C
(birth weight doubles by age 5 months and triples by age 1 year
Growth is very rapid during the first year of life. The birth weight approximately doubles by age 5 to 6 months and triples by age 1 year. The anterior fontanel closes at age 12 to 18 month
Which statement best describes the infant's physical development?
a. Anterior fontanel closes by age 6 to 10 months.
b. Binocularity is well established by age 8 months.
c. Birth weight doubles by age 5 months and triples by age 1 year.
d. Maternal iron s
B
(15 pounds
Birth weight doubles at about age 5 to 6 months. At 6 months, an infant who weighed 7 pounds at birth would weigh approximately 15 pounds. Ten pounds is too little; the infant would have gone from the 50th percentile at birth to below the 5th
The nurse is assessing a 6-month-old healthy infant who weighed 7 pounds at birth. The nurse should expect the infant to now weigh approximately:
a. 10 pounds.
b. 15 pounds.
c. 20 pounds
d. 25 pounds.
A
(a normal finding
Because the anterior fontanel normally closes between ages 12 and 18 months, this is a normal finding, and no further intervention is required.)
The nurse is doing a routine assessment on a 14-month-old infant and notes that the anterior fontanel is closed. This should be interpreted as:
a. A normal finding.
b. A questionable finding�the infant should be rechecked in 1 month.
c. An abnormal findin
A
(normal development
This indicates normal development. Reflexive grasping occurs during the first 2 to 3 months and then gradually becomes voluntary. No evidence of developmental lag, delayed development, or neurologic dysfunction is present.)
A 3-month-old infant, born at 38 weeks of gestation, will hold a rattle if it is put in her hands; however, she will not voluntarily grasp it. The nurse should interpret this as:
a. Normal development.
b. Significant developmental lag.
c. Slightly delayed
A
(6 to 8 weeks
The bones surrounding the posterior fontanel fuse and close by age 6 to 8 weeks. Ten weeks or longer is too late.)
By what age does the posterior fontanel usually close?
a. 6 to 8 weeks
b. 10 to 12 weeks
c. 4 to 6 months
d. 8 to 10 months
C
(8 months
Sitting erect without support is a developmental milestone usually achieved by 8 months. At age 4 months, an infant can sit with support. At age 6 months, the infant will maintain a sitting position if propped. By 10 months, the infant can man
At which age can most infants sit steadily unsupported?
a. 4 months
b. 6 months
c. 8 months
d. 10 months
D
(this is normal because of the immaturity of digestive processes at this age.
The immaturity of the digestive tract is evident in the appearance of the stools. Solid foods are passed incompletely broken down in the feces. An excess quantity of fiber pre
The parents of a 9-month-old infant tell the nurse that they have noticed foods such as peas and corn are not completely digested and can be seen in their infant's stool. The nurse bases her explanation on knowing that:
a. Children should not be given fib
A
(transfer objects from one hand to the other
By age 7 months, infants can transfer objects from one hand to the other, crossing the midline. The crude pincer grasp is apparent at about age 9 months. The infant can scribble spontaneously at age 15 months
In terms of fine motor development, the infant of 7 months should be able to:
a. Transfer objects from one hand to the other.
b. Use thumb and index finger in a crude pincer grasp.
c. Hold a crayon and make a mark on paper.
d. Release cubes into a cup.
C
(actively searches for a hidden object
During the first 6 months of life, infants believe that objects exist only as long as they can see them. When infants search for an object that is out of sight, this signals the attainment of object permanence, whe
Which behavior indicates that an infant has developed object permanence?
a. Recognizes familiar face such as the mother
b. Recognizes familiar object such as a bottle
c. Actively searches for a hidden object
d. Secures objects by pulling on a string
A
(roll from abdomen to back
Rolling from abdomen to back is developmentally appropriate for a 5-month-old infant. The ability to roll from back to abdomen usually occurs at 6 months old. Sitting erect without support is a developmental milestone usually
In terms of gross motor development, what would the nurse expect a 5-month-old infant to do?
a. Roll from abdomen to back.
b. Roll from back to abdomen.
c. sit erect without support
d. Move from prone to sitting position.
C
(9 months
Most infants can pull themselves to a standing position at age 9 months. Any infant who cannot pull to a standing position by age 11 to 12 months should be referred for further evaluation for developmental dysplasia of the hip. At 6 months, th
By what age should the nurse expect that an infant will be able to pull to a standing position?
a. 6 months
b. 8 months
c. 9 moths
d. 11 to 12 months
A
(infants' temperaments are part of their unique characteristics
Infant temperament has a strong biologic component. Together with interactions with the environment, primarily the family, the biologic component contributes to the infant's unique temperam
Sara, age 4 months, was born at 35 weeks' gestation. She seems to be developing normally, but her parents are concerned because she is a "more difficult" baby than their other child, who was term. The nurse should explain that:
a. Infants' temperaments ar
C
(secondary circular reactions
Infants are usually in the secondary circular reaction stage from age 4 months to 8 months. This stage is characterized by a continuation of the primary circular reaction for the response that results. For example, shaking
According to Piaget, the 6-month-old infant would be in what stage of the sensorimotor phase?
a. Use of reflexes
b. Primary circular reactions
c. Secondary circular reactions
d. Coordination of secondary schemata
C
(6 months
Between ages 6 and 8 months, fear of strangers and stranger anxiety become prominent and are related to the infant's ability to discriminate between familiar and nonfamiliar people. At age 2 months, the infant is just beginning to respond diff
A parent asks the nurse "At what age do most babies begin to fear strangers?" The nurse responds that most infants begin to fear strangers at age:
a. 2 months.
b. 4 months.
c. 6 months
d. 12 months.
A
(playing peek-a-boo
Because object permanence is a new achievement, peek-a-boo is an excellent activity to practice this new skill for visual stimulation. Playing pat-a-cake and showing how to clap hands will help with kinesthetic stimulation. Imitating
An appropriate play activity for a 7-month-old infant to encourage visual stimulation is:
a. Playing peek-a-boo.
b. Playing pat-a-cake.
c. Imitating animal sounds
d. Showing how to clap hands.
A
(is old enough to understand the word "No."
By age 10 months, children are able to associate meaning with words. The child should be old enough to understand the word "No." The 10-month-old is too young to understand the purpose of an electrical outlet.
