Question 1

The parent of 2-week-old infant asks the nurse if fluoride supplements are necessary because the infant is exclusively breastfed.What is the nurse's best response?

Accepted Answer

Fluoride supplementation is recommended by the American Academy of Pediatrics beginning at age 6 months if the child is not drinking adequate amounts of fluoridated water.Supplementation is not recommended before age 6 months regardless of whether the mother drinks fluoridated water.Infant cereal is not recommended at 2 weeks of age.

Question 2

The mother of a 6-month-old infant has returned to work and is expressing breast milk to be frozen.She asks for directions on how to safely thaw the breast milk in the microwave.What should the nurse recommend?

Accepted Answer

Using a microwave oven to thaw or heat breast milk decreases the anti-infective properties of the breast milk,lowers the vitamin C content,and changes the fat content.Breast milk should be thawed overnight in a refrigerator or in a warm water bath.A microwave should not be used.If steam is created,the milk is too hot.The bottle should be inverted several times after defrosting or warming.

Question 3

An infant,age 5 months,is brought to the clinic by his parents for a well-baby checkup.What is the best advice that the nurse should include at this time about injury prevention?

Accepted Answer

Aspiration of foreign objects is a great risk at this age.Parents are instructed to keep small objects out of the infant's reach.At this age,the child is not mobile enough to reach window sills.If window sills have cracked or chipped paint,it needs to be removed before he is a toddler.This child should already be rolling over.This information is reinforced but should have been taught earlier.Pulling to a stand occurs between 8 and 12 months of age.

Question 4

The mother of a 3-month-old breastfed infant asks about giving her baby water because it is summer and very warm.What should the nurse tell her?

Accepted Answer

Infants who are breastfed or bottle fed do not need additional water during the first 4 months of life.Excessive intake of water can create problems such as water intoxication,hyponatremia,or failure to thrive.Juices provide empty calories for infants.

Question 5

At what age is it safe to give infants whole milk instead of commercial infant formula?

Accepted Answer

The American Academy of Pediatrics does not recommend the use of cow's milk for children younger than 12 months.At 6 and 9 months,the infant should be receiving breast milk or iron-fortified commercial infant formula.At age 18 months,milk and formula are supplemented with solid foods,water,and some fruit juices.

Question 6

The nurse is performing an assessment on a 10-week-old infant.The nurse understands that the developmental characteristic of hearing at this age is which?

Accepted Answer

At 8 to 12 weeks of age,the infant turns the head to the side when sound is made at the level of the ear.At 16 to 24 weeks,the infant locates sound by turning the head to the side and then looking up or down.At 24 to 32 weeks,infants respond to their own name.At 32 to 40 weeks,the infant localizes sounds by turning the head directly toward the sound.

Question 7

The parent of an 8.2-kg (18-lb)9-month-old infant is borrowing a federally approved car seat from the clinic.The nurse should explain that the safest way to put in the car seat is what?

Accepted Answer

A rear-facing car seat provides the best protection for an infant's disproportionately heavy head and weak neck.The middle of the back seat is the safest position for the child.Severe injuries and deaths in children have occurred from air bags deploying on impact in the front passenger seat.

Question 8

The parents of a 4-month-old infant tell the nurse that they are getting a microwave oven and will be able to heat the baby's formula faster.What should the nurse recommend?

Accepted Answer

If a microwave is being used,the bottle should be left uncovered.This will allow heat to escape.No more than 4 oz should be heated at any one time.Bottles can be heated safely in microwave ovens if safety guidelines are followed.The bottle should be inverted 10 times; vigorous shaking is not necessary.

Question 9

The nurse is providing anticipatory guidance to parents of a 4-month-old infant on preventing an aspiration injury.What should the nurse include in the teaching?

Accepted Answer

Anticipatory guidance to prevent aspiration for a 4-month-old infant takes into account that the infant will begin to be more active and place objects in the mouth.Toys should be checked for removable parts; baby powder should be kept out of reach; and hard candy,nuts,and foods with pits should be avoided.The infant should not go to bed with a bottle.Teething biscuits should be used with caution because large chunks may be broken off and aspirated.

Question 10

An infant weighed 8 lb at birth and was 18 inches in length.What weight and length should the infant be at 5 months of age?

Accepted Answer

Infants gain 680 g (1.5 lb)per month until age 5 months,when the birth weight has at least doubled.Height increases by 2.5 cm (1 inch)per month during the first 6 months.Therefore,at 5 months the infant should weigh 16 lb and be 23 inches in length.

Question 11

At an 8-month-old well-baby visit,the parent tells the nurse that her infant falls asleep at night during the last bottle feeding but wakes up when moved to the infant's crib.What is the most appropriate response for the nurse to make?

Accepted Answer

Increasing the daytime intervals to 4 hours and placing the baby in the crib while still awake are interventions for nighttime sleeping problems.Putting the baby to bed 1 hour earlier with a pacifier will not stop the need for the bedtime bottle; there is no research that rice cereal in the bottle helps to satisfy the baby longer at night,and switching partners does not guarantee that the baby will go to sleep better.

