Deck 11: Health Problems of the Infant

Question 1

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

Answer 1

Associated with hereditary allergies

Question 2

At a well-child check-up, the nurse notes that an infant with a previous diagnosis of failure to thrive (FTT) is now steadily gaining weight. The nurse should recommend that fruit juice intake be limited to no more than how much?

A) 4 oz/day
B) 6 oz/day
C) 8 oz/day
D) 12 oz/day

Answer 2

4 oz/day

Question 3

What is marasmus?

A) Deficiency of protein with an adequate supply of calories
B) Syndrome that results solely from vitamin deficiencies
C) Not confined to geographic areas where food supplies are inadequate
D) Characterized by thin, wasted extremities and a prominent abdomen resulting from edema (ascites)

Answer 3

Not confined to geographic areas where food supplies are inadequate

Question 4

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 nurse's 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.

Question 5

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

Question 6

A new parent asks the nurse, "How can diaper rash be prevented?" What should the nurse recommend?

A) Wash the infant with soap before applying a thin layer of oil.
B) Clean the infant with soap and water every time diaper is changed.
C) Wipe stool from the skin using water and a mild cleanser.
D) When changing the diaper, wipe the buttocks with oil and powder the creases.

Question 7

The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for their children. Which is most likely lacking in their particular diet?

A) Fat
B) Protein
C) Vitamins C and A
D) Iron and calcium

Question 8

What may a clinical manifestations of failure to thrive (FTT) in a 13-month-old include?

A) Irregularity in activities of daily living
B) Preferring solid food to milk or formula
C) Weight that is at or below the 10th percentile
D) Appropriate achievement of developmental landmarks

Question 9

The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is often prone (face down) while awake. The nurse's response should be based on remembering what?

A) This is acceptable to encourage head control and turning over.
B) This is acceptable to encourage fine motor development.
C) This is unacceptable because of the risk of sudden infant death syndrome (SIDS).
D) This is unacceptable because it does not encourage achievement of developmental milestones.

Question 10

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.

Question 11

The nurse is examining an infant, age 10 months, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions. What is the most likely cause?

A) Impetigo
B) Urine and feces
C) Candida albicans infection
D) Infrequent diapering

Question 12

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

Question 13

After the introduction of the Back to Sleep campaign in 1992, an increased incidence has been noted of which pediatric issues?

A) Sudden infant death syndrome (SIDS)
B) Plagiocephaly
C) Failure to thrive
D) Apnea of infancy

Question 14

An infant has been diagnosed with an allergy to milk. In teaching the parent how to meet the infant's nutritional needs, the nurse states that

A) Most children will grow out of the allergy.
B) All dairy products must be eliminated from the child's 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.

Question 15

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) Cow's milk-based formula

Question 16

Where do eczematous lesions most commonly occur in an infant?

A) Abdomen, cheeks, and scalp
B) Buttocks, abdomen, and scalp
C) Back and flexor surfaces of the arms and legs
D) Cheeks and extensor surfaces of the arms and legs

Question 17

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 infant's 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.

Question 18

Which statement best describes colic?

A) Periods of abdominal pain resulting in weight loss
B) Usually the result of poor or inadequate mothering
C) Periods of abdominal pain and crying occurring in infants older than age 6 months
D) A paroxysmal abdominal pain or cramping manifested by episodes of loud crying

Question 19

Rickets is caused by a deficiency in what?

A) Vitamin A
B) Vitamin C
C) Folic acid and iron
D) Vitamin D and calcium

Question 20

A 1-year-old child is on a pure vegetarian (vegan) diet. This diet requires supplementation with what?

A) Niacin
B) Folic acid
C) Vitamins D and B12
D) Vitamins C and E

Question 21

The nurse is preparing to feed a 10-month-old child diagnosed with failure to thrive (FTT). Which actions should the nurse plan to implement? (Select all that apply.)

A) Be persistent.
B) Introduce new foods slowly.
C) Provide a stimulating atmosphere.
D) Maintain a calm, even temperament.
E) Feed the infant only when signs of hunger are exhibited.

