Nokea
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.
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Which one of the following strategies might be recommended for an infant with failure to thrive (FTT) to increase caloric intake?
- A. Vary the schedule for routine activities on a daily basis.
- B. Be persistent through 10 to 15 minutes of food refusal.
- C. Avoid solids until after the bottle is well accepted.
- D. Use developmental stimulation by a specialist during feedings.
Correct Answer: B
Rationale: Calm perseverance through 10 to 15 minutes of food refusal will eventually diminish negative behavior. Children with FTT need a structured routine to help establish rhythmicity in their activities of daily living. Many children with FTT are fed exclusively from a bottle. Solids should be fed first. Stimulation is reduced during mealtimes to maintain the focus on eating.
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.
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 new parent asks the nurse, How can diaper rash be prevented? What should the nurse recommend?
- A. Wash the infant with soap before applying a thin layer of oil.
- B. Clean the infant with soap and water every time diaper is changed.
- C. Wipe stool from the skin using water and a mild cleanser.
- D. When changing the diaper, wipe the buttocks with oil and powder the creases.
Correct Answer: C
Rationale: Change the diaper as soon as it becomes soiled. Gently wipe stool from the skin with water and mild soap. The skin should be thoroughly dried after washing. Applying oil does not create an effective barrier. Over washing the skin should be avoided, especially with perfumed soaps or commercial wipes, which may be irritating. Baby powder should not be used because of the danger of aspiration.
A 1-year-old child is on a pure vegetarian (vegan) diet. This diet requires supplementation with what?
- A. Niacin
- B. Folic acid
- C. Vitamins D and B12
- D. Vitamins C and E
Correct Answer: C
Rationale: Pure vegetarian (vegan) diets eliminate any food of animal origin, including milk and eggs. These diets require supplementation with many vitamins, especially vitamin B6, vitamin B12, riboflavin, vitamin D, iron, and zinc. Niacin, folic acid, and vitamins C and E are readily obtainable from foods of vegetable origin.