The nurse is interviewing the father of 10-month-old Megan. She is playing on the floor when she notices an electrical outlet and reaches up to touch it. Her father says "No" firmly and removes her from near the outlet. The nurse should use this opportuni
A
(Give large push-pull toys for kinesthetic stimulation
The 12-month-old child is able to pull to a stand and walk holding on or independently. Appropriate toys for a child of this age include large push-pull toys for kinesthetic stimulation. A cradle gy
Which information could be given to the parents of a 12-month-old child regarding appropriate play activities for this age?
a. Give large push-pull toys for kinesthetic stimulation.
b. Place cradle gym across crib to facilitate fine motor skills.
c. Provi
C
(reassure the mother that this is very normal at this age
Sucking is an infant's chief pleasure, and she may not be satisfied by bottle-feeding or breastfeeding alone. During infancy and early childhood, there is no need to restrict nonnutritive sucking
Latasha is a breastfed infant being seen in the clinic for her 6-month checkup. Her mother tells the nurse that Latasha recently began to suck her thumb. The best nursing intervention is to:
a. Recommend that the mother substitute a pacifier for Latasha's
A
(Allow to splash in bath
The feel of the water while the infant is splashing provides tactile stimulation. Various colored blocks provide visual stimulation for a 4- to 6-month-old infant. A music box, tapes, and CDs provide auditory stimulation. Swings
The best play activity to provide tactile stimulation for a 6-month-old infant is to:
a. Allow to splash in bath.
b. Give various colored blocks.
c. play music box, tapes, or CDs
d. Use infant swing or stroller.
B
(2 months
At age 2 months, the infant has a social, responsive smile. A reflex smile is usually present at age 1 month. The 3-month-old can recognize familiar faces. At age 4 months, the infant can enjoy social interactions.)
At what age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?
a. 1 month
b. 2 months
c. 3 months
d. 4 months
D
(Earlier-than-normal tooth eruption
This is earlier than expected. Most infants at age 6 months have two teeth. Six teeth at 6 months is not delayed; it is early tooth eruption. Although unusual, it is not dangerous.)
Austin, age 6 months, has six teeth. The nurse should recognize that this is:
a. Normal tooth eruption.
b. Delayed tooth eruption.
c. Unusual and dangerous
d. Earlier-than-normal tooth eruption.
C
(commercial iron-fortified formula
For children younger than 1 year, the American Academy of Pediatrics recommends the use of breast milk. If breastfeeding has been discontinued, iron-fortified commercial formula should be used. Cow's milk should not be
A mother tells the nurse that she is discontinuing breastfeeding her 5-month-old infant. The nurse should recommend that the infant be given:
a. Skim milk.
b. Whole cow's milk.
c. Commercial iron-fortified formula
d. Commercial formula without iron.
A
(soft and flexible shoes are generally better
The main purpose of the shoe is protection. Soft, well-constructed, athletic-type shoes are best for infants and children. High-top shoes are not necessary for support but may be helpful keeping the child's
The nurse notices that a 10-month-old infant being seen in the clinic is wearing expensive, inflexible, high-top shoes. The nurse should explain that:
a. Soft and flexible shoes are generally better.
b. High-top shoes are necessary for support.
c. Inflexi
B
(4 to 6 months
Physiologically and developmentally, the 4- to 6-month-old is in a transition period. The extrusion reflex has disappeared, and swallowing is a more coordinated process. In addition, the gastrointestinal tract has matured sufficiently to
When is the best age for solid food to be introduced into the infant's diet?
a. 2 to 3 months
b. 4 to 6 months
c. when birth weight has tripled
d. When tooth eruption has started
A
(Never heating a bottle in a microwave oven.
Neither infant formula nor breast milk should be warmed in a microwave oven as this may cause oral burns as a result of uneven heating in the container. The bottle may remain cool while hot spots develop in t
The parents of a 4-month-old infant tell the nurse that they are getting a microwave oven and will be able to heat the baby's formula faster. The nurse should recommend:
a. Never heating a bottle in a microwave oven.
b. Heating only 10 ounces or more.
c.
D
(A topical anesthetic, eutectic mixture of local anesthetic (EMLA), can be applied before injections are given.
Several topical anesthetic agents can be used to minimize the discomfort associated with immunization injections. These include EMLA and vapo
A mother tells the nurse that she doesn't want her infant immunized because of the discomfort associated with injections. The nurse should explain that:
a. This cannot be prevented.
b. Infants do not feel pain as adults do.
c. This is not a good reason fo
D
(This is a common and accepted practice, especially in some cultural groups.
Co-sleeping or sharing the family bed, in which the parents allow the children to sleep with them, is a common and accepted practice in many cultures. Parents should evaluate t
Parents tell the nurse that their 1-year-old son often sleeps with them. They seem unconcerned about this. The nurse's response should be based on the knowledge that:
a. Children should not sleep with their parents.
b. Separation from parents should be co
D
(Hot dogs must be cut into small, irregular pieces to prevent aspiration.
Hot dogs are of a consistency, diameter, and round shape that may cause complete obstruction of the child's airway. If given to young children, the hot dog should be cut into smal
The parents of a 12-month-old child ask the nurse if the child can eat hot dogs. The nurse's reply should be based on knowing that:
a. The child is too young to digest hot dogs.
b. The child is too young to eat hot dogs safely.
c. Hot dogs must be sliced
C
("She may need to begin taking them at age 6 months."
Fluoride supplementation is recommended by the American Academy of Pediatrics beginning at age 6 months if the child is not drinking adequate amounts of fluoridated water. The recommendation is to be
The parent of 2-week-old Sarah asks the nurse if Sarah needs fluoride supplements because she is exclusively breastfed. The nurse's best response is:
a. "She needs to begin taking them now."
b. "They are not needed if you drink fluoridated water."
c. "She
B
(Rear facing in back seat
The rear-facing car seat provides the best protection for an infant's disproportionately heavy head and weak neck. Infants should face the rear from birth to 20 pounds and as close to 1 year of age as possible. The middle of th
The clinic is lending a federally approved car seat to an infant's family. The nurse should explain that the safest place to put the car seat is:
a. Front facing in back seat.
b. Rear facing in back seat.
c. Front facing in front seat if an air bag is on
C
(Changing the infant's position frequently.
Changing the infant's position frequently may be beneficial. The parent can walk holding the infant face down and with the infant's chest across the parent's arm. The parent's hand can support the infant's abd
Parent guidelines for relieving colic in an infant include:
a. Avoiding touching the abdomen.
b. Avoiding using a pacifier.
c. Changing the infant's position frequently.
d. Placing the infant where the family cannot hear the crying.
A
(Encourage parent to verbalize feelings.
