Nokea
Lactose intolerance is diagnosed in an 11-month-old infant. Which should the nurse recommend as a milk substitute?
- A. Yogurt
- B. Ice cream
- C. Fortified cereal
- D. Cows milk-based formula
Correct Answer: A
Rationale: Yogurt contains the inactive lactase enzyme, which is activated by the temperature and pH of the duodenum. This lactase activity substitutes for the lack of endogenous lactase. Ice cream and cows milk-based formula contain lactose, which will probably not be tolerated by the child. Fortified cereal does not have the nutritional equivalents of milk.
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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.
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.
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.
What is an appropriate action when an infant becomes apneic?
- A. Shake vigorously.
- B. Roll the infants head to the side.
- C. Gently stimulate the trunk by patting or rubbing.
- D. Hold the infant by the feet upside down with the head supported.
Correct Answer: C
Rationale: If an infant is apneic, the infants trunk should be gently stimulated by patting or rubbing. If the infant is prone, turn onto the back. Vigorous shaking, rolling of the head, and hanging the child upside down can cause injury and should not be done.
At a well-child check-up, the nurse notes that an infant with a previous diagnosis of failure to thrive (FTT) is now steadily gaining weight. The nurse should recommend that fruit juice intake be limited to no more than how much?
- A. 4 oz/day
- B. 6 oz/day
- C. 8 oz/day
- D. 12 oz/day
Correct Answer: A
Rationale: Restrict juice intake in children with FTT until adequate weight gain has been achieved with appropriate milk sources; thereafter, give no more than 4 oz/day of juice.