Nokea
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.
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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.
The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for their children. Which is most likely lacking in their particular diet?
- A. Fat
- B. Protein
- C. Vitamins C and A
- D. Iron and calcium
Correct Answer: D
Rationale: Deficiencies can occur when various substances in the diet interact with minerals. For example, iron, zinc, and calcium can form insoluble complexes with phytates or oxalates (substances found in plant proteins), which impair the bioavailability of the mineral. This type of interaction is important in vegetarian diets because plant foods such as soy are high in phytates. Fat and vitamins C and A are readily available from vegetable sources. Plant proteins are available.
What is marasmus?
- A. Deficiency of protein with an adequate supply of calories
- B. Syndrome that results solely from vitamin deficiencies
- C. Not confined to geographic areas where food supplies are inadequate
- D. Characterized by thin, wasted extremities and a prominent abdomen resulting from edema (ascites)
Correct Answer: C
Rationale: Marasmus is a syndrome of emotional and physical deprivation. It is not confined to geographic areas were food supplies are inadequate. Marasmus is characterized by gradual wasting and atrophy of body tissues, especially of subcutaneous fat. The child appears old, with flabby and wrinkled skin. Marasmus is a deficiency of both protein and calories.
Which term refers to the relative lactase deficiency observed in preterm infants of less than 34 weeks of gestation?
- A. Congenital lactase deficiency
- B. Primary lactase deficiency
- C. Secondary lactase deficiency
- D. Developmental lactase deficiency
Correct Answer: D
Rationale: Developmental lactase deficiency refers to the relative lactase deficiency observed in preterm infants of less than 34 weeks of gestation. Congenital lactase deficiency occurs soon after birth after the newborn has consumed lactose-containing milk. Primary lactase deficiency, sometimes referred to as late-onset lactase deficiency, is the most common type of lactose intolerance and is manifested usually after 4 or 5 years of age. Secondary lactase deficiency may occur secondary to damage of the intestinal lumen, which decreases or destroys the enzyme lactase.
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.