The nurse is discussing feeding with parents of a 1-year-old. Important teaching points should include:

Do not let the child feed herself finger foods as this could lead to aspiration.

Give whole milk until the child is 2 years old.

Do not introduce foods which may cause allergies until 2 years of age.

Transition to 1% milk now to ensure a heart healthy diet.

Answer and Explanation

The Correct Answer is B

Choice A reason: This statement is incorrect, as letting the child feed herself finger foods is not a risk factor for aspiration, but a way to promote self-feeding skills, independence, and appetite. The nurse should encourage the parents to offer the child a variety of soft, bite-sized, and nutritious foods, such as cooked vegetables, fruits, cheese, or bread, and to supervise the child during meals.

Choice B reason: This statement is correct, as giving whole milk is recommended for children between 1 and 2 years old, as it provides adequate fat, protein, calcium, and vitamin D for their growth and development. The nurse should advise the parents to give the child about 16 to 24 ounces of whole milk per day, and to avoid low-fat or skim milk until the child is 2 years old.

Choice C reason: This statement is incorrect, as delaying the introduction of foods which may cause allergies is not necessary or beneficial for the prevention of food allergies in children. The nurse should inform the parents that there is no evidence that avoiding certain foods, such as eggs, peanuts, or fish, can reduce the risk of food allergies, and that introducing these foods early, around 6 months of age, may actually prevent or reduce the severity of food allergies.

Choice D reason: This statement is incorrect, as transitioning to 1% milk is not advisable for children under 2 years old, as it does not provide enough fat and calories for their growth and development. The nurse should explain to the parents that low-fat or skim milk is not suitable for young children, as they need more fat for their brain and nervous system development, and that switching to 1% milk should only be done after consulting with the doctor.

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Correct Answer is B

Explanation

Choice A reason: This is not a good choice. Watching for signs of cyanosis and administering high dose steroids are not the first steps in managing infective endocarditis. Cyanosis is a late sign of hypoxia and steroids are not indicated for this condition.

Choice B reason: This is the correct choice. Obtaining blood cultures, administering high dose antibiotics, and assessing for cardiac decompensation are the priority interventions for a child with infective endocarditis. Blood cultures are needed to identify the causative organism and guide antibiotic therapy. High dose antibiotics are needed to eradicate the infection and prevent further damage to the heart valves. Cardiac decompensation is a serious complication of infective endocarditis that can lead to heart failure and shock.

Choice C reason: This is not a good choice. Starting high dose antibiotics, obtaining serial blood cultures, and putting the child on high flow oxygen are not the best order of management for infective endocarditis. Blood cultures should be obtained before starting antibiotics to avoid false negative results. High flow oxygen may not be necessary unless the child has signs of hypoxia or respiratory distress.

Choice D reason: This is not a good choice. Obtaining CBC, CXR and starting child on high dose aspirin are not the first steps in managing infective endocarditis. CBC and CXR are useful tests to monitor the infection and the cardiac function, but they are not as urgent as blood cultures. High dose aspirin is not recommended for infective endocarditis as it can increase the risk of bleeding.

A. Chromosomal mutation is the cause. B. Slow feeding will be necessary for a few months. C. Dietary restrictions will be required throughout childhood. D. Surgery will be necessary.

Correct Answer is D

Explanation

Choice A reason: Chromosomal mutation is not the cause of hypertrophic pyloric stenosis. The exact cause is unknown, but it may be related to genetic, environmental, or hormonal factors.

Choice B reason: Slow feeding will not be sufficient to manage hypertrophic pyloric stenosis. The infant will have persistent vomiting, dehydration, and weight loss due to the obstruction of the pylorus.

Choice C reason: Dietary restrictions will not be effective for hypertrophic pyloric stenosis. The infant will not be able to tolerate any oral intake until the pylorus is surgically corrected.

Choice D reason: Surgery will be necessary to treat hypertrophic pyloric stenosis. The surgery is called pyloromyotomy, which involves cutting the thickened muscle of the pylorus to allow the stomach to empty into the duodenum.

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The nurse is discussing feeding with parents of a 1-year-old. Important teaching points should include:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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