The nurse is providing education to parents about preventing otitis media recurrence in their infant. Which instruction should the nurse include?

Avoid smoke exposure.

Inspect the infant's ears daily.

Position prone after feeding.

Breastfeed frequently.

Answer and Explanation

The Correct Answer is A

To prevent recurrence of otitis media in their infant. Exposure to secondhand smoke has been identified as a risk factor for recurrent otitis media.

B. While it is important to monitor the infant's ears for signs of infection, daily inspection alone is not sufficient to prevent recurrence of otitis media.

C. The prone position after feeding is not recommended for infants due to the risk of choking and aspiration, and it is not a preventive measure for otitis media.

D. While breastfeeding is associated with a reduced risk of otitis media, frequent breastfeeding alone is not sufficient to prevent recurrence of the condition.

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Correct Answer is D

Explanation

A. Many infants with congenital heart defects exhibit audible murmurs due to turbulent blood flow through abnormal openings or stenotic valves. While a murmur is a diagnostic hallmark of the condition, it is often an expected finding and does not necessarily indicate acute physiological deterioration. The nurse must document the murmur, but it is rarely the most urgent finding to report.

B. A heart rate of 162 beats/minute in an infant is slightly elevated above the typical resting range but can be triggered by crying, feeding, or baseline cardiac stress from the defect. Although tachycardia requires close monitoring to ensure the infant is not entering a state of high-output failure, it is less critical than signs of fluid overload. It represents a compensatory mechanism rather than an immediate life-threatening complication.

C. Infants with cardiac defects often experience fatigue during feeding because of the high metabolic demand and decreased cardiac output. Poor suckling effort and inadequate oral intake are common symptoms of pediatric heart failure that lead to failure to thrive over time. While this finding is significant for long-term nutritional management, it does not suggest an acute, rapid shift in stability like sudden weight changes.

D. Rapid weight gain of 1 kg within 48 hours is the most critical finding because it indicates acute fluid volume excess and potential congestive heart failure. In an infant, such a significant increase is almost certainly due to fluid retention rather than nutritional growth. This clinical sign suggests that the heart is unable to manage the systemic or pulmonary circulation effectively, necessitating immediate medical intervention.

A. Review prior insulin prescriptions. B. Obtain point-of-care glucose. C. Assess urine for ketones. D. Check blood pressure.

Correct Answer is B

Explanation

The adolescent's symptoms suggest that their blood glucose levels may be very high. Obtaining a point-of- care glucose reading is the first step in assessing the adolescent's current blood glucose levels and determining the appropriate course of action.

Reviewing prior insulin prescriptions, assessing urine for ketones, and checking blood pressure are also important interventions but should occur after the blood glucose level has been determined.

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The nurse is providing education to parents about preventing otitis media recurrence in their infant. Which instruction should the nurse include?

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