Deck 60: Infants With Special Needs: Birth to 12 Months

Question 1

What is the MOST important nursing intervention for the infant who has acute gastroenteritis?

A)administering antibiotics prophylactically
B)ensuring adequate hydration and replacing lost fluids
C)ensuring that immunizations are current
D)providing frequent small feedings

Answer 1

ensuring adequate hydration and replacing lost fluids

Question 2

What is the earliest manifestation of cystic fibrosis?

A)circumoral cyanosis
B)insufficient lecithin level
C)meconium ileus
D)salty-tasting skin

Answer 2

meconium ileus

Question 3

Which of these instructions should the nurse give to parents of children who have sickle-cell anemia?

A)Allow the child to lead a normal life.
B)Have the child immunized with pneumococcal,meningococcal,and hepatitis B vaccines.
C)Supplement the child's diet with oral iron drops.
D)Seek symptomatic treatment before crises arise.

Answer 3

Have the child immunized with pneumococcal,meningococcal,and hepatitis B vaccines.

Question 4

The main objective of treatment of hyperbilirubinemia is to reduce the amount of which element in the infant's blood?

A)conjugated bilirubin
B)lumirubin
C)unconjugated bilirubin
D)urobilinogen

Question 5

A client who has cystic fibrosis has a nursing diagnosis of Delayed growth and development related to inability to digest nutrients.Which of these nursing interventions would be indicated?

A)calculating and maintaining required fluid intake
B)ensuring high-caloric intake
C)initiating aerosol therapy 1 hour before or after meals
D)referring the family for genetic counseling

Question 6

Which of these factors will contribute to preventing otitis media in infants up to 12 months old?

A)a smoke-free environment
B)bottle-feeding infants on a flat surface
C)breastfeeding
D)keeping infant's room at 72 degrees Fahrenheit

Question 7

Which of these factors places infants at a greater risk of developing otitis media than adults?

A)horizontal position of eustachian tubes
B)immature immune systems
C)increased number of upper respiratory infections
D)no overt initial symptoms

Question 8

To help parents prevent their infant from developing positional plagiocephaly,the nurse should teach the parents to:

A)alternate the infant's head position during sleep
B)allow the infant to sleep in an infant carrier
C)place the infant in a high Fowler's position during the day and in the tummy position for sleep
D)keep the infant on an air mattress for play and sleep

Question 9

A nurse caring for an infant undergoing antibiotic therapy sees that the infant has painless white patches on the oral mucosa.The nurse suspects this to be:

A)colic
B)dysplasia
C)pruritus
D)thrush

Question 10

A 6-month-old client with a severe congenital heart defect is likely to exhibit signs and symptoms of:

A)congestive heart failure
B)hyaline membrane disease
C)intussusception
D)iron-deficiency anemia

Question 11

An infant exhibiting a bluish discoloration surrounding the mouth would be experiencing:

A)acrocyanosis
B)central cyanosis
C)circumoral cyanosis
D)peripheral cyanosis

Question 12

When does iron-deficiency anemia generally appear in infants?

A)birth to 6 months
B)2 to 8 months
C)5 to 6 months
D)9 months or older

Question 13

Which of these congenital defects may recur,even after correction?

A)congenital talipes equinovarus
B)hip dysplasia
C)hydrocephalus
D)pyloric stenosis

Question 14

Infants who have congenital heart disease are often treated with which of these therapies to improve the heart's contractility and increase cardiac output?

A)digoxin
B)furosemide
C)oxygen administration
D)potassium supplements

Question 15

What is the leading cause of death of infants over 1 month of age?

A)congenital heart disease
B)meningitis
C)physical abuse
D)sudden infant death syndrome

Question 16

During the first 24 hours of life,which of these signs may be the FIRST indication that a newborn may have Hirschsprung's disease?

A)has projectile vomiting and visible peristaltic waves
B)fails to pass a stool
C)has numerous black,tarry,mucous stools
D)turns dusky and chokes during any attempt at oral feedings

Question 17

What is the MOST common prognosis for an infant with pyloric stenosis?

A)complete recovery with surgical treatment
B)dependence on the actual extent of the defect
C)ongoing treatment with commercially prepared pancreatic enzymes
D)prevalent neurological disabilities

Question 18

An infant's mother reports the child had a "cold" for several days.The nurse observes the client has profuse nasal drainage,increased respiratory effort,inspiratory stridor,cough,and hoarse cry.The nurse should suspect this infant has developed which of these conditions?

A)cystic fibrosis
B)laryngotracheobronchitis (LTB)
C)pneumonia
D)respiratory distress syndrome

Question 19

Which of these statements about surgical repair of cleft lip and palate malformations in a 4-week-old infant is TRUE?

