Chapter 31

A 3-month-old bottle-fed infant is allergic to cow's milk. The nurse's BESToption for a substitute is: goat's milk. soy-based formula. skim milk diluted with water. amino acid formula.

4

A nurse is caring for a 2-month-old exclusively breast-fed infant with an admitting diagnosis of colic. Based on the nurse's knowledge of breastfed infants, what type of stool is expected? Dark brown and small hard pebbles Loose with green mucus streaks Formed and with white mucus Semiformed, seedy, yellow

4

The nurse expects which characteristic of fine motor skills in a 5-month-old infant? Strong grasp reflex Neat pincer grasp Able to build a tower of two cubes Able to grasp object voluntarily

4

A 9-month-old infant is seen in the emergency department after developing a urticaric rash with cough and wheezing. When collecting the history of events before the sudden onset of the rash with cough and wheezing, the mother states they were "feeding the baby new foods." Which food is the possible cause of this type of reaction in the infant? Potatoes Green beans Spinach Peanut butter

4

The nurse is assessing a 6-month-old infant who smiles, coos, and has a strong head lag. The nurse should recognize that: this assessment is normal. the child is probably cognitively impaired. developmental/neurologic evaluation is needed. the parent needs to work with the infant to stop head lag.

3

Which strategy might be recommended for an infant with failure-to-thrive to increase caloric intake? Using developmental stimulation by a specialist during feedings Avoiding solids until after the bottle is well accepted Being persistent through 10 to 15 minutes of food refusal Varying schedule of routine activities on a daily basis

3

Apnea of infancy has been diagnosed in an infant who will soon be discharged with home monitoring. When teaching the parents about the infant's care, what is the most important information the nurse should include in the discharge teaching plan? Cardiopulmonary resuscitation (CPR) Administration of intravenous (IV) fluids Reassurance that the infant cannot be electrocuted during monitoring Advice that the infant not be left with other caretakers such as baby-sitters

1

The mother of a 3-month-old breastfed infant asks about giving her baby water since it is summer and very warm. The nurse should recommend that: fluids in addition to breast milk are not needed. water should be given if the infant seems to nurse longer than usual. water once or twice a day will make up for losses caused by environmental temperature. clear juices would be better than water to promote adequate fluid intake.

1

The nurse educator instructs a nursing student that according to Erikson, infancy is concerned with acquiring a sense of: trust. industry. initiative. separation.

1

The primary goals in the nutritional management of children with failure to thrive (FTT) are: (Select all that apply.) allow for catch-up growth. correct nutritional deficiencies. achieve ideal weight for height. restore optimum body composition. educate the parents or primary caregivers on child's nutritional requirements. educate the parents or primary caregivers that the child will need tube feedings first.

1,2,3,4,5

When preparing to administer Hepatitis B vaccine to a newborn, the nurse should: (Select all that apply.) initiate an immunization record. confirm the hepatitis B status of the newborn's mother. obtain a syringe with a 25-gauge, 5/8-inch needle. assess the dorsogluteal muscle as the preferred site for injection. confirm that the newborn's mother has signed the informed consent.

1,2,3,5

The nurse should provide further teaching about sudden infant death syndrome (SIDS) prevention when hearing the mother of an 8 week old make which statement? (Select all that apply.) "I only smoke in the kitchen." "I put my baby to sleep on her back." "I have my baby sleep with me instead of alone in the crib." "I make sure my baby wears a flannel sleeper and has two blankets to keep warm in her crib." "I always leave my baby's favorite stuffed bunny rabbit in the crib to keep her from crying at night."

1,3,4,5

A mother is bringing her 4-month-old infant into the clinic for a routine well-baby check. The mother is exclusively breastfeeding. There are no other liquids given to the infant. What vitamin does the nurse anticipate the provider will prescribe for this infant? Vitamin B Vitamin D Vitamin C Vitamin K

2

A parent of an 8-month-old infant tells the nurse that the baby cries and screams whenever he or she is left with the grandparents. The nurse's reply should be based on knowledge that: the infant is most likely spoiled. this is a normal reaction for this age. this is an abnormal reaction for this age. grandparents are not responsive to that infant.

