A nurse is providing teaching to the parents of a 6-month-old infant who is beginning to eat solid foods. The nurse should identify which of the following findings as an indication of an allergic reaction?
Fever
Jaundice
Bruising
Diarrhea
The Correct Answer is D
Choice A reason: Fever is not an indication of an allergic reaction, as it is a sign of infection or inflammation. The nurse should assess the infant for other causes of fever, such as ear infection, urinary tract infection, or viral illness.
Choice B reason: Jaundice is not an indication of an allergic reaction, as it is a sign of liver dysfunction or hemolysis. The nurse should evaluate the infant for other causes of jaundice, such as hepatitis, biliary atresia, or hemolytic anemia.
Choice C reason: Bruising is not an indication of an allergic reaction, as it is a sign of trauma or bleeding disorder. The nurse should examine the infant for other causes of bruising, such as injury, coagulopathy, or leukemia.
Choice D reason: Diarrhea is an indication of an allergic reaction, as it is a sign of gastrointestinal hypersensitivity or intolerance. The nurse should ask the parents about the infant's food intake, history of allergies, and symptoms of anaphylaxis, such as hives, swelling, or difficulty breathing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Hypernatremia is not a sign of water intoxication, but rather the opposite condition. Hypernatremia means high sodium levels in the blood, which can occur when the body loses more water than sodium, such as in dehydration, diabetes insipidus, or excessive salt intake. Water intoxication causes hyponatremia, which means low sodium levels in the blood, due to excessive water intake or retention.
Choice B reason: Weak pulses are not a specific sign of water intoxication, but rather a general sign of poor perfusion or circulation. Weak pulses can have many causes, such as hypotension, shock, heart failure, or peripheral vascular disease. Water intoxication can cause hypotension, but it can also cause hypertension, depending on the volume status of the client.
Choice C reason: Muscle weakness is a sign of water intoxication, as it reflects the effect of low sodium levels on the neuromuscular system. Sodium is essential for nerve and muscle function, as it helps generate electrical impulses and contractions. When sodium levels drop too low, the nerves and muscles become less responsive and weaker. Other signs of water intoxication affecting the nervous system include confusion, headache, seizures, and coma.
Choice D reason: Exaggerated reflexes are not a sign of water intoxication, but rather a sign of hyperreflexia, which is a condition of overactive reflexes. Hyperreflexia can have many causes, such as spinal cord injury, stroke, multiple sclerosis, or electrolyte imbalance. Water intoxication can cause electrolyte imbalance, but it usually leads to hyporeflexia, which is a condition of reduced or absent reflexes.
Correct Answer is ["B","C"]
Explanation
Choice A reason: Nuts are not a complete protein, as they are low in the essential amino acid lysine¹. However, nuts can be combined with other plant-based foods, such as grains or legumes, to form a complete protein.
Choice B reason: Eggs are a complete protein, as they contain all nine essential amino acids in adequate amounts². Eggs are also a good source of protein, with about 6 grams per egg³.
Choice C reason: Poultry, such as chicken, turkey, or duck, is a complete protein, as it contains all nine essential amino acids in sufficient amounts⁴. Poultry is also a lean source of protein, with about 25 grams per 3-ounce serving.
Choice D reason: Legumes, such as beans, peas, or lentils, are not a complete protein, as they are low in the essential amino acid methionine. However, legumes can be combined with other plant-based foods, such as grains or nuts, to form a complete protein.
Choice E reason: Grains, such as wheat, rice, or oats, are not a complete protein, as they are low in the essential amino acid lysine. However, grains can be combined with other plant-based foods, such as legumes or nuts, to form a complete protein.
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