Nokea
The breast-feeding mother of a 1-month-old diagnosed with cow's milk sensitivity asks the nurse what she should do about feeding her infant. Which of the following recommendations would be most appropriate?
- A. Continue to breast-feed but eliminate all milk products from your own diet.
- B. Discontinue breast-feeding and start using a predigested formula.
- C. Limit breast-feeding to once per day and begin feeding an iron-fortified formula.
- D. Change to a soy-based formula exclusively and begin solid foods.
Correct Answer: A
Rationale: Eliminating dairy from the mother's diet prevents milk proteins from passing to the infant via breast milk, allowing breastfeeding to continue. Formula or solids are less appropriate at this age.
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The nurse is examining an infant for hip placement and has abducted her flexed legs. The nurse should next:
- A. Rotate the hips.
- B. Extend the legs.
- C. Listen for a 'click.'
- D. Palpate the hips for a mass.
Correct Answer: C
Rationale: Listening for a 'click' (Ortolani's sign) is the next step to detect hip dislocation in developmental dysplasia of the hip after abducting the flexed legs.
The mother of a preschooler reports that her child creates a scene every night at bedtime. The nurse and the mother decide that the best course of action would be to do which of the following?
- A. Allow the child to stay up later one or two nights a week.
- B. Establish a set bedtime and follow a routine.
- C. Encourage active play before bedtime.
- D. Give the child a cookie if bedtime is pleasant.
Correct Answer: B
Rationale: A consistent bedtime routine promotes healthy sleep habits.
When preparing the teaching plan for the mother of a child with asthma, which of the following should the nurse include as signs to alert the mother that her child is having an asthma attack?
- A. Secretion of thin, copious mucus.
- B. Tight, productive cough.
- C. Wheezing on expiration.
- D. Temperature of 99.4°F (37.4°C).
Correct Answer: C
Rationale: Wheezing on expiration is a hallmark sign of an asthma attack, indicating airway narrowing. The mother should be taught to recognize this to initiate prompt treatment.
Which of the following meals would be most appropriate for a 15-year-old with glomerulonephritis with severe hypertension?
- A. Egg noodles, hamburger, canned peas, milk.
- B. Baked ham, baked potato, pear, canned carrots, milk.
- C. Baked chicken, rice, beans, orange juice.
- D. Hot dog on a bun, corn chips, pickle, cookie, milk.
Correct Answer: C
Rationale: Low-sodium diet is recommended.
The nurse manager on a pediatric floor is reviewing national sentinel event alerts and preparing recommendations for the unit. Which strategy would help reduce pediatric medication errors? Select all that apply.
- A. Eliminate the pediatric satellite pharmacy.
- B. Increase the steps in the medication administration procedure.
- C. Utilize only oral syringes to administer oral medication.
- D. Limit the size of I.V. fluid bags that can be hung on small children.
- E. Reduce the available concentrations or dose strengths to the minimum.
Correct Answer: C,D,E
Rationale: Oral syringes ensure accurate dosing, smaller IV bags prevent fluid overload, and fewer concentrations reduce dosing errors.