. These position changes encourage gross motor, not fine motor, development.