Nokea
At an 8-month-old well-baby visit, the parent tells the nurse that her infant falls asleep at night during the last bottle feeding but wakes up when moved to the infant's crib. What is the most appropriate response for the nurse to make?
- A. You should put your baby to sleep 1 hour earlier without the nighttime feeding but with a pacifier for soothing.
- B. You could place rice cereal in the last bottle feeding of the day to ensure a longer sleep pattern.
- C. You should have your partner give the last bottle of the day and observe whether your infant stays awake for your partner.
- D. You could increase daytime feeding intervals to every 4 hours and put your baby in the crib while the baby is still awake.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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The parents of an infant with a cleft palate ask the nurse, "What follow-up care will our infant need after the repair?" Which is an accurate response by the nurse?
- A. Your infant will not need any subsequent follow-up care
- B. Your infant will only need to be evaluated by an audiologist
- C. Your infant will only need follow-up with a speech pathologist
- D. Your infant will need follow-up with audiologists and orthodontists
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The nurse is caring for a very low-birth-weight (VLBW) infant with a peripheral intravenous infusion. What nursing considerations regarding infiltration should be included in planning IV care?
- A. Infiltration is not solely related to the activity level of VLBW infants.
- B. Continuous infusion pumps do not always stop automatically when infiltration occurs.
- C. Hypertonic solutions can cause severe tissue damage if infiltration occurs.
- D. The infusion site should be checked regularly to prevent infiltration-related complications.
Correct Answer: C
Rationale: Hypertonic solutions can damage tissues if they leak from the vein due to infiltration. It is crucial to monitor for this complication to prevent severe tissue damage. Infiltration is not solely related to the activity level of VLBW infants; it can occur due to various reasons such as vein condition, catheter placement, and fluid type. Continuous infusion pumps may not always detect infiltration, as they typically alarm for pressure changes but not all infiltration instances. Checking the infusion site regularly, preferably hourly, is essential to prevent complications like tissue damage from extravasations, fluid overload, and dehydration.
Which is usually the only symptom of pediculosis capitis (head lice)?
- A. Itching
- B. Vesicles
- C. Scalp rash
- D. Localized inflammatory response
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The clinic nurse is instructing parents about caring for a toddler with ascariasis (common roundworm). Which statement made by the parents indicates a need for further teaching?
- A. We will wash our hands often, especially after diaper changes
- B. We know that roundworm can be transmitted from person to person
- C. We will be sure to continue the nitazoxanide (Alinia) orally for 3 days
- D. We will bring a stool sample to the clinic for examination in 2 weeks
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
In the newborn, into what muscle is intramuscular vitamin K administered?
- A. Deltoid
- B. Dorsogluteal
- C. Rectus femoris
- D. Vastus lateralis
Correct Answer: D
Rationale: In newborns, intramuscular vitamin K is traditionally administered into the vastus lateralis muscle. This site is preferred due to its large muscle mass and accessibility. The dorsogluteal site is not recommended for newborns due to the risk of injury to the sciatic nerve. The deltoid site is also not recommended for newborns. The rectus femoris muscle is not commonly used for intramuscular injections in newborns.