A nurse working at a clinic speaks on the telephone with a parent of a 2-month-old infant. The parent tells the nurse that the infant has projectile vomiting followed by hunger after meals.
Which of the following responses by the nurse is appropriate?
“Bring your infant into the clinic today to be seen.”.
“Burp your child more frequently during feedings.”.
“Give your infant an oral rehydrating solution.”.
“You might want to try switching to a different formula.”.
The Correct Answer is A
Choice A rationale
The symptoms described by the parent - projectile vomiting followed by hunger - could indicate a serious condition such as pyloric stenosis, which is a narrowing of the opening from the stomach to the small intestine. This condition can lead to severe dehydration and requires immediate medical attention.
Choice B rationale
While burping can help to relieve gas and minor stomach discomfort, it would not address the underlying issue causing the projectile vomiting. This advice might be appropriate for a baby with simple colic or gas, but not for the symptoms described.
Choice C rationale
While oral rehydrating solutions can help to replace lost fluids and electrolytes, they do not address the underlying cause of the projectile vomiting. Furthermore, if the baby is vomiting frequently, they may not be able to keep down the solution.
Choice D rationale
Switching formulas can sometimes help babies who have allergies or intolerances to certain ingredients in their current formula. However, the symptoms described are not typical of a formula intolerance or allergy. Moreover, switching formulas without seeking medical advice can potentially lead to other complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Jaundice, a yellowing of the skin and eyes, is not typically a symptom of Wilms’ tumor. It is more commonly associated with conditions that cause liver dysfunction.
Choice B rationale
An abdominal mass is one of the most common symptoms of Wilms’ tumor. Parents or healthcare providers may feel a lump or swelling in the child’s abdomen.
Choice C rationale
Swollen joints are not a typical symptom of Wilms’ tumor. They are more commonly associated with conditions that affect the joints, such as juvenile arthritis.
Choice D rationale
Diarrhea is not a typical symptom of Wilms’ tumor. It is more commonly a symptom of gastrointestinal illnesses.
Correct Answer is A
Explanation
Choice A rationale
Activated charcoal is often used in cases of drug overdose or poisoning, including aspirin ingestion. It works by binding to the drug or toxin in the stomach, preventing it from being absorbed into the body. This makes activated charcoal an effective treatment for aspirin overdose in a toddler.
Choice B rationale
A chelating agent is a substance that can bind to heavy metals in the body, helping to remove them. While useful in cases of heavy metal poisoning, it would not be the first choice for an aspirin overdose.
Choice C rationale
Acetylcysteine is an antidote for acetaminophen (Tylenol) overdose, not aspirin. It works by replenishing glutathione, a substance that helps to detoxify the liver.
Choice D rationale
Digoxin immune FAB is used to treat digoxin toxicity. Digoxin is a medication used to treat heart conditions, and it is not related to aspirin.
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