Colic is multifactorial, and no single treatment is effective for all infants. The parent is verbalizing concern and worry. The nurse should allow the parent to put these feelings into words. An empathic, gentle,
A parent of an infant with colic tells the nurse, "All this baby does is scream at me; it is a constant worry." The nurse's best action is:
a. Encourage parent to verbalize feelings.
b. Encourage parent not to worry so much.
c. Assess parent for other sig
B
(Eliminate all secondhand smoke contact.
To prevent and treat colic, teach parents that if household members smoke, they should avoid smoking near the infant; smoking activity should preferably be confined to outside of the home. A pacifier can be intro
A nurse is teaching parents about prevention and treatment of colic. Which should the nurse include in the teaching plan?
a. Avoid use of pacifiers.
b. Eliminate all secondhand smoke contact.
c. Lay infant flat after feeding.
d. Avoid swaddling the infant
D
(Make a follow-up home visit to parents as soon as possible after the infant's death.
A competent, qualified professional should visit the family at home as soon as possible after the death and provide the family with printed information about SIDS. An
An important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS) is to:
a. Explain how SIDS could have been predicted and prevented.
b. Interview parents in depth concerning the cir
A
(Avoidance of eye contact.
One of the clinical manifestations of nonorganic failure to thrive is the child's avoidance of eye contact with the health professional. A malabsorption defect would result in a physiologic problem, not behavioral. Weight (but
Clinical manifestations of failure to thrive caused by behavioral problems resulting in inadequate intake of calories include:
a. Avoidance of eye contact.
b. An associated malabsorption defect.
c. Weight that falls below the 15th percentile.
d. Normal ac
A
(Establish a structured routine and follow it consistently.
The infant with failure to thrive should have a structured routine that is followed consistently. Disruptions in other activities of daily living can have a great impact on feeding behaviors. B
Which is an important nursing consideration when caring for an infant with failure to thrive?
a. Establish a structured routine and follow it consistently.
b. Maintain a nondistracting environment by not speaking to the infant during feeding.
c. Place the
D
(Gently stimulate trunk by patting or rubbing.
If the infant is apneic, the infant's trunk should be gently stimulated by patting or rubbing. If the infant is prone, turn onto the back. The infant should not be shaken vigorously, have the head rolled si
Which is the most appropriate action when an infant becomes apneic?
a. Shake vigorously.
b. Roll head side to side.
c. Hold by feet upside down with head supported.
d. Gently stimulate trunk by patting or rubbing.
A
(Place the infant prone for 30 to 60 minutes per day.
Prevention of positional plagiocephaly may begin shortly after birth by implementing prone positioning or "tummy time" for approximately 30 to 60 minutes per day when the infant is awake. Soft mattre
With the goal of preventing plagiocephaly, the nurse should teach new parents to:
a. Place the infant prone for 30 to 60 minutes per day.
b. Buy a soft mattress.
c. Allow the infant to nap in the car safety seat.
d. Have the infant sleep with the parents.
D
(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 and then be placed on their abdomens when awake to enhance development of milestones su
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 knowledge that this is:
a. Unacceptable because of the risk of sudden infant death syn
C
("What time did you find the infant?"
During a SIDS incident, if the infant is not pronounced dead at the scene, he or she may be transported to the emergency department to be pronounced dead by a physician. While they are in the emergency department, t
An infant has been pronounced dead from sudden infant death syndrome (SIDS) in the emergency department. Which is an appropriate question to ask the parents?
a. "Did you hear the infant cry out?"
b. "Why didn't you check on the infant earlier?"
c. "What t
A, C , E
(A. "We will put a plastic fillers in all electrical plugs."
C. "we will place a gate at the top and bottom of stairways."
E. "we will remove front knobs from the stove."
By the time babies reach 6 months of age, they begin to become much more ac
A nurse has completed a teaching session for parents about "baby-proofing" the home. Which statements made by the parents indicate an understanding of the teaching (select all that apply)?
a. "We will put plastic fillers in all electrical plugs."
b. "We w
C
("we will check the monitor several times a day to be sure the alarm is working."
The parents should check the monitor several times a day to be sure the alarm is working and that it can be heard from room to room. The parents should not adjust the moni
An infant experienced an apparent life-threatening event and is being placed on home apnea monitoring. The parents have understood the instructions for use of a home apnea monitor when they state:
a. "We can adjust the monitor to eliminate false alarms.
C
(12 months
The American Academy of Pediatrics does not recommend the use of cow's milk for children younger than 12 months. At 6 and 9 months, the infant should be receiving commercial infant formula or breast milk. At age 18 months, milk and formula ar
The nurse should teach parents that which age is safe to give infants whole milk instead of commercial infant formula?
a. 6 months
b. 9 months
c. 12 months
d. 18 months
B, C, E, F
(B. Rotavirus (RV)
C. Diptheria, tetanus, and acellular pertussis (DTaP)
E. Haemophilus influenzae type b (HIB)
F. Inactivated poliovirus (IPV)
The recommended immunization schedule for a 4-month-old, up to date on immunizations, would be to ad
A nurse is preparing to administer routine immunizations to a 4-month-old infant. The infant is currently up to date on all previously recommended immunizations. Which immunizations will the nurse prepare to administer (select all that apply)?
a. Measles,
D
(The acellular pertussis vaccine is recommended by the American Academy of Pediatrics beginning at age 6 weeks. Infants are at greater risk for complications of pertussis. The vaccine is not given after age 7 years, when the risks of the vaccine become
A parent asks the nurse whether her infant is susceptible to pertussis. The nurse's response should be based on which statement concerning susceptibility to pertussis?
a. Neonates will be immune the first few months.
b. If the mother has had the disease,
A, C, E
(An important aspect of compassionate care for parents experiencing a SIDS incident is allowing them to say good-bye to their infant. These are the parents' last moments with their infant, and they should be as quiet, meaningful, peaceful, and und
Which interventions should the nurse implement when caring for a family of a sudden infant death syndrome (SIDS) infant (select all that apply)?
a. Allow parents to say goodbye to their infant.
b. Once parents leave the hospital, no further follow-up is r
A, B, E
(A good pacifier should be easily grasped by the infant. One-piece construction is necessary to avoid having the nipple and guard separate. The material should be sturdy and flexible. An attached ribbon or string and soft, pliable material are not
Pacifiers can be extremely dangerous because of the frequency of use and the intensity of the infant's suck. In teaching parents about appropriate pacifier selection, the nurse should explain that a pacifier should have which characteristics (select all t
B, C, E
(Certain groups of infants are at increased risk for SIDS: those with low birth weight, low Apgar scores, or recent viral illness, and those of male sex. Breastfed infants and infants of average or above-average weight are not at higher risk for S
A nurse is conducting education classes for parents of infants. The nurse plans to discuss sudden infant death syndrome (SIDS). Which risk factors should the nurse include as increasing an infant's risk of a SIDS incident (select all that apply)?
a. Breas
A, B
(Rolling from abdomen to back and placing the feet in the mouth when supine are developmentally appropriate for a 5-month-old infant. Rolling from back to abdomen is developmentally appropriate for a 6-month-old infant. An 8-month-old infant should b
In terms of gross motor development, what would the nurse expect a 5-month-old infant to do (select all that apply)?
a. Roll from abdomen to back.
b. Put feet in mouth when supine.
c. Roll from back to abdomen.
d. Sit erect without support.
e. Move from p
D
(Able to grasp object voluntarily.)