Question 22

The nurse is teaching parents about potential causes of colic in infancy. Which should the nurse include in the teaching session? (Select all that apply.)

A) Overeating
B) Understimulation
C) Frequent burping
D) Parental smoking
E) Swallowing excessive air

Question 23

What is an important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS)?

A) Discourage the parents from making a last visit with the infant.
B) Make a follow-up home visit to the parents as soon as possible after the child's death.
C) Explain how SIDS could have been predicted and prevented.
D) Interview the parents in depth concerning the circumstances surrounding the child's death.

Question 24

The nurse is planning care for an infant with eczema. Which interventions should the nurse include in the care plan? (Select all that apply.)

A) Avoid giving the infant a bubble bath.
B) Avoid the use of a humidifier in the infant's room.
C) Avoid overdressing the infant.
D) Avoid the use of topical steroids on the infant's skin.
E) Avoid wet compresses on the infant's most affected areas.

Question 25

The community health nurse is reviewing risk factors for vitamin D deficiency. Which children are at high risk for vitamin D deficiency? (Select all that apply.)

A) Children with fair pigmentation
B) Children who are overweight or obese
C) Children who are exclusively bottle fed
D) Children with diets low in sources of vitamin D
E) Children of families who use milk products not supplemented with vitamin D

Question 26

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)

Question 27

The nurse is teaching parents about foods that are hyperallergenic. Which foods should the nurse include? (Select all that apply.)

A) Peanuts
B) Bananas
C) Potatoes
D) Egg noodles
E) Tomato juice

Question 28

A 12-month-old infant has been diagnosed with failure to thrive (FTT). Which assessment findings does the nurse expect to be documented with this infant? (Select all that apply.)

A) Fear of strangers
B) Minimal smiling
C) Avoidance of eye contact
D) Meeting developmental milestones
E) Wide-eyed gaze and continual scan of the environment

Question 29

A bottle-fed infant has been diagnosed with cow's milk allergy. Which formula should the nurse expect to be prescribed for the infant?

A) Similac
B) Pregestimil
C) Enfamil with iron
D) Gerber Good Start

Question 30

The nurse is teaching a parent with a 2-month-old infant who has been diagnosed with colic about ways to relieve colic. Which statement by the parent indicates the need for additional teaching?

A) "I should let my infant cry for at least 30 minutes before I respond."
B) "I will swaddle my infant tightly with a soft blanket."
C) "I should massage my infant's abdomen whenever possible."
D) "I will place my infant in an upright seat after feeding."

Question 31

A new parent relates to the nurse that the family has many known food allergies. Which is considered a primary strategy for feeding the infant with many family food allergies?

A) Using soy formula for feeding
B) Maternal avoidance of cow's milk protein
C) Exclusive breastfeeding for 4 to 6 months
D) Delaying the introduction of highly allergenic foods past 6 months

Question 32

The nurse is teaching parents guidelines for feeding their 8-month-old infant with failure to thrive (FTT). Which statement by the parents indicates a need for further teaching?

A) "We will continue to use the 24-kcal/oz formula."
B) "We will be sure to follow the formula preparation instructions."
C) "We will be sure to give our infant at least 8 oz of juice every day."
D) "We will be sure to feed our infant according to the written schedule."

Question 33

A parent brings a 12-month-old infant into the emergency department and tells the nurse that the infant is allergic to peanuts and was accidentally given a cookie with peanuts in it. The infant is dyspneic, wheezing, and cyanotic. The health care provider has prescribed a dose of epinephrine to be administered. The infant weighs 24 lb. How many milligrams of epinephrine should be administered?

A) 0.11 to 0.33 mg
B) 0.011 to 0.3 mg
C) 1.1 to 3.3 mg
D) 11 to 33 mg

Question 34

The nurse has administered a dose of epinephrine to a 12-month-old infant. For which adverse reactions of epinephrine should the nurse monitor? (Select all that apply.)

A) Nausea
B) Tremors
C) Irritability
D) Bradycardia
E) Hypotension

Question 35

The nurse is administering an oral antihistamine at bedtime to a child with atopic dermatitis (eczema). Which antihistamine should the nurse expect to be prescribed at bedtime?

