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What is the most appropriate nursing action when intermittently gavage feeding a preterm infant?
- A. Allow formula to flow by gravity
- B. Avoid allowing the infant to suck on the tube
- C. Insert the tube through the nares instead of the mouth
- D. Apply gentle pressure to the syringe to deliver the formula
Correct Answer: A
Rationale: The correct action when intermittently gavage feeding a preterm infant is to allow the formula to flow by gravity. This method helps prevent overfeeding and aspiration, which can occur if the formula is delivered too quickly under pressure. Choice B is incorrect as sucking on the tube can cause complications. Choice C is incorrect as the tube is typically inserted through the mouth. Choice D is incorrect as steady pressure can lead to rapid delivery of the formula, increasing the risk of complications.
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The nurse is educating a new nurse on the identification of pain in children. What does the nurse teach about physiologic measurements in children's pain assessment?
- A. Not useful as the only indicator for pain
- B. Best indicator of pain in children of all ages
- C. Most valuable when children also report having pain
- D. Essential to determine whether a child is telling the truth about pain
Correct Answer: A
Rationale: Physiologic manifestations of pain may vary considerably, so they do not provide a consistent measure of pain. Heart rate may increase or decrease. The same signs that may suggest fear, anxiety, or anger also indicate pain. In chronic pain, the body adapts, and these signs decrease or stabilize. Physiologic measurements are of limited value and must be viewed in the context of a pain rating scale, behavioral assessment, and parental report. When the child reports pain on an appropriate pain scale, the appropriate interventions should be used. Therefore, physiologic measurements are not considered a reliable standalone indicator for pain in children, making choice A the correct answer. Choice B is incorrect because physiologic measurements alone do not serve as the best indicator of pain. Choice C is incorrect as physiologic measurements are still limited even when children report pain. Choice D is incorrect as physiologic measurements are not primarily used to determine the truthfulness of a child's pain report.
For minimal change nephrotic syndrome (MCNS), prednisone is effective when what occurs?
- A. Appetite increases and blood pressure is normal
- B. Urinary tract infection is gone and edema subsides
- C. Generalized edema subsides and blood pressure is normal
- D. Diuresis occurs as urinary protein excretion diminishes
Correct Answer: D
Rationale: The effectiveness of prednisone in treating MCNS is indicated by diuresis and a decrease in urinary protein excretion. Subsidence of generalized edema is also a positive sign, but the key indicator is the reduction in proteinuria, which is achieved through diuresis.
What is an important consideration in understanding the reactions of parents when their infant is born with physical defects?
- A. Grief lasts until the defects are repaired.
- B. Denial is a common adaptive reaction.
- C. The psychologic reaction is similar to that with the death of an infant.
- D. Reactions of health professionals to the birth of an infant can affect parents' reactions.
Correct Answer: C
Rationale: When a parent's infant is born with physical defects, understanding the psychological reactions is crucial. The reaction is often similar to the grief experienced when facing the death of a child. Parents need to grieve for the loss of the expected child and adapt to the needs of a child with physical defects. The grief process typically involves stages like shock, frustration, and anger, which can last for years. Denial during the shock phase is not maladaptive but can help parents cope initially. Additionally, parents are sensitive to the behavior of health professionals, whose interactions can significantly influence the parents' reactions to the infant. Therefore, recognizing the similarity of the psychological reaction to grief is an important consideration in understanding how parents cope with their infant's physical defects.
What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis?
- A. Infarction of renal vessels
- B. Immune complex formation and glomerular deposition
- C. Bacterial endotoxin deposition on and destruction of glomeruli
- D. Embolization of glomeruli by bacteria and fibrin from endocardial vegetation
Correct Answer: B
Rationale: Postinfectious glomerulonephritis is typically caused by immune complex deposition in the glomeruli following a streptococcal infection. This immune response leads to inflammation and impaired kidney function.
A parent asks the nurse what would be the first indication that acute glomerulonephritis was improving. What would be the nurse's best response?
- A. Blood pressure will stabilize.
- B. Your child will have more energy.
- C. Urine will be free of protein.
- D. Urine output will increase.
Correct Answer: D
Rationale: Increased urine output is often the first sign that acute glomerulonephritis is improving, as it indicates a reduction in fluid retention and better kidney function. Stabilization of blood pressure and other symptoms typically follow.