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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.
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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.
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.
Which term refers to the relative lactase deficiency observed in preterm infants of less than 34 weeks of gestation?
- A. Congenital lactase deficiency
- B. Primary lactase deficiency
- C. Secondary lactase deficiency
- D. Developmental lactase deficiency
Correct Answer: D
Rationale: Developmental lactase deficiency refers to the relative lactase deficiency observed in preterm infants of less than 34 weeks of gestation. Congenital lactase deficiency occurs soon after birth after the newborn has consumed lactose-containing milk. Primary lactase deficiency, sometimes referred to as late-onset lactase deficiency, is the most common type of lactose intolerance and is manifested usually after 4 or 5 years of age. Secondary lactase deficiency may occur secondary to damage of the intestinal lumen, which decreases or destroys the enzyme lactase.
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.
The nurse is interviewing the parents of a 4-month-old boy brought to the hospital emergency department. The infant is dead, and no attempt at resuscitation is made. The parents state that the baby was found in his crib with a blanket over his head, lying face down in bloody fluid from his nose and mouth. The nurse might initially suspect his death was caused by what?
- A. Suffocation
- B. Child abuse
- C. Infantile apnea
- D. Sudden infant death syndrome (SIDS)
Correct Answer: D
Rationale: The description of how the child was found in the crib is suggestive of SIDS. The nurse is careful to tell the parents that a diagnosis cannot be confirmed until an autopsy is performed.