2

The exhausted parents of a 2-month-old infant with colic ask the nurse what is the best method to promote comfort and sleep for the infant. The nurse's initialaction is to: advise the mother to follow a milk-free diet for 3 to 5 days. take a thorough, detailed history of usual daily events. administer simethicone drops to provide relief from gas pains. explain that the parents need to stay calm so the infant will remain calm.

2

The parents of a 5-month-old girl complain to the nurse that they are exhausted because she still wakes up as often as every 1 to 2 hours during the night. When she awakens, they change her diaper, and her mother nurses her back to sleep. What should the nurse suggest to help them deal with this problem? Putting her in parents' bed to cuddle. Beginning to put her to bed while still awake. Letting her cry herself back to sleep. Giving her a bottle of formula instead of breastfeeding her so often at night.

2

Infants most at risk for sudden infant death syndrome (SIDS) are those: (Select all that apply.) who sleep supine. who sleep prone. who were premature. with prenatal drug exposure. with a cousin who died of SIDS.

2,3,4

The nurse is providing education to a parent of a 10-month-old infant receiving iron supplements. What will be included in the teaching? (Select all that apply.) Administer iron with meals. Place iron toward the back side of the mouth with a dropper. Mix iron with milk for greater absorption. Report black, tarry stools to health care provider. Apply barrier ointment if needed to buttocks.

2,5

A 4-month-old infant is brought to the clinic by his parents for a well-baby checkup. What should the nurse include at this time concerning injury prevention? "Never shake baby powder directly on your infant because it can be aspirated into his lungs." "Do not permit your child to chew paint from window ledges because he might absorb too much lead." "When your baby learns to roll over, you must supervise him whenever he is on a surface from which he might fall." "Keep doors of appliances closed at all times."

3

A nurse is providing education to a community group in preparation for a mission trip to a third world country with limited access to protein-based food sources. The nurse is aware that children in this country are at increased risk for: rickets. marasmus. kwashiorkor. pellagra.

3

At what age would the nurse advise parents to expect their infant to be able to say "mama" and "dada" with meaning? 4 months 6 months 10 months 14 months

3

The MOST appropriate recommendation for relief of teething pain is to instruct the parents to: rub gums with aspirin to relieve inflammation. apply hydrogen peroxide to gums to relieve irritation. give child a frozen teething ring to relieve inflammation. have child chew on a warm teething ring to encourage tooth eruption.

3

The nurse in the pediatric clinic identifies which infants at risk for developing vitamin D-deficient rickets? Lacto-ovo vegetarians Those who are breastfed exclusively Those using yogurt as primary source of milk Those exposed to daily sunlight

3

The nurse is interviewing the parents of a 4-month-old male infant brought to the hospital emergency department. The infant is dead on arrival, 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. They say he was "just fine" when they put him in his crib already asleep. The nurse should suspect his death was caused by: suffocation. child abuse. infantile apnea. sudden infant death syndrome (SIDS).

4

The parent of a 12-month-old infant says to the nurse, "He pushes the teaspoon right out of my hand when I feed him. I cannot let him feed himself; he makes too much of a mess." The nurse's BEST response is: "It is important not to give into this kind of temper tantrum at this age. Simply ignore the behavior and the mess." "You need to try different types of utensils, bowls, and plates. Some are specifically designed for young children." "It is important to let him make a mess. Just try not to worry about it so much." "Feeding himself will help foster his growth and development. Perhaps we can discuss ways to make the messes more tolerable."

4

The parents of a 9-month-old infant tell the nurse that they are worried about their baby's thumb-sucking. What is the nurse's BEST reply? A pacifier should be substituted for the thumb. Thumb-sucking should be discouraged by age 12 months. Thumb-sucking should be discouraged when the teeth begin to erupt. There is no need to restrain nonnutritive sucking during infancy.

4