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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.
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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.
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.
What is most descriptive of atopic dermatitis (AD) (eczema) in an infant?
- A. Easily cured
- B. Worse in humid climates
- C. Associated with hereditary allergies
- D. Related to upper respiratory tract infections
Correct Answer: C
Rationale: AD is a type of pruritic eczema that usually begins during infancy and is associated with allergy with a hereditary tendency. Approximately 50% of children with AD develop asthma. AD can be controlled but not cured. Manifestations of the disease are worse when environmental humidity is lower. AD is not associated with respiratory tract infections.
The parent of an infant with colic tells the nurse, All this baby does is scream at me; it is a constant worry. What is the nurses best action?
- A. Encourage the parent to verbalize feelings.
- B. Encourage the parent not to worry so much.
- C. Assess the parent for other signs of inadequate parenting.
- D. Reassure the parent that colic rarely lasts past age 9 months.
Correct Answer: A
Rationale: Colic is multifactorial, and no single treatment is effective for all infants. The parent is verbalizing concern and worry. The nurse should allow the parent to put these feelings into words. An empathetic, gentle, and reassuring attitude, in addition to suggestions about remedies, will help alleviate the parents anxiety. The nurse should reassure the parent that he or she is not doing anything wrong. The infant with colic is experiencing spasmodic pain that is manifested by loud crying, in some cases up to 3 hours each day. Telling the parent that it will eventually go away does not help him or her through the current situation.
The nurse is discussing the management of atopic dermatitis (eczema) with a parent. What should be included?
- A. Dress infant warmly to prevent chilling.
- B. Keep the infants fingernails and toenails cut short and clean.
- C. Give bubble baths instead of washing lesions with soap.
- D. Launder clothes in mild detergent; use fabric softener in the rinse.
Correct Answer: B
Rationale: The infants nails should be kept short and clean and have no sharp edges. Gloves or cotton socks can be placed over the childs hands and pinned to the shirt sleeves. Heat and humidity increase perspiration, which can exacerbate the eczema. The child should be dressed properly for the climate. Synthetic material (not wool) should be used for the childs clothing during cold months. Baths are given as prescribed with tepid water, and emollients such as Aquaphor, Cetaphil, and Eucerin are applied within 3 minutes. Soap (except as indicated), bubble bath oils, and powders are avoided. Fabric softener should be avoided because of the irritant effects of some of its components.