A nurse is obtaining vital signs from 2-month-old infant. The infant's heart rate is 190/min and his temperature is 40° C (104° F). The father asks the nurse why the infant's heart is beating so fast. Which of the following responses by the nurse is appropriate

"The fever is causing an increase in your baby's heart rate."

"Your baby's heart is beating fast in an attempt to cool down his body

“This is within the expected range for your baby."

"As your baby begins to fall asleep, his heart rate will decrease.

Answer and Explanation

The Correct Answer is A

A.   In the case of a fever, the body's response often includes an increase in heart rate to help distribute heat and manage the fever.
B.   While the body might attempt to regulate temperature through various means, the increased heart rate is primarily due to the fever itself.
C.   A heart rate of 190/min is higher than normal for a 2-month-old infant and is likely elevated due to the fever.
D.   Heart rate tends to decrease during sleep but doesn't explain the elevated heart rate specifically in response to the fever.

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Correct Answer is B

Explanation

A. Solitary play, where a child plays alone, is more common in younger toddlers, typically before the age of 2.
B. Parallel play, where toddlers play alongside each other without actively engaging with one another, is common in 2-year-olds.
C. Toddlers often engage in play both at home and outside the home, with various interactions and experiences in different settings.
D. Cooperative play, where children actively play together in an organized or coordinated way, often emerges later in early childhood, around ages 3 to 4.

A. Encourage the parents to rock the infant. B. Position the infant on her abdomen. C. Administer ibuprofen as needed for pain. D. Offer the infant a pacifier.

Correct Answer is A

Explanation

A. Encouraging the parents to rock the infant provides comfort and soothing without risking trauma to the surgical site. It also promotes bonding and emotional reassurance.
B. Positioning the infant on the abdomen is contraindicated because it can put pressure on the surgical site, increasing the risk of complications. The infant should be positioned on their back or side to protect the repair.
C. Administering ibuprofen is not appropriate for a 2-month-old infant due to the risk of gastrointestinal and renal complications. Acetaminophen is typically used for pain management at this age.
D. Offering a pacifier is not recommended because sucking motions could disrupt the surgical repair and delay healing. Alternative soothing methods should be used instead.

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A nurse is obtaining vital signs from 2-month-old infant. The infant's heart rate is 190/min and his temperature is 40° C (104° F). The father asks the nurse why the infant's heart is beating so fast. Which of the following responses by the nurse is appropriate

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