Question 12

The nurse is teaching parents about expected language development for their 6-month-old infant.The nurse recognizes the parents understand the teaching if they make which statement?

Accepted Answer

By 6 months,infants imitate sounds; add the consonants t,d,and w; and combine syllables (e.g.,"dada"),but they do not ascribe meaning to the word until 10 to 11 months of age.By 9 to 10 months,they comprehend the meaning of the word "no" and obey simple commands accompanied by gestures.By age 1 year,they can say three to five words with meaning and may understand as many as 100 words.

Question 13

The parents of a 12-month-old child ask the nurse if the child can eat hot dogs as do their other children.The nurse's reply should be based on what?

Accepted Answer

To eat a hot dog safely,the child should be sitting down,and the hot dog should be cut into small,irregular pieces rather than served whole or in slices.The child's digestive system is mature enough to digest hot dogs.Hot dogs are of a consistency,diameter,and shape that may cause complete obstruction of the child's airway if not cut into irregular,small pieces.

Question 14

The nurse is providing anticipatory guidance to parents of an 8-month-old infant on preventing a drowning injury.Which should the nurse include in the teaching?

Accepted Answer

Anticipatory guidance to prevent drowning for an 8-month-old infant takes into account that the child will begin to crawl,cruise around furniture,walk,and climb.Fences should be placed around swimming pools,unnecessary pools of water should be eliminated,one hand should be kept on the child when bathing,and the child should be supervised when near any source of water.The bathroom doors should be kept closed.

Question 15

The nurse is teaching a group of parents at a community education program about introducing solid foods to their infants.Which recommendations should the nurse include?

Accepted Answer

Teaching related to feeding an infant solid foods should include introducing a wide variety of foods because an infant has not developed a strong food preference as seen with a toddler.As solid food consumption increases,the amount of milk consumed should decrease to less than 1 L/day to prevent overfeeding.Introduction to citrus fruits,meats,and eggs should be delayed until after 6 months of age because of the potential to cause food allergies.New foods should be introduced at 5- to 7-day intervals to evaluate for food allergies.Spoon feedings should be introduced after a small ingestion of milk,not at the end of a milk feeding,to associate the activity with pleasure.In general,low-calorie milk and food should be avoided.

Question 16

In teaching parents about appropriate pacifier selection,the nurse should recommend which characteristic?

Accepted Answer

A good pacifier should be easily grasped by the infant.One-piece construction is necessary to avoid having the nipple and guard separate,posing a risk for aspiration.The material should be sturdy and flexible.If the pacifier is too pliable,it may be aspirated.No ribbon or string should be attached.This poses additional risks.

Question 17

What is the best age to introduce solid food into an infant's diet?

Accepted Answer

Physiologically and developmentally,4- to 6-month-old infants are in a transition period.The extrusion reflex has disappeared,and swallowing is a more coordinated process.In addition,the gastrointestinal tract has matured sufficiently to handle more complex nutrients and is less sensitive to potentially allergenic food.Infants of this age will try to help during feeding.Two to 3 months is too young.The extrusion reflex is strong,and the child will push food out with the tongue.No research indicates that the addition of solid food to a bottle has any benefit.Infant birth weight doubles at 1 year.Solid foods can be started earlier.Tooth eruption can facilitate biting and chewing; most infant foods do not require this ability.

Question 18

The nurse is performing an assessment on a 12-month-old infant.Which fine or gross motor developmental skill demonstrates the proximodistal acquisition of skills?

Accepted Answer

Acquisition of fine and gross motor skills occurs in an orderly center-to-periphery (proximodistal)or head-to-toe (cephalocaudal)sequence.A fully developed pincer grasp is an example of the proximodistal development because infants use a palmar grasp before developing the finer pincer grasp.Standing,sitting without assistance,and taking a few steps are examples of a cephalocaudal development sequence.

Question 19

The clinic nurse is teaching parents about physiologic anemia that occurs in infants.What statement should the nurse include about the cause of physiologic anemia?

Accepted Answer

Fetal hemoglobin results in a shortened survival of red blood cells (RBCs)and thus a decreased number of RBCs.Maternally derived iron stores are present for the first 5 to 6 months results in a shortened survival of RBCs and thus a decreased number of RBCs.High levels of fetal hemoglobin depress the production of erythropoietin,a hormone released by the kidney that stimulates RBC production.

Question 20

The nurse is providing anticipatory guidance to the parents of a 1-month-old infant on preventing a suffocation injury.Which should the nurse include in the teaching?

Accepted Answer

Anticipatory guidance for a 1-month-old infant to prevent a suffocation injury takes into account that the infant will have increased eye-hand coordination and a voluntary grasp reflex as well as a crawling reflex that may propel the infant forward or backward.Pillows should not be placed in the infant's crib,plastic bags should be kept out of reach,and a pacifier should not be tied on a string around the neck.Crib slats should be 2.4 inches apart (4 inches is too wide),and the mattress should not be covered with plastic even if a sheet is used to cover it.

Quiz 10: Health Promotion of the Infant and Family