Chapter 10 - Health Problem of Infants

Question 1

Rickets is caused by a deficiency in what?

a. Vitamin A
b. Vitamin C
c. Folic acid and iron
d. Vitamin D and calcium

Answer 1

d. Vitamin D and calcium

Question 2

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

Answer 2

a. Milk

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 Ccontaining 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.

Question 3

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

Answer 3

d. Iron and calcium

Question 4

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

Answer 4

c. Vitamins D and B12

Question 5

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 5

c. Not confined to geographic areas where food supplies are inadequate

Question 6

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 6

a. 4 oz/day

Restrict juice intake in children with FTT until adequate weight gain has been achieved with appropriate milk sources; thereafter, give no more than 4 oz/day of juice

Question 7

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.

Answer 7

a. Most children will grow out of the allergy.

Question 8

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 milkbased formula

Answer 8

a. Yogurt

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 milkbased formula contain lactose, which will probably not be tolerated by the child. Fortified cereal does not have the nutritional equivalents of milk.

Question 9

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

Answer 9

d. Developmental lactase deficiency

Question 10

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

Answer 10

d. A paroxysmal abdominal pain or cramping manifested by episodes of loud crying

Question 11

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.

Answer 11

a. Encourage the parent to verbalize feelings.

Question 12

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

Answer 12

a. Irregularity in activities of daily living

One of the clinical manifestations of children with FTT is irregularity or low rhythmicity in activities of daily living. Children with FTT often refuse to switch from liquids to solid foods. Weight below the fifth percentile is indicative of FTT. Developmental delays, including social, motor, adaptive, and language, exist

Question 13

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.

Answer 13

b. Be persistent through 10 to 15 minutes of food refusal.

Question 14

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

Answer 14

c. Candida albicans infection

Question 15

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

Answer 15

c. Wipe stool from the skin using water and a mild cleanser.

Change the diaper as soon as it becomes soiled. Gently wipe stool from the skin with water and mild soap. The skin should be thoroughly dried after washing. Applying oil does not create an effective barrier. Over washing the skin should be avoided, especially with perfumed soaps or commercial wipes, which may be irritating. Baby powder should not be used because of the danger of aspiration.

Question 16

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 16

c. Associated with hereditary allergies

Question 17

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

Answer 17

d. Cheeks and extensor surfaces of the arms and legs

Question 18

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.

Answer 18

b. Keep the infants fingernails and toenails cut short and clean.

Question 19

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 nurses 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.

Answer 19

a. This is acceptable to encourage head control and turning over.

These parents are implementing the guidelines to reduce the risk of SIDS. Infants should sleep on their backs to reduce the risk of SIDS and then be placed on their abdomens when awake to enhance achievement of milestones such as head control. These position changes encourage gross motor, not fine motor, development

Question 20

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

Answer 20

b. Plagiocephaly

Plagiocephaly is a misshapen head caused by the prolonged pressure on one side of the skull. If that side becomes misshapen, facial asymmetry may result. SIDS has decreased by more than 40% with the introduction of the Back to Sleep campaign. Apnea of infancy and failure to thrive are unrelated to the Back to Sleep campaign.

Question 21

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)

Answer 21

d. Sudden infant death syndrome (SIDS)

Question 22

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 childs death.
c. Explain how SIDS could have been predicted and prevented.
d. Interview the parents in depth concerning the circumstances surrounding the childs death.

Answer 22

b. Make a follow-up home visit to the parents as soon as possible after the childs death.

A competent, qualified professional should visit the family at home as soon as possible after the death. Printed information about SIDS should be provided to the family. Parents should be allowed and encouraged to make a last visit with their child. SIDS cannot always be prevented or
predicted, but parents can take steps to reduce the risk (e.g., supine sleeping, removing blankets and pillows from the crib, and not smoking). Discussions about the cause only increase parental guilt. The parents should be asked only factual questions to determine the cause of death.

Question 23

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.

Answer 23

c. Gently stimulate the trunk by patting or rubbing.

Question 24

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

Answer 24

b. 0.011 to 0.3 mg

The correct dose of epinephrine to use in the emergency management of an anaphylactic reaction is 0.001 mg/kg up to a maximum of 0.3 mg, giving a range of 0.011 to 0.3 mg using a weight of 11 kg (24 lb).

Question 25

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 infants abdomen whenever possible.
d. I will place my infant in an upright seat after feeding.

Answer 25

a. I should let my infant cry for at least 30 minutes before I respond.

Because the infant has been diagnosed with colic, the parent should respond to the infant immediately or any type of interventions to relieve colic may not be effective. Also, the infant may develop a mistrust of the world if his or her needs are not met. The parent should swaddle the baby tightly with a soft blanket, massage the baby’s abdomen, and place the infant in an upright seat after a feeding to help relieve colic.