The nurse expects which characteristic of fine motor skills in a 5-month-old infant?
A. Strong grasp reflex
B. Neat pincer grasp
C. Able to build a tower of two cubes
D. Able to grasp object voluntarily
C
(developmental/neurologic evaluation is needed.)
The nurse is assessing a 6-month-old infant who smiles, coos, and has a strong head lag. The nurse should recognize that:
A. this assessment is normal.
B. the child is probably cognitively impaired.
C. developmental/neurologic evaluation is needed.
D. the
A
(trust.)
The nurse educator instructs a nursing student that according to Erikson, infancy is concerned with acquiring a sense of:
A. trust.
B. industry.
C. initiative.
D. separation.
B
(this is a normal reaction for this age.)
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:
A. the infant is most likely spoiled.
B. this is a normal reaction for
C
(10 months)
At what age would the nurse advise parents to expect their infant to be able to say "mama" and "dada" with meaning?
A. 4 months
B. 6 months
C. 10 months
D. 14 months
D
(There is no need to restrain nonnutritive sucking during infancy.)
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. A pacifier should be substituted for the thumb.
B. Thumb-sucking should be discouraged by age 12 months.
C. Thumb
C
(give child a frozen teething ring to relieve inflammation.)
The MOST appropriate recommendation for relief of teething pain is to instruct the parents to:
A. rub gums with aspirin to relieve inflammation.
B. apply hydrogen peroxide to gums to relieve irritation.
C. give child a frozen teething ring to relieve infl
A
(fluids in addition to breast milk are not needed.)
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:
A. fluids in addition to breast milk are not needed.
B. water should be given if the infant seems to nurse lon
D
("Feeding himself will help foster his growth and development. Perhaps we can discuss ways to make the messes more tolerable.")
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 can't let him feed himself; he makes too much of a mess." The nurse's BEST response is:
A. "It's important not to give in to this kind o
B
(Beginning to put her to bed while still awake)
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
C
("When your baby learns to roll over, you must supervise him whenever he is on a surface from which he might fall.")
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?
A. "Never shake baby powder directly on your infant because it can be aspirated into his lungs.
C
(Those using yogurt as primary source of milk.)
The nurse in the pediatric clinic identifies which infants at risk for developing vitamin D-deficient rickets?
A. Lacto-ovo vegetarians
B. Those who are breastfed exclusively
C. Those using yogurt as primary source of milk
D. Those exposed to daily sunlig
D
(casein hydrolysate milk formula.)
A 3-month-old bottle-fed infant is allergic to cow's milk. The nurse's BEST option for a substitute is:
A. goat's milk.
B. soy-based formula.
C. skim milk diluted with water.
D. casein hydrolysate milk formula.
B
(take a thorough, detailed history of usual daily events.)
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 initial action is to:
A. advise the mother to follow a milk-free diet for 3 to 5 days.
B. take a thorou
C
(Being persistent through 10 to 15 minutes of food refusal)
Which strategy might be recommended for an infant with failure-to-thrive to increase caloric intake?
A. Using developmental stimulation by a specialist during feedings
B. Avoiding solids until after the bottle is well accepted
C. Being persistent through
D
(sudden infant death syndrome (SIDS).)
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 o
A
(Cardiopulmonary resuscitation (CPR))
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?
A. Cardio
B
(Vitamin D)
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
C
(kwashiorkor.)
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:
A. rickets.
B. ma
D
(Semiformed, seedy, yellow)
A nurse is caring for a 2-month-old exclusively breastfed infant with an admitting diagnosis of colic. Based on the nurse's knowledge of breastfed infants, what type of stool is expected?
A. Dark brown and small hard pebbles
B. Loose with green mucus stre
D
(Peanut butter)
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
A, C, D, E
(A. "I only smoke in the kitchen."
C. "I have my baby sleep with me instead of alone in the crib."
D. "I make sure my baby wears a flannel sleeper and has two blankets to keep warm in her crib."
E. "I always leave my baby's favorite stuffed bun
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.)
A. "I only smoke in the kitchen."
B. "I put my baby to sleep on her back
A, B, C, E
(A. initiate an immunization record.
B. confirm the hepatitis B status of the newborn's mother.
C. obtain a syringe with a 25-gauge, 5/8-inch needle.
E. confirm that the newborn's mother has signed the informed consent.)
When preparing to administer Hepatitis B vaccine to a newborn, the nurse should: (Select all that apply.)
A. initiate an immunization record.
B. confirm the hepatitis B status of the newborn's mother.
C. obtain a syringe with a 25-gauge, 5/8-inch needle.
B, C, D
(B. who sleep prone
C. who were premature
D. with prenatal drug exposure)
Infants most at risk for sudden infant death syndrome (SIDS) are those: (Select all that apply.)
A. who sleep supine
B. who sleep prone
C. who were premature
D. with prenatal drug exposure
E. with a cousin that died of SIDS
B, E
(B. Place iron toward the back side of the mouth with a dropper.
E. Apply barrier ointment if needed to buttocks.)
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.)
A. Administer iron with meals.
B. Place iron toward the back side of the mouth with a dropper
A, B, C, D, E
(A. allow for catch-up growth.
B. correct nutritional deficiencies.
C. achieve ideal weight for height.
D. restore optimum body composition.
E. educate the parents or primary caregivers on child's nutritional requirements.)
The primary goals in the nutritional management of children with failure to thrive (FTT) are: (Select all that apply.)
