NURS-4331-600-NURS CHILDREN & ADOLESCENTS
A new mother is concerned about the risk of her 6-month-old aspirating and choking. Which of the following should the nurse recommend to her? Select all that apply. 1. Don't prop up the baby's bottle when feeding him 2. Offer only unbuttered popcorn 3. Use only pacifiers that have a two-piece construction and small flange 4, Allow only toys that fit inside a toilet paper roll 5. Use only clothing without decorative buttons
- Don't prop up the baby's bottle when feeding him - Use only clothing without decorative buttons Aspiration is a potential threat to infants throughout the first year. Educate parents who feed their infant formula not to prop bottles. By doing this, they are overestimating their infant's ability to push the bottle away, sit up, turn the head to the side, cough, and clear the airway if milk should flow too rapidly into the mouth and an infant begins to aspirate. Using clothing without decorative buttons, and checking toys and rattles to ensure they have no small parts that could snap off or fall out are good steps for parents to follow. A test of whether a toy could be dangerous if an infant puts it inside the mouth is whether it fits inside a toilet paper roll. If it does, it is small enough to be aspirated. Children under about 5 years should not be offered popcorn or peanuts because of this danger of aspiration. If parents are going to offer an infant a pacifier, they should use one that has a one-piece construction with a flange large enough to keep it from completely entering the child's mouth.
In providing anticipatory guidance related to choking hazards for infants, what should the nurse include in the teaching? Select all that apply. 1. Shape sorter 2. Propping a bottle 3. Raw carrots 4. Plastic bags 5. Stuffed animals
- Propping a bottle - Raw carrots - Plastic bags The nurse should include teaching related to propping a bottle; foods that are choking hazards such as raw carrots, peanuts, hot dogs, and grapes; and plastic bags and balloons. Any toy or object that the infant can put in their mouth should be considered a choking hazard.
The postpartum nurse observes new mothers as they put their newborns in the bassinet to sleep. Which actions by the new mothers require further instruction from the nurse? Select all that apply. 1.A mother tells her husband to be sure to place the newborn on his back when putting the baby in the bassinet 2. A mother places her newborn on its side after falling asleep 3. A mother states all of her children like sleeping on their abdomen and this newborn likes it too 4.A mother places the baby comforter her grandmother made over the newborn's body 5. A mother states her baby looks too warm, so she is moving the bassinet in front of the air conditioner to cool him off
- A mother places her newborn on its side after falling asleep -A mother states all of her children like sleeping on their abdomen and this newborn likes it too -A mother places the baby comforter her grandmother made over the newborn's body -A mother states her baby looks too warm, so she is moving the bassinet in front of the air conditioner to cool him off Newborns and infants should be on their backs when sleeping in order to help prevent sudden infant death syndrome (SIDS). a firm mattress without pillows or comforters should also be used. The baby's bed should be placed away from air conditioner vents, open windows, and open heaters.
A nurse is administering a liquid oral medication to a 5-month-old. Which nursing action provides the correct dosage? Select all that apply. 1. Placing the end of the dropper or syringe at the back of the infant's mouth 2. Administering the medicine such that it flows slowly into the child's mouth 3. Viewing the medication in the medication cup at eye level 4. Gently restraining the child's arms and head 5. Placing the child supine on the examination table before giving the dose 6. Using a medicine dropper
- Administering the medicine such that it flows slowly into the child's mouth - Using a medicine dropper - Gently restraining the child's arms and head In infants, oral medication can be given with a medicine dropper or a unit dose syringe (without a needle). The nurse would not choose a medicine cup for administration. Never give medicine with the child lying completely flat; otherwise, a child could choke and aspirate. Instead, gently restrain the child's arms and head by holding the child against your body with the head raised. A crying child is already opening the mouth for you; otherwise, gently open the mouth by pressing on the child's chin. Press the bulb of the medicine dropper or use the plunger of the syringe so that the fluid flows slowly into the side of the child's mouth. Be certain the end of the syringe or dropper rests at the side of the infant's mouth to help prevent aspiration.
The nurse observes an infant interacting with his parents. What are normal social behavioral developments for this age group? Select all that apply. Answer, 1. Around 3 to 6 months of age the infant may enjoy socially interactive games such as patty-cake and peek-a-boo. 2.Around 2 months the infant exhibits a first real smile. 3.Around 3 months the infant smiles widely and gurgles when interacting with the caregiver. 4.Around 5 months the infant may develop "stranger anxiety." 5.Around 3 months the infant will mimic the parent's facial movements, such as sticking out the tongue. 6.Separation anxiety may also start in the last few months of infancy.
