Nokea
The parents of a 9-month-old infant tell the nurse that they have noticed foods such as peas and corn are not completely digested and can be seen in their infant's stools. The nurse's explanation of this is based on which statement?
- A. Child should not be given fibrous foods until digestive tract matures at age 4 years.
- B. Child should not be given any solid foods until this digestive problem is resolved.
- C. This is abnormal and requires further investigation.
- D. This is normal because of the immaturity of digestive processes at this age.
Correct Answer: D
Rationale: The correct answer is D. This is normal because of the immaturity of digestive processes at this age. At 9 months old, infants are still in the process of developing their digestive system. It is common for them to have difficulty digesting certain foods, especially those high in fiber like peas and corn. This is due to the immaturity of their digestive enzymes and processes. As the infant grows, their digestive system will continue to mature, and they will be able to digest these types of foods more effectively. Therefore, there is no need for further investigation or restriction of solid foods.
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Which is the most appropriate nursing action when intermittently gavage-feeding a preterm newborn?
- A. Allow formula to flow by gravity.
- B. Insert tube through nares rather than mouth.
- C. Avoid letting newborn suck on tube.
- D. Apply steady pressure to syringe to deliver formula to stomach in a timely manner.
Correct Answer: C
Rationale: The most appropriate nursing action when intermittently gavage-feeding a preterm newborn is to avoid letting the newborn suck on the tube. Preterm infants are at risk for disorganized feeding patterns and can develop a non-nutritive sucking habit when the tube is in their mouth. Allowing them to suck on the tube can lead to difficulty transitioning to oral feeding once they are ready, as they may associate feeding with the tube rather than with proper suckling at the breast or bottle. Therefore, it is important to prevent non-nutritive sucking during gavage feedings to promote successful oral feeding later on.
The nurse is caring for a newborn with hyperbilirubinemia who is receiving phototherapy. Which is an appropriate nursing intervention for this newborn?
- A. Apply lotion as prescribed to moisturize skin.
- B. Maintain nothing-by-mouth (NPO) status to prevent nausea and vomiting.
- C. Monitor temperature to prevent hypothermia or hyperthermia.
- D. Keep eye patches on for at least 8 to 12 of every 24 hours.
Correct Answer: C
Rationale: Monitoring temperature to prevent hypothermia or hyperthermia is an appropriate nursing intervention for a newborn with hyperbilirubinemia receiving phototherapy. Phototherapy can increase the risk of hypothermia in newborns due to increased heat loss from evaporation, convection, and conduction. On the other hand, hyperthermia can occur if the newborn is over-wrapped or placed too closely to the light source. Therefore, frequent temperature monitoring is essential to maintain a stable body temperature within a normal range and prevent adverse effects related to temperature dysregulation.
The physician prescribes glipizide (Glucotrol), an oral antidiabetic agent, for a client with type 2 diabetes mellitus who has been having trouble controlling the blood glucose level through diet and exercise. Which medication instruction should the nurse provide?
- A. "Be sure to take glipizide 30 minutes before meals."
- B. "Glipizide may cause a low serum sodium level, so make sure you have your sodium level checked monthly."
- C. "You won't need to check you blood glucose level after you start taking glipizide."
- D. "Take glipizide after a metal to prevent heartburn."
Correct Answer: A
Rationale: A. "Be sure to take glipizide 30 minutes before meals."
A worried mother of a 4-year-old boy describes attacks of inconsolable crying and prefers to play alone. The MOST appropriate action is
- A. reassures her that this is a normal phenomenon
- B. seek more history regarding other skills and developmental domains
- C. refer her to pediatric psychiatry
- D. investigate social issues of the family
Correct Answer: B
Rationale: Further history is needed to rule out behavioral or psychological issues.
Osteosarcoma is the most common primary malignant bone tumor in children and adolescents; it has multiple subtypes and requires different modalities of treatment including surgery and chemotherapy. Of the following, the subtype of osteosarcoma which is treated by surgery alone is
- A. fibroblastic
- B. chondroblastic
- C. parosteal
- D. periosteal
Correct Answer: D
Rationale: Periosteal osteosarcoma is often treated with surgery alone if margins are clear.