A. allow for catch-up growth.
B. correct nutritional deficiencies.
C. achieve ideal weight for height.
D. restore optimum body compositi
C
(birth weight doubles by age 5 months and triples by age 1 year
Growth is very rapid during the first year of life. The birth weight approximately doubles by age 5 to 6 months and triples by age 1 year. The anterior fontanel closes at age 12 to 18 month
Which statement best describes the infant's physical development?
a. Anterior fontanel closes by age 6 to 10 months.
b. Binocularity is well established by age 8 months.
c. Birth weight doubles by age 5 months and triples by age 1 year.
d. Maternal iron s
B
(15 pounds
Birth weight doubles at about age 5 to 6 months. At 6 months, an infant who weighed 7 pounds at birth would weigh approximately 15 pounds. Ten pounds is too little; the infant would have gone from the 50th percentile at birth to below the 5th
The nurse is assessing a 6-month-old healthy infant who weighed 7 pounds at birth. The nurse should expect the infant to now weigh approximately:
a. 10 pounds.
b. 15 pounds.
c. 20 pounds
d. 25 pounds.
A
(a normal finding
Because the anterior fontanel normally closes between ages 12 and 18 months, this is a normal finding, and no further intervention is required.)
The nurse is doing a routine assessment on a 14-month-old infant and notes that the anterior fontanel is closed. This should be interpreted as:
a. A normal finding.
b. A questionable finding�the infant should be rechecked in 1 month.
c. An abnormal findin
A
(normal development
This indicates normal development. Reflexive grasping occurs during the first 2 to 3 months and then gradually becomes voluntary. No evidence of developmental lag, delayed development, or neurologic dysfunction is present.)
A 3-month-old infant, born at 38 weeks of gestation, will hold a rattle if it is put in her hands; however, she will not voluntarily grasp it. The nurse should interpret this as:
a. Normal development.
b. Significant developmental lag.
c. Slightly delayed
A
(6 to 8 weeks
The bones surrounding the posterior fontanel fuse and close by age 6 to 8 weeks. Ten weeks or longer is too late.)
By what age does the posterior fontanel usually close?
a. 6 to 8 weeks
b. 10 to 12 weeks
c. 4 to 6 months
d. 8 to 10 months
C
(8 months
Sitting erect without support is a developmental milestone usually achieved by 8 months. At age 4 months, an infant can sit with support. At age 6 months, the infant will maintain a sitting position if propped. By 10 months, the infant can man
At which age can most infants sit steadily unsupported?
a. 4 months
b. 6 months
c. 8 months
d. 10 months
D
(this is normal because of the immaturity of digestive processes at this age.
The immaturity of the digestive tract is evident in the appearance of the stools. Solid foods are passed incompletely broken down in the feces. An excess quantity of fiber pre
The parents of a 9-month-old infant tell the nurse that they have noticed foods such as peas and corn are not completely digested and can be seen in their infant's stool. The nurse bases her explanation on knowing that:
a. Children should not be given fib
A
(transfer objects from one hand to the other
By age 7 months, infants can transfer objects from one hand to the other, crossing the midline. The crude pincer grasp is apparent at about age 9 months. The infant can scribble spontaneously at age 15 months
In terms of fine motor development, the infant of 7 months should be able to:
a. Transfer objects from one hand to the other.
b. Use thumb and index finger in a crude pincer grasp.
c. Hold a crayon and make a mark on paper.
d. Release cubes into a cup.
C
(actively searches for a hidden object
During the first 6 months of life, infants believe that objects exist only as long as they can see them. When infants search for an object that is out of sight, this signals the attainment of object permanence, whe
Which behavior indicates that an infant has developed object permanence?
a. Recognizes familiar face such as the mother
b. Recognizes familiar object such as a bottle
c. Actively searches for a hidden object
d. Secures objects by pulling on a string
A
(roll from abdomen to back
Rolling from abdomen to back is developmentally appropriate for a 5-month-old infant. The ability to roll from back to abdomen usually occurs at 6 months old. Sitting erect without support is a developmental milestone usually
In terms of gross motor development, what would the nurse expect a 5-month-old infant to do?
a. Roll from abdomen to back.
b. Roll from back to abdomen.
c. sit erect without support
d. Move from prone to sitting position.
C
(9 months
Most infants can pull themselves to a standing position at age 9 months. Any infant who cannot pull to a standing position by age 11 to 12 months should be referred for further evaluation for developmental dysplasia of the hip. At 6 months, th
By what age should the nurse expect that an infant will be able to pull to a standing position?
a. 6 months
b. 8 months
c. 9 moths
d. 11 to 12 months
A
(infants' temperaments are part of their unique characteristics
Infant temperament has a strong biologic component. Together with interactions with the environment, primarily the family, the biologic component contributes to the infant's unique temperam
Sara, age 4 months, was born at 35 weeks' gestation. She seems to be developing normally, but her parents are concerned because she is a "more difficult" baby than their other child, who was term. The nurse should explain that:
a. Infants' temperaments ar
C
(secondary circular reactions
Infants are usually in the secondary circular reaction stage from age 4 months to 8 months. This stage is characterized by a continuation of the primary circular reaction for the response that results. For example, shaking
According to Piaget, the 6-month-old infant would be in what stage of the sensorimotor phase?
a. Use of reflexes
b. Primary circular reactions
c. Secondary circular reactions
d. Coordination of secondary schemata
C
(6 months
Between ages 6 and 8 months, fear of strangers and stranger anxiety become prominent and are related to the infant's ability to discriminate between familiar and nonfamiliar people. At age 2 months, the infant is just beginning to respond diff
A parent asks the nurse "At what age do most babies begin to fear strangers?" The nurse responds that most infants begin to fear strangers at age:
a. 2 months.
b. 4 months.
c. 6 months
d. 12 months.
A
(playing peek-a-boo
Because object permanence is a new achievement, peek-a-boo is an excellent activity to practice this new skill for visual stimulation. Playing pat-a-cake and showing how to clap hands will help with kinesthetic stimulation. Imitating
An appropriate play activity for a 7-month-old infant to encourage visual stimulation is:
a. Playing peek-a-boo.
b. Playing pat-a-cake.
c. Imitating animal sounds
d. Showing how to clap hands.
A
(is old enough to understand the word "No."
By age 10 months, children are able to associate meaning with words. The child should be old enough to understand the word "No." The 10-month-old is too young to understand the purpose of an electrical outlet.