A) Cetirizine (Zyrtec)
B) Loratadine (Claritin)
C) Fexofenadine (Allegra)
D) Diphenhydramine (Benadryl)

Question 36

What is an appropriate action when an infant becomes apneic?

A) Shake vigorously.
B) Roll the infant's 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.

Question 37

An infant has been diagnosed with failure to thrive (FTT) classified according to the pathophysiology of inadequate caloric intake. The nurse understands that the reason for the FTT is most likely related to what?

A) Cow's milk allergy
B) Congenital heart disease
C) Metabolic storage disease
D) Incorrect formula preparation

Question 38

The nurse is teaching parents about caring for their infant with seborrheic dermatitis (cradle cap). Which statement by the parents indicates understanding of the teaching?

A) "We will rinse off the shampoo quickly and dry the scalp thoroughly."
B) "We will shampoo the hair every other day with antiseborrheic shampoo."
C) "We will be sure to shampoo the hair without removing any of the crusts."
D) "We will use a fine-tooth comb to help remove the loosened crusts from the strands of hair."

Question 39

The nurse is collecting a stool sample from an infant with lactose intolerance. Which fecal pH should the nurse expect as the result?

A) 5.5
B) 7.0
C) 7.5
D) 8

Question 40

An infant has been diagnosed with failure to thrive (FTT) classified according to the pathophysiology of defective utilization. The nurse understands that the reason for the FTT is most likely related to what?

A) Cystic fibrosis
B) Hyperthyroidism
C) Congenital infection
D) Breastfeeding problems

Question 41

MATCHING
Match the following terms related to food sensitivities to the accurate descriptions.

A food elicits a reproducible adverse reaction but does not have an established immunologic mechanism

A)Food allergy
B)Food allergen
C)Food intolerance
D)Sensitization
E)Atopy

Question 42

A health care provider prescribes vitamin D supplements, 300 IU orally, daily. The medication label states: "Vitamin D 1000 IU/10 ml." The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer in a whole number.
________________

Question 43

The nurse is teaching parents strategies to manage their child's refusal to go to sleep. Which should the nurse include in the teaching session? (Select all that apply.)

A) Keep bedtime early.
B) Enforce consistent limits.
C) Use a reward system with the child.
D) Have a consistent before bedtime routine.

Question 44

MATCHING
Match the following terms related to food sensitivities to the accurate descriptions.

Allergy with a hereditary tendency

A)Food allergy
B)Food allergen
C)Food intolerance
D)Sensitization
E)Atopy

Question 45

MATCHING
Match the following terms related to food sensitivities to the accurate descriptions.

Specific components of food or ingredients in food that are recognized by allergen-specific immune cells eliciting an immune reaction

A)Food allergy
B)Food allergen
C)Food intolerance
D)Sensitization
E)Atopy

Question 46

A health care provider prescribes iron supplements (Fer-In-Sol), 1 mg/kg/day orally (PO). The infant weighs 5 kg. The medication label states: "Fer-In-Sol 25 mg/1 ml." The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer to one decimal place.
________________

Question 47

What are risk factors for sudden infant death syndrome? (Select all that apply.)

A) Postterm
B) Female gender
C) Low Apgar scores
D) Recent viral illness
E) Native American infants

Question 48

MATCHING
Match the following terms related to food sensitivities to the accurate descriptions.

Initial exposure to an allergen resulting in an immune response; subsequent exposure induces a much stronger response

A)Food allergy
B)Food allergen
C)Food intolerance
D)Sensitization
E)Atopy

Question 49

MATCHING
Match the following terms related to food sensitivities to the accurate descriptions.

An adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food

A)Food allergy
B)Food allergen
C)Food intolerance
D)Sensitization
E)Atopy

Question 50

A health care provider prescribes adrenaline (epinephrine), intramuscularly (IM) 0.15 mg, times one, stat. The medication label states: "Epinephrine 1:1000 1 mg/1 ml." The nurse prepares to administer the stat dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer using two decimal places.
________________