A parent calls a clinic and reports to a nurse that his 2-month-old infant is hungry more than usual but is projectile vomiting immediately after eating. Which of the following responses should the nurse make?

"Bring your baby into the clinic today."

"Give your infant an oral rehydration solution."

"Burp your baby more frequently during feedings."

"Try switching to a diﬀerent formula."

Answer and Explanation

The Correct Answer is A

Choice A: This response is appropriate, as it indicates urgency and concern for the infant's condition. Projectile vomiting immediately after eating can be a sign of pyloric stenosis, which is a condition that causes the narrowing of the pylorus, which is the opening between the stomach and the small intestine. Pyloric stenosis can prevent food from passing through and cause dehydration, electrolyte imbalance, or weight loss. The infant needs to be evaluated by a provider as soon as possible and may need surgery to correct the problem.

Choice B: This response is not appropriate, as it does not address the underlying cause of the infant's condition. Oral rehydration solution can help replace ﬂuids and electrolytes lost through vomiting, but it does not treat pyloric stenosis or prevent further vomiting. Oral rehydration solution may also be vomited out by the infant if given too soon or too much.

Choice C: This response is not appropriate, as it does not address the underlying cause of the infant's condition. Burping the baby more frequently during feedings can help release air bubbles and prevent gas or colic, but it does not treat pyloric stenosis or prevent further vomiting. Burping may also trigger vomiting by increasing pressure on the stomach.

Choice D: This response is not appropriate, as it does not address the underlying cause of the infant's condition. Switching to a diﬀerent formula can help if the infant has an allergy or intolerance to certain ingredients in their current formula, but it does not treat pyloric stenosis or prevent further vomiting. Switching formulas may also cause diarrhea or constipation by changing the infant's bowel ﬂora.

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Correct Answer is D

Explanation

Choice A reason: This choice is incorrect because the BCG vaccine is not recommended for adolescents in the United States. The BCG vaccine is a vaccine that protects against tuberculosis (TB), a bacterial infection that aﬀects the lungs and other organs. It may be used for children who live in countries where TB is common or who have a high risk of exposure to TB, but it is not routinely given in the United States because of the low incidence of TB and the possibility of false-positive results on TB skin tests.

Choice B reason: This choice is incorrect because the pneumococcal polysaccharide vaccine is not recommended for adolescents unless they have certain medical conditions. The pneumococcal polysaccharide vaccine is a vaccine that protects against pneumococcal disease, a bacterial infection that can cause pneumonia, meningitis, or sepsis. It may be used for adults who are 65 years or older or who have chronic diseases, immunosuppression, or cochlear implants, but it is not routinely given to adolescents who are healthy.

Choice C reason: This choice is incorrect because the inﬂuenza vaccine is recommended for adolescents every year, not just before college. The inﬂuenza vaccine is a vaccine that protects against inﬂuenza, a viral infection that aﬀects the respiratory system. It may be given as an injection or a nasal spray, and it may prevent or reduce the severity of inﬂuenza and its complications. It is recommended for everyone who is 6 months or older, especially those who have a high risk of inﬂuenza-related complications.

Choice D reason: This choice is correct because the meningococcal polysaccharide vaccine is recommended for adolescents before college. The meningococcal polysaccharide vaccine is a vaccine that protects against meningococcal disease, a bacterial infection that can cause meningitis, septicemia, or death. It may be given as a single dose or a booster dose, and it may prevent outbreaks of meningococcal disease in crowded settings such as dormitories or military barracks. It is recommended for adolescents who are 11 to 12 years old, with a booster dose at 16 years old, or for those who are entering college and have not been previously vaccinated.

A. Iron deficiency anemia B. Diabetes mellitus C. Obesity D. Rickets

Correct Answer is A

Explanation

Choice A: Iron deficiency anemia is a condition in which the body does not have enough iron to produce hemoglobin, the protein that carries oxygen in the blood. Toddlers who drink too much milk and eat too few solid foods may not get enough iron from their diet, as milk is a poor source of iron. Iron deficiency anemia can cause fatigue, weakness, pale skin, and increased susceptibility to infections.

Choice B: Diabetes mellitus is a condition in which the body does not produce enough insulin or use it properly, resulting in high blood glucose levels. Toddlers who drink too much milk and eat too few solid foods are not at increased risk for diabetes mellitus, as milk does not contain glucose and does not affect insulin secretion or action.

Choice C: Obesity is a condition in which the body has excess fat that can impair health and increase the risk of chronic diseases. Toddlers who drink too much milk and eat too few solid foods may be at risk for obesity, as milk is high in calories and fat and can displace other nutritious foods from their diet. However, obesity is not a disorder but a risk factor for other disorders.

Choice D: Rickets is a condition in which the bones become soft and weak due to a lack of vitamin D or calcium. Toddlers who drink too much milk and eat too few solid foods are not at risk for rickets, as milk is a good source of vitamin D and calcium and can prevent rickets.

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A parent calls a clinic and reports to a nurse that his 2-month-old infant is hungry more than usual but is projectile vomiting immediately after eating. Which of the following responses should the nurse make?

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