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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.
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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.
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.
Which factors will decrease iron absorption and should not be given at the same time as an iron supplement?
- A. Milk
- B. Fruit juice
- C. Multivitamin
- D. Meat, fish, poultry
Correct Answer: A
Rationale: Many foods interfere with iron absorption and should be avoided when iron is consumed. These foods include phosphates found in milk, phytates found in cereals, and oxalates found in many vegetables. Vitamin C-containing juices enhance the absorption of iron. Multivitamins may contain iron; no contraindication exists to taking the two together. Meat, fish, and poultry do not affect absorption.
A parent brings a 12-month-old infant into the emergency department and tells the nurse that the infant is allergic to peanuts and was accidentally given a cookie with peanuts in it. The infant is dyspneic, wheezing, and cyanotic. The health care provider has prescribed a dose of epinephrine to be administered. The infant weighs 24 lb. How many milligrams of epinephrine should be administered?
- A. 0.11 to 0.33 mg
- B. 0.011 to 0.3 mg
- C. 1.1 to 3.3 mg
- D. 11 to 33 mg
Correct Answer: B
Rationale: The correct dose of epinephrine to use in the emergency management of an anaphylactic reaction is 0.001 mg/kg up to a maximum of 0.3 mg, giving a range of 0.011 to 0.3 mg using a weight of 11 kg (24 lb).
After the introduction of the Back to Sleep campaign in 1992, an increased incidence has been noted of which pediatric issues?
- A. Sudden infant death syndrome (SIDS)
- B. Plagiocephaly
- C. Failure to thrive
- D. Apnea of infancy
Correct Answer: B
Rationale: Plagiocephaly is a misshapen head caused by the prolonged pressure on one side of the skull. If that side becomes misshapen, facial asymmetry may result. SIDS has decreased by more than 40% with the introduction of the Back to Sleep campaign. Apnea of infancy and failure to thrive are unrelated to the Back to Sleep campaign.