- Around 2 months the infant exhibits a first real smile. - Around 3 months the infant smiles widely and gurgles when interacting with the caregiver. - Around 3 months the infant will mimic the parent's facial movements, such as sticking out the tongue. - Separation anxiety may also start in the last few months of infancy. The infant exhibits a first real smile at age 2 months. By about 3 months of age the infant will start an interaction with a caregiver by smiling widely and possibly gurgling. The 3- to 4-month-old will also mimic the parent's facial movements, such as widening the eyes and sticking out the tongue. Separation anxiety may also start in the last few months of infancy. Around the age of 8 months the infant may develop stranger anxiety. At 6 to 8 months of age the infant may enjoy socially interactive games such as patty-cake and peek-a-boo.
Which statement(s) accurately describes the typical infant's achievement of milestones in gross motor skills? Select all that apply. Incorrect answer: 1. At 6 months, the infant pulls to stand up. 2. At 1 month, the infant lifts and turns the head to the side in the prone position. 3.At 9 months, the infant crawls with the abdomen off the floor 4. At 10 months, the infant walks independently 5. At 2 months, the infant rolls from supine to prone to back again. 6. At 7 months, the infant sits alone with some use of hands for support.
- At 1 month, the infant lifts and turns the head to the side in the prone position. - At 9 months, the infant crawls with the abdomen off the floor - At 7 months, the infant sits alone with some use of hands for support. At 1 month, the infant lifts and turns the head to the side in the prone position. At 4 months, the infant lifts the head and looks around. At 7 months, the infant sits alone with some use of hands for support. At 9 months, the infant crawls with the abdomen off the floor. At 10 months, the infant pulls to stand up. At 12 months, the infant stands independently and may take a few steps.
A 6-week-old infant is being assessed for vision acuity. What questions should the nurse ask the parents to ascertain adequate vision? Select all that apply. 1. Can the baby focus on a moving object 2. Does the baby follow you with their eyes? 3. Do the parents have any concerns? 4. Is there any drainage from the eyes? 5. Does the baby have any unusual eye movements?
- Can the baby focus on a moving object - Does the baby follow you with their eyes? - Do the parents have any concerns? Newborns should be able to focus on a moving object such as a finger and follow it to the midline. Infants see black and white better than they do colored objects. They seem to see objects that are at a distance of about 8 to 10 inches. The parents should be asked if their infant's eyes follow them as they move around the room. An infant older than 6 weeks should be able to return the parents' smiles. Parents should be asked if they have any reason to think their child has vision difficulty. Unusual eye movements and drainage from the eyes indicate there is a medical problem and not a visual problem.
The nurse is assessing the neurological status of a 10-month-old infant. Which findings does the nurse determine to be abnormal when performing this assessment? Select all that apply. 1. The infant reflexively grasps when the nurse touches the palm 2.With sudden extension of the infant's head, the arms abduct and move upward and the hands form a "C" 3. The infant demonstrates reflexive sucking when nipple or finger is placed in infant's mouth 4. The infant fans and extends the toes when the nurse strokes along the lateral aspect of the sole and across the plantar surface of the foot 5.The infant turns to the right side, searching with mouth, when the right side of the cheek is stroked
- With sudden extension of the infant's head, the arms abduct and move upward and the hands form a "C" .- The infant reflexively grasps when the nurse touches the palm - The infant demonstrates reflexive sucking when nipple or finger is placed in infant's mouth - The infant fans and extends the toes when the nurse strokes along the lateral aspect of the sole and across the plantar surface of the foot - The infant turns to the right side, searching with mouth, when the right side of the cheek is stroked The primitive reflexes (root, suck, palmar grasp, moro) should be absent by 10 months of age. The Babinski reflex persists until 12 months of age so the presence of this reflex would be considered a normal finding in the 10-month-old.
The nurse is explaining to a new graduate nurse about how to assess for pain in an infant. The nurse knows the teaching was effective when the graduate nurse identifies which symptom(s) as a sign of pain in an infant? Select all that apply. 1. high-pitched cry 2.quivering chin 3. clenched fists 4. Diffuse body movements 5. tears 6. inconsolability
- high-pitched cry - quivering chin - clenched fists - Diffuse body movements - tears - inconsolability Clues that an infant is in pain are diffuse body movements; tears; a high-pitched, harsh cry; a stiff posture; alterations in facial expression such as eyes squeezed shut; a quivering chin; lack of play; and fisting. Perhaps the chief mark in infants, however, is that when pain is present, they cannot be comforted completely.
The nurse is assessing the respiratory system of a newborn. Which anatomic differences place the infant at risk for respiratory compromise? Select all that apply. 1. The nasal passages are narrower. 2. The larynx is more funnel shaped. 3.The tongue is smaller. 4. The bronchi and bronchioles are shorter and wider. 5. The trachea and chest wall are less compliant.
1. The nasal passages are narrower. 2. The larynx is more funnel shaped. In comparison with the adult, in the infant, the nasal passages are narrower, the trachea and chest wall are more compliant, the bronchi and bronchioles are shorter and narrower, the larynx is more funnel shaped, and the tongue is larger in comparison. These anatomic differences place the infant at higher risk for respiratory compromise. The respiratory system does not reach adult levels of maturity until about 7 years of age.
