Nokea
The nurse is providing nutrition education to the parents of an infant with failure to thrive (FTT). Which statement made by the parent should the nurse recognize as an appropriate understanding of interventions?
- A. Breast milk provides adequate calories for the child.
- B. Regular syringe feedings promote rapid weight gain.
- C. High-calorie formula encourages increased growth.
- D. Fruit juice increases the child's daily vitamin intake.
Correct Answer: C
Rationale: High-calorie formula provides the increased caloric intake needed to promote growth in infants with FTT.
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The nurse is caring for a school-age child with crusting and swollen eyelids, purulent drainage, and inflamed conjunctiva. The child receives a prescription for an ophthalmic anti-infective ointment. Which instruction should the nurse provide the child's caregivers during discharge education?
- A. Discontinue the ointment once drainage resolves.
- B. Prepare the child for blurry vision after ointment application.
- C. Use a disposable moist wipe to remove eye crusts.
- D. Remove secretions by wiping toward the opposite eye.
Correct Answer: B
Rationale: Ophthalmic ointment can cause temporary blurry vision, and preparing the child for this effect is important.
The parents of a child with Wilms tumor ask the nurse why surgery is necessary before a biopsy is performed. Which information should the nurse provide?
- A. Biopsy may rupture the encapsulated tumor and cause the cancer cells to spread.
- B. Metal clips are surgically applied at the tumor site for exact marking for radiation.
- C. Surgery is necessary to stage the tumor and determine metastasis to other sites.
- D. The surgery provides a visualization of other pathology and dysfunction of the kidney.
Correct Answer: A
Rationale: Biopsy risks rupturing the encapsulated Wilms tumor, potentially spreading cancer cells, making surgery the preferred initial approach.
A breastfeeding infant, screened for congenital hypothyroidism, is found to have low levels of thyroxine (T4) and high levels of thyroid stimulating hormone (TSH). Which is the best explanation for this finding?
- A. The TSH is high because of the low production of T4 by the thyroid.
- B. The thyroxine level is low because the TSH level is high.
- C. The thyroid gland does not produce normal levels of thyroxine for several weeks after birth.
- D. High thyroxine levels normally occur in breastfeeding infants.
Correct Answer: A
Rationale: High TSH levels are a compensatory response to low T4 production, indicating congenital hypothyroidism, which requires prompt treatment to prevent developmental delays.
While obtaining the vital signs of a 10-year-old child who had a tonsillectomy this morning, the nurse observes the child swallowing every 2 to 3 minutes. Which assessment should the nurse implement?
- A. Inspect the posterior oropharynx.
- B. Touch the tonsillar pillars to stimulate the gag reflex.
- C. Ask the child to speak to evaluate change in voice tone.
- D. Assess for teeth clenching or grinding.
Correct Answer: A
Rationale: Frequent swallowing may indicate postoperative bleeding, so inspecting the oropharynx is critical.
When starting a peripheral intravenous (IV) infusion on an infant, which intervention should the nurse implement?
- A. Select a site that is least restrictive to the infant.
- B. Assess dorsal surface of feet for an IV site.
- C. Instruct parents to sing or croon to the infant.
- D. Apply soft restraints to all four extremities.
Correct Answer: A
Rationale: Selecting a least restrictive site minimizes discomfort and maintains mobility, ensuring safe and effective IV placement.