A nurse is caring for a 2-month-old infant with heart failure. Which of the following actions should the nurse take?
Limit oral feedings to about 30 minutes in length
Check the infant’s oxygen saturation every 6 hours
Weigh the infant every other day
Place the infant in the prone position for naps
The Correct Answer is A
A. Correct – Infants with heart failure experience fatigue during feeding, leading to poor weight gain. Limiting feeding time reduces energy expenditure.
B. Incorrect – Oxygen saturation should be checked more frequently than every 6 hours, especially if the infant has cyanosis or respiratory distress.
C. Incorrect – Daily weight monitoring is necessary to assess fluid status and nutritional intake.
D. Incorrect – The infant should be placed on their back for naps to prevent sudden infant death syndrome (SIDS).
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. While encouraging personal beliefs is supportive, it does not ensure that the alternative therapy is safe or evidence-based.
B. Directing the client to an online support group is not as reliable as reviewing information with a knowledgeable professional.
C. This response acknowledges the client's interest and promotes safe, informed decision-making by reviewing available, credible information regarding alternative therapies.
D. Relying solely on the provider to inform the client may limit the client's autonomy in exploring additional safe options.
Correct Answer is D
Explanation
A. Watching TV may be overstimulating.
B. Atomoxetine is a non-stimulant ADHD medication, not used for panic attacks.
C. Teaching meditation should be done after the panic attack subsides, not during.
D. During a panic attack, the nurse should stay with the client and offer a calm, reassuring presence.
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