The nurse is interviewing the father of 10-month-old Megan. She is playing on the floor when she notices an electrical outlet and reaches up to touch it. Her father says "No" firmly and removes her from near the outlet. The nurse should use this opportuni
A
(Give large push-pull toys for kinesthetic stimulation
The 12-month-old child is able to pull to a stand and walk holding on or independently. Appropriate toys for a child of this age include large push-pull toys for kinesthetic stimulation. A cradle gy
Which information could be given to the parents of a 12-month-old child regarding appropriate play activities for this age?
a. Give large push-pull toys for kinesthetic stimulation.
b. Place cradle gym across crib to facilitate fine motor skills.
c. Provi
C
(reassure the mother that this is very normal at this age
Sucking is an infant's chief pleasure, and she may not be satisfied by bottle-feeding or breastfeeding alone. During infancy and early childhood, there is no need to restrict nonnutritive sucking
Latasha is a breastfed infant being seen in the clinic for her 6-month checkup. Her mother tells the nurse that Latasha recently began to suck her thumb. The best nursing intervention is to:
a. Recommend that the mother substitute a pacifier for Latasha's
A
(Allow to splash in bath
The feel of the water while the infant is splashing provides tactile stimulation. Various colored blocks provide visual stimulation for a 4- to 6-month-old infant. A music box, tapes, and CDs provide auditory stimulation. Swings
The best play activity to provide tactile stimulation for a 6-month-old infant is to:
a. Allow to splash in bath.
b. Give various colored blocks.
c. play music box, tapes, or CDs
d. Use infant swing or stroller.
B
(2 months
At age 2 months, the infant has a social, responsive smile. A reflex smile is usually present at age 1 month. The 3-month-old can recognize familiar faces. At age 4 months, the infant can enjoy social interactions.)
At what age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?
a. 1 month
b. 2 months
c. 3 months
d. 4 months
D
(Earlier-than-normal tooth eruption
This is earlier than expected. Most infants at age 6 months have two teeth. Six teeth at 6 months is not delayed; it is early tooth eruption. Although unusual, it is not dangerous.)
Austin, age 6 months, has six teeth. The nurse should recognize that this is:
a. Normal tooth eruption.
b. Delayed tooth eruption.
c. Unusual and dangerous
d. Earlier-than-normal tooth eruption.
C
(commercial iron-fortified formula
For children younger than 1 year, the American Academy of Pediatrics recommends the use of breast milk. If breastfeeding has been discontinued, iron-fortified commercial formula should be used. Cow's milk should not be
A mother tells the nurse that she is discontinuing breastfeeding her 5-month-old infant. The nurse should recommend that the infant be given:
a. Skim milk.
b. Whole cow's milk.
c. Commercial iron-fortified formula
d. Commercial formula without iron.
A
(soft and flexible shoes are generally better
The main purpose of the shoe is protection. Soft, well-constructed, athletic-type shoes are best for infants and children. High-top shoes are not necessary for support but may be helpful keeping the child's
The nurse notices that a 10-month-old infant being seen in the clinic is wearing expensive, inflexible, high-top shoes. The nurse should explain that:
a. Soft and flexible shoes are generally better.
b. High-top shoes are necessary for support.
c. Inflexi
B
(4 to 6 months
Physiologically and developmentally, the 4- to 6-month-old is in a transition period. The extrusion reflex has disappeared, and swallowing is a more coordinated process. In addition, the gastrointestinal tract has matured sufficiently to
When is the best age for solid food to be introduced into the infant's diet?
a. 2 to 3 months
b. 4 to 6 months
c. when birth weight has tripled
d. When tooth eruption has started
A
(Never heating a bottle in a microwave oven.
Neither infant formula nor breast milk should be warmed in a microwave oven as this may cause oral burns as a result of uneven heating in the container. The bottle may remain cool while hot spots develop in t
The parents of a 4-month-old infant tell the nurse that they are getting a microwave oven and will be able to heat the baby's formula faster. The nurse should recommend:
a. Never heating a bottle in a microwave oven.
b. Heating only 10 ounces or more.
c.
D
(A topical anesthetic, eutectic mixture of local anesthetic (EMLA), can be applied before injections are given.
Several topical anesthetic agents can be used to minimize the discomfort associated with immunization injections. These include EMLA and vapo
A mother tells the nurse that she doesn't want her infant immunized because of the discomfort associated with injections. The nurse should explain that:
a. This cannot be prevented.
b. Infants do not feel pain as adults do.
c. This is not a good reason fo
D
(This is a common and accepted practice, especially in some cultural groups.
Co-sleeping or sharing the family bed, in which the parents allow the children to sleep with them, is a common and accepted practice in many cultures. Parents should evaluate t
Parents tell the nurse that their 1-year-old son often sleeps with them. They seem unconcerned about this. The nurse's response should be based on the knowledge that:
a. Children should not sleep with their parents.
b. Separation from parents should be co
D
(Hot dogs must be cut into small, irregular pieces to prevent aspiration.
Hot dogs are of a consistency, diameter, and round shape that may cause complete obstruction of the child's airway. If given to young children, the hot dog should be cut into smal
The parents of a 12-month-old child ask the nurse if the child can eat hot dogs. The nurse's reply should be based on knowing that:
a. The child is too young to digest hot dogs.
b. The child is too young to eat hot dogs safely.
c. Hot dogs must be sliced
C
("She may need to begin taking them at age 6 months."
Fluoride supplementation is recommended by the American Academy of Pediatrics beginning at age 6 months if the child is not drinking adequate amounts of fluoridated water. The recommendation is to be
The parent of 2-week-old Sarah asks the nurse if Sarah needs fluoride supplements because she is exclusively breastfed. The nurse's best response is:
a. "She needs to begin taking them now."
b. "They are not needed if you drink fluoridated water."
c. "She
B
(Rear facing in back seat
The rear-facing car seat provides the best protection for an infant's disproportionately heavy head and weak neck. Infants should face the rear from birth to 20 pounds and as close to 1 year of age as possible. The middle of th
The clinic is lending a federally approved car seat to an infant's family. The nurse should explain that the safest place to put the car seat is:
a. Front facing in back seat.
b. Rear facing in back seat.
c. Front facing in front seat if an air bag is on
C
(Changing the infant's position frequently.
Changing the infant's position frequently may be beneficial. The parent can walk holding the infant face down and with the infant's chest across the parent's arm. The parent's hand can support the infant's abd
Parent guidelines for relieving colic in an infant include:
a. Avoiding touching the abdomen.
b. Avoiding using a pacifier.
c. Changing the infant's position frequently.
d. Placing the infant where the family cannot hear the crying.
A
(Encourage parent to verbalize feelings.
