Question 1

A mother who is bottlefeeding her newborn is discharged 48 hours postdelivery. When should the nurse schedule the first office visit for the newborn with the pediatrician?

Accepted Answer

The first office visit for a newborn with the pediatrician should be scheduled within 5 days of discharge, especially for infants who are bottle-fed, to ensure the baby is feeding well, gaining weight, and to address any concerns the parents might have.

Question 2

A nurse assesses the height and weight measurements on an infant and documents these measurements at the 75th percentile. The nurse notes that the measurements 2 months ago were at the 25th percentile. Which interpretation of these data by the nurse is accurate?

Accepted Answer

The infant has gained a significant amount of weight, moving from the 25th percentile to the 75th percentile. This indicates that the infant is growing well and gaining weight appropriately. The measurements are likely accurate, as they were taken by a nurse. Option A is incorrect because the infant is gaining weight appropriately. Option C is incorrect because there is no indication that the measurements are inaccurate. Option D is also incorrect because there is no indication that the previous measurements were inaccurate.

Question 3

A nurse is assessing an 11-month-old infant, and notes that the infant's height and weight are at the 5th percentile on the growth chart; the infant was previously plotted at the 25th percentile. Psychosocial history reveals that the parents are separated and are planning to divorce. Which is the priority when planning this infant's care?

Accepted Answer

The priority for this infant is to assess for and address any risk for failure to thrive, as the drop in growth percentiles may indicate inadequate nutrition and/or other factors impacting growth and development. The psychosocial history may also contribute to this risk, making it a priority to address. While parental anxiety and risk for injury are important considerations, they are not as immediate a concern as the infant's physical and developmental well-being. Excessive nutritional intake is not indicated in this scenario, as the infant's growth is declining rather than increasing.

Question 4

Which nursing actions are appropriate for the 2-month-old infant during a scheduled health maintenance visit? Select all that apply.

Accepted Answer

At a 2-month-old health maintenance visit, it is appropriate to review infant fluid needs, reinforce safe bottle heating practices, and demonstrate proper gum care. Introducing solid foods and juice is not recommended at this age.

Question 5

The nurse is preparing for a health maintenance visit for a 9-month-old infant. Which teaching topics are appropriate for the nurse to include during the scheduled visit? Select all that apply.

Accepted Answer

A) Using iron-fortified formula is appropriate to ensure adequate iron intake for the baby's growing needs.
B) Encouraging self-feeding of finger foods promotes the development of fine motor skills and independence. 
C) Increasing the number of daily milk feedings is not appropriate at this age as the infant should be transitioning to solid foods.
D) Encouraging cups for all feedings is not appropriate at this age as the infant still needs the nutrients provided by formula or breast milk, which are best delivered through a bottle.
E) Introducing burping techniques may be appropriate but is not a priority topic during a health maintenance visit for a 9-month-old infant.

Question 6

The nurse is working with first-time parents. Which activity will the nurse suggest to encourage the development of good muscle tone in their infant?

Accepted Answer

Surrounding an infant with toys and other stimulating items encourages them to reach for, grasp, and manipulate objects, which in turn promotes the development of good muscle tone through active movement and engagement with their environment.

Question 7

During a health supervision visit, the nurse is attempting to develop a partnering relationship with the child and family. Which is the initial action by the nurse?

Accepted Answer

Discussing a plan with the family to address the child's health needs is the initial action that fosters a partnering relationship. It involves collaboration and respects the family's input and concerns, laying a foundation for mutual trust and goal setting.

Question 8

A parent says to a nurse, "How do you know when my baby needs these screening tests the doctor just mentioned?" Which response by the nurse is most appropriate?

Accepted Answer

Screening tests are scheduled at specific ages because those are the times when children are most at risk for developing certain conditions. These tests are designed to detect potential health issues early, even before symptoms appear, allowing for timely intervention and treatment.

Question 9

What is the purpose of making general observations during the assessment process for an infant during a scheduled health maintenance visit? Select all that apply.

Accepted Answer

Making general observations during the assessment process for an infant during a scheduled health maintenance visit serves to invite discussion with the parents, validate positive parenting efforts, and promote a partnership between healthcare providers and parents. While assessments may include monitoring for communicable diseases, this is not the primary purpose of making general observations during the visit. Additionally, meeting The Joint Commission accreditation standards is not a specific purpose of general observations during the assessment process.

Question 10

Which observation in a health supervision visit leads the nurse to have concerns about the infant's mental health?

Accepted Answer

A 9-month-old avoiding eye contact with both parents and the nurse could indicate developmental concerns, including those related to mental health or autism spectrum disorders. Eye contact is an important part of social and emotional development, and difficulties in this area can be a sign of underlying issues.

Question 11

Which actions are appropriate when the nurse is performing general observations during the assessment process for an infant? Select all that apply.

