A nurse in a pediatric clinic is assessing a 6-week-old infant whose parent reports frequent episodes of inconsolable crying, especially in the evening, lasting several hours and several weeks.
The infant has a normal physical exam, is gaining weight appropriately, and feeds well.
Which of the following interventions should the nurse recommend to the parent to help manage the infant's symptoms?
Provide tummy time immediately after each feeding.
Change the infant's formula to a soy-based formula.
Administer omeprazole drops with every feeding.
Offer soothing techniques such as swaddling and rhythmic rocking during crying episodes.
The Correct Answer is D
Choice A rationale
Providing tummy time immediately after each feeding is generally discouraged for infants, especially those with reflux or colic-like symptoms. It can increase pressure on the abdomen and potentially worsen discomfort or lead to spitting up. Tummy time is beneficial for development but should be done when the infant is awake and not immediately after eating.
Choice B rationale
Changing the infant's formula to a soy-based formula is not a first-line recommendation for managing inconsolable crying in a 6-week-old with a normal physical exam and weight gain. While some infants may have sensitivities to cow's milk protein, a formula change should only be considered after other potential causes, like colic, have been explored and under the guidance of a healthcare provider.
Choice C rationale
Administering omeprazole drops, a proton pump inhibitor that reduces stomach acid, is not indicated for a 6-week-old infant with inconsolable crying, normal weight gain, and feeding. Omeprazole is used to treat conditions like gastroesophageal reflux disease (GERD) with documented symptoms beyond typical infant spitting up. Routine use for crying is not recommended and could have potential side effects.
Choice D rationale
Offering soothing techniques such as swaddling and rhythmic rocking are evidence-based interventions for managing inconsolable crying in young infants, often associated with colic. Swaddling provides a sense of security, mimicking the womb, while rhythmic rocking can be calming and help regulate the infant's nervous system. These non-pharmacological approaches are recommended as initial management strategies for unexplained crying in healthy infants.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Isotretinoin absorption is enhanced with high-fat meals because it is a lipophilic drug. While this is important for maximizing the medication's effectiveness, it is not the priority nursing action related to the significant risks associated with the drug.
Choice B rationale
Isotretinoin can cause increased photosensitivity, making the skin more susceptible to sunburn. Monitoring for and educating the child and family about sun protection measures, such as sunscreen and protective clothing, is crucial to prevent skin damage.
Choice C rationale
Isotretinoin is a known teratogen, meaning it can cause severe birth defects if taken during pregnancy. Therefore, ensuring that female patients of childbearing potential are using two effective forms of contraception and have a negative pregnancy test before starting treatment is a paramount safety concern and a priority nursing action.
Choice D rationale
There is no specific contraindication or recommendation regarding increased dairy intake for children receiving isotretinoin. Dairy intake does not directly address the major risks associated with the medication.
Correct Answer is C
Explanation
Choice A rationale
Corn is naturally gluten-free and is generally safe for individuals with celiac disease to consume. Celiac disease is an autoimmune disorder triggered by gluten, a protein found in wheat, barley, and rye.
Choice B rationale
Rice, in all its forms (white, brown, wild), is naturally gluten-free and is a staple grain in the diet of individuals with celiac disease. It does not contain the gliadin protein that triggers the autoimmune response in celiac disease.
Choice C rationale
Wheat contains gluten, specifically the gliadin fraction, which triggers the damaging autoimmune response in the small intestine of individuals with celiac disease. Therefore, all products containing wheat, including bread, pasta, and many processed foods, must be strictly avoided.
Choice D rationale
Oats are naturally gluten-free; however, they are often processed in facilities that also handle wheat, barley, or rye, leading to cross-contamination. While certified gluten-free oats are available, regular oats may not be safe for individuals with celiac disease due to this risk of contamination.
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