Colic is multifactorial, and no single treatment is effective for all infants. The parent is verbalizing concern and worry. The nurse should allow the parent to put these feelings into words. An empathic, gentle,
A parent of an infant with colic tells the nurse, "All this baby does is scream at me; it is a constant worry." The nurse's best action is:
a. Encourage parent to verbalize feelings.
b. Encourage parent not to worry so much.
c. Assess parent for other sig
B
(Eliminate all secondhand smoke contact.
To prevent and treat colic, teach parents that if household members smoke, they should avoid smoking near the infant; smoking activity should preferably be confined to outside of the home. A pacifier can be intro
A nurse is teaching parents about prevention and treatment of colic. Which should the nurse include in the teaching plan?
a. Avoid use of pacifiers.
b. Eliminate all secondhand smoke contact.
c. Lay infant flat after feeding.
d. Avoid swaddling the infant
D
(Make a follow-up home visit to parents as soon as possible after the infant's death.
A competent, qualified professional should visit the family at home as soon as possible after the death and provide the family with printed information about SIDS. An
An important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS) is to:
a. Explain how SIDS could have been predicted and prevented.
b. Interview parents in depth concerning the cir
A
(Avoidance of eye contact.
One of the clinical manifestations of nonorganic failure to thrive is the child's avoidance of eye contact with the health professional. A malabsorption defect would result in a physiologic problem, not behavioral. Weight (but
Clinical manifestations of failure to thrive caused by behavioral problems resulting in inadequate intake of calories include:
a. Avoidance of eye contact.
b. An associated malabsorption defect.
c. Weight that falls below the 15th percentile.
d. Normal ac
A
(Establish a structured routine and follow it consistently.
The infant with failure to thrive should have a structured routine that is followed consistently. Disruptions in other activities of daily living can have a great impact on feeding behaviors. B
Which is an important nursing consideration when caring for an infant with failure to thrive?
a. Establish a structured routine and follow it consistently.
b. Maintain a nondistracting environment by not speaking to the infant during feeding.
c. Place the
D
(Gently stimulate trunk by patting or rubbing.
If the infant is apneic, the infant's trunk should be gently stimulated by patting or rubbing. If the infant is prone, turn onto the back. The infant should not be shaken vigorously, have the head rolled si
Which is the most appropriate action when an infant becomes apneic?
a. Shake vigorously.
b. Roll head side to side.
c. Hold by feet upside down with head supported.
d. Gently stimulate trunk by patting or rubbing.
A
(Place the infant prone for 30 to 60 minutes per day.
Prevention of positional plagiocephaly may begin shortly after birth by implementing prone positioning or "tummy time" for approximately 30 to 60 minutes per day when the infant is awake. Soft mattre
With the goal of preventing plagiocephaly, the nurse should teach new parents to:
a. Place the infant prone for 30 to 60 minutes per day.
b. Buy a soft mattress.
c. Allow the infant to nap in the car safety seat.
d. Have the infant sleep with the parents.
D
(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 and then be placed on their abdomens when awake to enhance development of milestones su
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 knowledge that this is:
a. Unacceptable because of the risk of sudden infant death syn
C
("What time did you find the infant?"
During a SIDS incident, if the infant is not pronounced dead at the scene, he or she may be transported to the emergency department to be pronounced dead by a physician. While they are in the emergency department, t
An infant has been pronounced dead from sudden infant death syndrome (SIDS) in the emergency department. Which is an appropriate question to ask the parents?
a. "Did you hear the infant cry out?"
b. "Why didn't you check on the infant earlier?"
c. "What t
A, C , E
(A. "We will put a plastic fillers in all electrical plugs."
C. "we will place a gate at the top and bottom of stairways."
E. "we will remove front knobs from the stove."
By the time babies reach 6 months of age, they begin to become much more ac
A nurse has completed a teaching session for parents about "baby-proofing" the home. Which statements made by the parents indicate an understanding of the teaching (select all that apply)?
a. "We will put plastic fillers in all electrical plugs."
b. "We w
C
("we will check the monitor several times a day to be sure the alarm is working."
The parents should check the monitor several times a day to be sure the alarm is working and that it can be heard from room to room. The parents should not adjust the moni
An infant experienced an apparent life-threatening event and is being placed on home apnea monitoring. The parents have understood the instructions for use of a home apnea monitor when they state:
a. "We can adjust the monitor to eliminate false alarms.
C
(12 months
The American Academy of Pediatrics does not recommend the use of cow's milk for children younger than 12 months. At 6 and 9 months, the infant should be receiving commercial infant formula or breast milk. At age 18 months, milk and formula ar
The nurse should teach parents that which age is safe to give infants whole milk instead of commercial infant formula?
a. 6 months
b. 9 months
c. 12 months
d. 18 months
B, C, E, F
(B. Rotavirus (RV)
C. Diptheria, tetanus, and acellular pertussis (DTaP)
E. Haemophilus influenzae type b (HIB)
F. Inactivated poliovirus (IPV)
The recommended immunization schedule for a 4-month-old, up to date on immunizations, would be to ad
A nurse is preparing to administer routine immunizations to a 4-month-old infant. The infant is currently up to date on all previously recommended immunizations. Which immunizations will the nurse prepare to administer (select all that apply)?
a. Measles,
D
(The acellular pertussis vaccine is recommended by the American Academy of Pediatrics beginning at age 6 weeks. Infants are at greater risk for complications of pertussis. The vaccine is not given after age 7 years, when the risks of the vaccine become
A parent asks the nurse whether her infant is susceptible to pertussis. The nurse's response should be based on which statement concerning susceptibility to pertussis?
a. Neonates will be immune the first few months.
b. If the mother has had the disease,
A, C, E
(An important aspect of compassionate care for parents experiencing a SIDS incident is allowing them to say good-bye to their infant. These are the parents' last moments with their infant, and they should be as quiet, meaningful, peaceful, and und
Which interventions should the nurse implement when caring for a family of a sudden infant death syndrome (SIDS) infant (select all that apply)?
a. Allow parents to say goodbye to their infant.
b. Once parents leave the hospital, no further follow-up is r
A, B, E
(A good pacifier should be easily grasped by the infant. One-piece construction is necessary to avoid having the nipple and guard separate. The material should be sturdy and flexible. An attached ribbon or string and soft, pliable material are not
Pacifiers can be extremely dangerous because of the frequency of use and the intensity of the infant's suck. In teaching parents about appropriate pacifier selection, the nurse should explain that a pacifier should have which characteristics (select all t
B, C, E
(Certain groups of infants are at increased risk for SIDS: those with low birth weight, low Apgar scores, or recent viral illness, and those of male sex. Breastfed infants and infants of average or above-average weight are not at higher risk for S
A nurse is conducting education classes for parents of infants. The nurse plans to discuss sudden infant death syndrome (SIDS). Which risk factors should the nurse include as increasing an infant's risk of a SIDS incident (select all that apply)?
a. Breas
A, B
(Rolling from abdomen to back and placing the feet in the mouth when supine are developmentally appropriate for a 5-month-old infant. Rolling from back to abdomen is developmentally appropriate for a 6-month-old infant. An 8-month-old infant should b
In terms of gross motor development, what would the nurse expect a 5-month-old infant to do (select all that apply)?
a. Roll from abdomen to back.
b. Put feet in mouth when supine.
c. Roll from back to abdomen.
d. Sit erect without support.
e. Move from p
D
(Able to grasp object voluntarily.)