Accepted Answer

These actions are appropriate for general observations during an infant assessment. Asking about family adjustment, monitoring for parental fatigue, and assessing bonding behaviors provide insight into the infant's environment and family dynamics.

Question 12

The clinic administrator has asked each nurse to classify the nursing activities as a beginning step of clinic reorganization. Which of these strategies can be classified as health promotion and health maintenance? Select all that apply.

Accepted Answer

A) Instructing on how to use dental floss is a health promotion activity as it involves teaching individuals how to maintain good oral hygiene.
C) Administering the flu vaccine to infants 6 to 23 months old is a health maintenance activity as it prevents the occurrence of the flu infection and maintains the health of infants.
D) Working with new parents to create daily feeding schedules for infants is a health promotion activity as it promotes optimal infant nutrition and growth.
E) Conducting developmental screening examinations for toddlers is a health maintenance activity as it monitors and maintains the developmental health of toddlers.

Question 13

The nurse is assessing a small-for-gestational-age newborn who had an older sibling who died of sudden infant death syndrome (SIDS). Which should the nurse include in the newborns plan of care based on these data?

Accepted Answer

The risk of SIDS is increased in siblings of infants who died from SIDS. The nurse should encourage safe sleep practices, including placing the newborn in a crib with a tight-fitting, firm mattress without any soft bedding or toys. The newborn should also be placed on their back to sleep. Co-sleeping or placing the newborn on their abdomen to sleep increases the risk of SIDS.

Question 14

During a scheduled health maintenance visit for a 6-month-old infant the nurse asks, "Does the baby sit without assistance, and is the baby crawling?" Which process is the nurse using in this interaction?

Accepted Answer

The nurse is using developmental surveillance, which is the ongoing process of monitoring and assessing children's developmental progress during routine health care visits. The nurse is checking to see if the infant is meeting developmental milestones related to gross motor skills. Health promotion involves encouraging healthy behaviors and reducing risk factors for disease, while disease surveillance involves monitoring for the occurrence of specific diseases or conditions. Health maintenance involves providing preventive care to maintain optimal health.

Question 15

Parents are in the pediatric clinic with their infant for a 1-month checkup. Which assessment question regarding immunizations should the nurse ask the infant's parents?

Accepted Answer

The hepatitis B vaccine is typically given to newborns prior to hospital discharge as part of the standard immunization schedule in many countries. The other vaccines listed (influenza, rubella, and rotavirus) are not typically given to newborns prior to hospital discharge.

Question 16

The nurse is educating the parents of a 2-month-old infant when to contact the healthcare provider. Which statements by the parents indicate the need for further instruction? Select all that apply.

Accepted Answer

A 2-month-old infant may not have a bowel movement every day, so this is not necessarily a reason to contact a doctor. A temperature greater than 99°F is not typically concerning unless it reaches 100.4°F or higher. Not finishing each bottle is also not unusual for infants and does not always require contacting a healthcare provider.

Question 17

While interviewing the parents of a toddler-age client, the nurse notes that the mother is pregnant. At the end of the visit, the nurse decides to give a new pamphlet to the parents about car seat usage for newborns. Which is the purpose of this action by the nurse?

Accepted Answer

When the nurse provides the new pamphlet to the parents about car seat usage for newborns, the purpose is to provide primary preventative health maintenance by educating parents before the birth of the new baby about the importance of proper car seat usage for their newborn. This education can help to prevent potential injuries and accidents from occurring.

Question 18

The mother of a 2-year-old child becomes very anxious when the child has a temper tantrum in the medical office. Which response by the nurse to the mother is appropriate?

Accepted Answer

This response acknowledges the mother's concerns and invites her to share her usual response to temper tantrums, which can help the nurse provide appropriate support and guidance. Option A suggests ignoring the behavior, which may not be the most effective strategy. Option C may come across as dismissive or invalidating of the mother's feelings. Option D may reinforce the child's undesirable behavior by rewarding it with cuddles.

Question 19

Which topics are appropriate for the nurse to include when teaching preventive disease strategies during infancy? Select all that apply.

Accepted Answer

Metabolic and hearing screenings are important preventive measures to detect potential disease or conditions in infancy. Environmental smoke exposure is a common risk factor for respiratory illnesses and should be addressed as part of preventive disease strategies during infancy. Stranger danger strategies and bike safety are not relevant topics for discussing preventive disease strategies during infancy.

Question 20

The mother of a newborn asks the nurse what the purpose of the first scheduled health maintenance visit will be. Which are appropriate responses by the nurse to this question? Select all that apply.

Accepted Answer

The answer of The mother of a newborn asks the...

Quiz 34: Health Promotion and Maintenance: General Concepts, the Newborn, and the Infant