A)It will be delayed until the growth of the craniofacial bones is complete.
B)It will be done in stages with the lip being the last repair done.
C)The lip will be repaired at 6 to 12 weeks and the palate at 12 to 18 months.
D)Only the palate will be repaired,and the lip can be done later if cosmetic surgery is desired.

Question 20

Which of these conditions usually occurs in preterm infants and requires immediate administration of surfactant through an endotracheal tube at the time of birth?

A)bronchopulmonary dysplasia
B)cystic fibrosis
C)pneumothorax
D)respiratory distress syndrome

Question 21

A child is born with clubfeet.When the caregiver ask the nurse how this will be treated,the nurse would explain that the initial management is to:

A)try traction first
B)use surgical intervention as soon as possible
C)do a frequent series of casting
D)wait and monitor only as the child will usually outgrow this condition after learning to walk

Question 22

A child has a diagnosis of croup (laryngotracheobronchitis).He has received a corticosteroid and cool mist therapy.His caregiver asks the nurse why the doctor did not order antibiotics.The MOST appropriate response is:

A)the child is too young to receive antibiotics
B)the child may be allergic to antibiotics so the risks outweigh the benefit.
C)most antibiotics are used for bacterial germs and his type of croup is due to a virus.
D)the doctor would rather wait and see if he can get better without them.

Question 23

Which of these is thought to be a causative factor of spina bifida?

A)maternal rubella infection
B)fetal prematurity
C)maternal folic-acid deficiency
D)fetal infection

Question 24

Which of the following outcomes demonstrates a knowledge deficit in a caregiver's role of managing the child's sickle cell anemia?

A)seeks medical care at the first sign of an infection
B)gives narcotics to assist with pain management in crisis episodes
C)prohibit the child from playing football or soccer
D)limits fluids in the evening to discourage bed-wetting

Question 25

Which of these conditions is often associated with hypospadias?

A)Down syndrome
B)hydrocele
C)neural tube defects
D)undescended testes

Question 26

To improve ambulation in a child who has cerebral palsy,which of the following surgical interventions is indicated?

A)closure of the defect
B)lengthening of the Achilles tendon and releasing the hamstrings
C)placement of a VP shunt to relieve cerebral pressure
D)placing affected limbs in flexible casts

Question 27

To assist parents of an infant who has atopic dermatitis to realistically reduce the number of causative factors in their child's environment,which of these suggestions should the nurse offer?

A)removal of all actual or potential allergens from the home environment
B)frequent bathing in mild baby soap to remove sebaceous secretions from the scalp
C)frequent diaper changes,exposing affected areas to air,and use of a barrier ointment or cream
D)moving the family pet outside of the home

Question 28

During a routine nursing assessment of a small child,the nurse palpates a mass in the abdomen.Which of these actions is essential at this time?

A)Ask the parents if they had previously noted the abnormality.
B)Assess the mass site for indication of pain.
C)Continue the exam,noting the approximate size of the mass boundaries.
D)Stop palpation immediately.

Question 29

A caregiver of a child with cystic fibrosis understands the use of a pancreatic enzyme if the caregiver states:

A)"is a bronchodilator to help my child's lungs"
B)"is a medication to break down white blood cells in the lungs"
C)"should be given with meals and snacks to aid digestion"
D)"should be stopped if my child begins wheezing"

Question 30

What is the preferred treatment for the majority of children who have febrile seizures?

A)administrating anticonvulsants to reduce the number of subsequent seizures
B)teaching parents about seizure precautions
C)doing nothing,since most febrile seizures stop before the infant can be taken for medical attention
D)treating the underlying disease processes only

Question 31

In addition to administering antibiotics,nursing care of the infant with meningitis includes which of these interventions?

A)maintaining isolation for a minimum of 72 hours
B)monitoring neurological status every 4 hours
C)observing the infant's developmental status
D)ensuring the parents receive prophylactic treatment

Question 32

As intracranial pressure increases in the infant who has hydrocephalus,the anterior fontanel becomes tense and bulges,and the eyes appear to be pushed downward.What is this condition called?

A)circumoral cyanosis
B)intussusception
C)meningitis
D)sunset eyes

Question 33

Which of the following assessment findings would the nurse expect in an infant with Hirschsprung's disease?

A)foul-smelling fatty stool
B)currant jelly-like stool
C)thick,black,tarry stool
D)constipation alternating with ribbonlike stools.

Question 34

Cystic fibrosis is suspected in a child with frequent respiratory infections and failure to thrive.The nurse would expect which of the following tests ordered to make a definite diagnosis?

A)electrolytes and CBC
B)sweat chloride test
C)chest X-ray
D)endoscopy