The nurse expects which characteristic of fine motor skills in a 5-month-old infant?
A. Strong grasp reflex
B. Neat pincer grasp
C. Able to build a tower of two cubes
D. Able to grasp object voluntarily
C
(developmental/neurologic evaluation is needed.)
The nurse is assessing a 6-month-old infant who smiles, coos, and has a strong head lag. The nurse should recognize that:
A. this assessment is normal.
B. the child is probably cognitively impaired.
C. developmental/neurologic evaluation is needed.
D. the
A
(trust.)
The nurse educator instructs a nursing student that according to Erikson, infancy is concerned with acquiring a sense of:
A. trust.
B. industry.
C. initiative.
D. separation.
B
(this is a normal reaction for this age.)
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:
A. the infant is most likely spoiled.
B. this is a normal reaction for
C
(10 months)
At what age would the nurse advise parents to expect their infant to be able to say "mama" and "dada" with meaning?
A. 4 months
B. 6 months
C. 10 months
D. 14 months
D
(There is no need to restrain nonnutritive sucking during infancy.)
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. A pacifier should be substituted for the thumb.
B. Thumb-sucking should be discouraged by age 12 months.
C. Thumb
C
(give child a frozen teething ring to relieve inflammation.)
The MOST appropriate recommendation for relief of teething pain is to instruct the parents to:
A. rub gums with aspirin to relieve inflammation.
B. apply hydrogen peroxide to gums to relieve irritation.
C. give child a frozen teething ring to relieve infl
A
(fluids in addition to breast milk are not needed.)
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:
A. fluids in addition to breast milk are not needed.
B. water should be given if the infant seems to nurse lon
D
("Feeding himself will help foster his growth and development. Perhaps we can discuss ways to make the messes more tolerable.")
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 can't let him feed himself; he makes too much of a mess." The nurse's BEST response is:
A. "It's important not to give in to this kind o
B
(Beginning to put her to bed while still awake)
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
C
("When your baby learns to roll over, you must supervise him whenever he is on a surface from which he might fall.")
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?
A. "Never shake baby powder directly on your infant because it can be aspirated into his lungs.
C
(Those using yogurt as primary source of milk.)
The nurse in the pediatric clinic identifies which infants at risk for developing vitamin D-deficient rickets?
A. Lacto-ovo vegetarians
B. Those who are breastfed exclusively
C. Those using yogurt as primary source of milk
D. Those exposed to daily sunlig
D
(casein hydrolysate milk formula.)
A 3-month-old bottle-fed infant is allergic to cow's milk. The nurse's BEST option for a substitute is:
A. goat's milk.
B. soy-based formula.
C. skim milk diluted with water.
D. casein hydrolysate milk formula.
B
(take a thorough, detailed history of usual daily events.)
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 initial action is to:
A. advise the mother to follow a milk-free diet for 3 to 5 days.
B. take a thorou
C
(Being persistent through 10 to 15 minutes of food refusal)
Which strategy might be recommended for an infant with failure-to-thrive to increase caloric intake?
A. Using developmental stimulation by a specialist during feedings
B. Avoiding solids until after the bottle is well accepted
C. Being persistent through
D
(sudden infant death syndrome (SIDS).)
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 o
A
(Cardiopulmonary resuscitation (CPR))
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?
A. Cardio
B
(Vitamin D)
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
C
(kwashiorkor.)
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:
A. rickets.
B. ma
D
(Semiformed, seedy, yellow)
A nurse is caring for a 2-month-old exclusively breastfed infant with an admitting diagnosis of colic. Based on the nurse's knowledge of breastfed infants, what type of stool is expected?
A. Dark brown and small hard pebbles
B. Loose with green mucus stre
D
(Peanut butter)
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
A, C, D, E
(A. "I only smoke in the kitchen."
C. "I have my baby sleep with me instead of alone in the crib."
D. "I make sure my baby wears a flannel sleeper and has two blankets to keep warm in her crib."
E. "I always leave my baby's favorite stuffed bun
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.)
A. "I only smoke in the kitchen."
B. "I put my baby to sleep on her back
A, B, C, E
(A. initiate an immunization record.
B. confirm the hepatitis B status of the newborn's mother.
C. obtain a syringe with a 25-gauge, 5/8-inch needle.
E. confirm that the newborn's mother has signed the informed consent.)
When preparing to administer Hepatitis B vaccine to a newborn, the nurse should: (Select all that apply.)
A. initiate an immunization record.
B. confirm the hepatitis B status of the newborn's mother.
C. obtain a syringe with a 25-gauge, 5/8-inch needle.
B, C, D
(B. who sleep prone
C. who were premature
D. with prenatal drug exposure)
Infants most at risk for sudden infant death syndrome (SIDS) are those: (Select all that apply.)
A. who sleep supine
B. who sleep prone
C. who were premature
D. with prenatal drug exposure
E. with a cousin that died of SIDS
B, E
(B. Place iron toward the back side of the mouth with a dropper.
E. Apply barrier ointment if needed to buttocks.)
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.)
A. Administer iron with meals.
B. Place iron toward the back side of the mouth with a dropper
A, B, C, D, E
(A. allow for catch-up growth.
B. correct nutritional deficiencies.
C. achieve ideal weight for height.
D. restore optimum body composition.
E. educate the parents or primary caregivers on child's nutritional requirements.)
The primary goals in the nutritional management of children with failure to thrive (FTT) are: (Select all that apply.)
A. allow for catch-up growth.
B. correct nutritional deficiencies.
C. achieve ideal weight for height.
D. restore optimum body compositi