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Flashcards in Chapter 11 Deck (10):
1

Which strategy might be recommended to increase caloric intake in an infant with failure to thrive?
a. Use developmental stimulation by a specialist during feedings.
b. Avoid solids until after the bottle is well accepted.
c. Be persistent through 10 to 15 minutes of food refusal.
d. Vary the schedule for routine activities on a daily basis.

Ans: C
Calm perseverance is important. Parents often cannot persist through the child's refusals, but they should be encouraged to do so and supported.
Feeding should take place in a nonstimulating environment so that the focus is on feeding, enhancing the chances of increasing caloric intake.
Solids should be introduced slowly to decrease dependence on the bottle, beginning at 6 months of age.
The feeding schedule should be structured for the infant to have consistency and develop a routine for feeding.

2

A mother is bringing her 4-month-old infant into the clinic for a routine well-baby check. The mother is exclusively breastfeeding. There are no other liquids given to the infant. What vitamin does the nurse anticipate the provider will prescribe for this infant?
a. Vitamin B
b. Vitamin D
c. Vitamin C
d. Vitamin K

Ans: B
The American Academy of Pediatrics recommends that infants who are exclusively breastfed receive 200 IU of vitamin D daily by age 2 months to decrease vitamin D deficiency.
Vitamin B is not needed.
Vitamin C is not needed.
Vitamin K is not needed.

3

A nurse is providing education to a community group in preparation for a mission trip to a third world country with limited access to protein-based food sources. The nurse is aware that children in this country are at increased risk for
a. rickets.
b. marasmus.
c. kwashiorkor.
d. pellagra.

Ans: C
Kwashiorkor is defined as primarily a deficiency of protein with an adequate supply of calories.
Rickets results from a lack of vitamin D, calcium, or phosphate. It leads to softening and weakening of the bones.
Marasmus results from general malnutrition of both calories and protein.
Pellagra is a vitamin-deficiency disease most commonly caused by a chronic lack of niacin (vitamin B3) in the diet.

4

A nurse is caring for a 2-month-old exclusively breastfed infant with an admitting diagnosis of colic. Based on the nurse’s knowledge of breastfed infants, what type of stool is expected?
a. Dark brown and small hard pebbles
b. Loose with green mucus streaks
c. Formed and with white mucus
d. Semiformed, seedy, yellow

Ans: D
Colic does not change the appearance, texture, or color of stools. The color, consistency, and texture of the stools would be normal for the type of feeding. In a breastfeeding infant, that would be semiformed, seedy, and yellow.
Dark brown, small hard pebbles are not a typical bowel movement of an exclusively breastfed infant.
Loose stool with green mucus streaks is not a typical bowel movement of an exclusively breastfed infant.
Formed stool with white mucus is not a typical bowel movement of an exclusively breastfed infant.

5

The nurse is providing education to parents of an infant diagnosed with colic. What would the nurse include in the discharge teaching?
a. The child will have to be watched for gastrointestinal issues in the future.
b. The symptoms of colic typically disappear by 3 months of age.
c. Providing juice at the start of the fussy period will help decrease the length of the crying episodes.
d. The feeding method needs to be changed to a hypoallergenic formula.

Ans: B
The symptoms of colic typically disappear by 3 months of age.
The child will not have to be watched for gastrointestinal issues in the future, because colic is not related to long-term gastrointestinal problems.
Providing juice at the start of the fussy period will help decrease the length of the crying episodes. There is no evidence that juice will decrease the length of crying in colicky babies.
Changing the feeding method to a hypoallergenic formula is not typically recommended for the infant with colic.

6

A 1-month-old infant is admitted to the hospital for failure to thrive (FTT) secondary to a cardiac condition. Based on the nurse’s knowledge of the different types of FTT, this type of FTT is categorized as
a. nonorganic.
b. organic.
c. idiopathic.
d. generalized.

Ans: B
Organic FTT is the result of a physical cause, such as a cardiac condition, neurologic condition, renal failure, endocrine system disorder, or other possible chronic or acute disease process.
Nonorganic FTT is most often the result of psychosocial factors, such as inadequate nutritional information by the parent.
Idiopathic FTT is unexplained by the usual organic and environmental etiologies.
Generalized FTT is not a recognized term.

7

A 9-month-old infant is seen in the emergency department after developing urticaric rash with cough and wheezing. When collecting the history of events prior to the sudden onset of the rash with cough and wheezing, the mother states they were “feeding the baby new foods.” Which food is the possible cause of this type of reaction in the infant?
a. Potatoes
b. Green beans
c. Spinach
d. Peanut butter

Ans: D
Nuts of any type, including peanuts, have a high allergy index in children and infants. The infant has demonstrated the cutaneous and respiratory type of reaction after possible ingestion of peanut butter.
Potatoes are not a highly allergenic food.
Green beans are not a highly allergenic food.
Spinach is not a highly allergenic food.

8

Infants most at risk for sudden infant death syndrome (SIDS) are those (Select all that apply)
a. Who sleep supine
b. Who sleep prone
c. Who were premature
d. With prenatal drug exposure
e. With a cousin that died of SIDS

Ans: B, C, D

9

The nurse is providing education to a parent of a 10-month-old infant with the diagnosis of cow’s milk allergy. What will be included in the teaching? (Select all that apply.)
a. Reading of all food labels to avoid products with milk.
b. Use of milk to desensitize the child.
c. Introduction of soy-based products to replace milk.
d. Signs and symptoms associated with potential accidental ingestion of milk.

Ans: A, C, D

10

The primary goals in the nutritional management of children with failure to thrive (FTT) are (Select all that apply)
a. allow for catch-up growth.
b. correct nutritional deficiencies.
c. achieve ideal weight for height.
d. restore optimum body composition.
e. educate the parents or primary caregivers on child’s nutritional requirements
f. educate the parents or primary caregivers that the child will need tube feedings first.

Ans: A, B, C, D, E