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 A
Explanation
Choice A rationale
Cryptorchidism is the medical term for the failure of one or both testicles to descend into the scrotum. The scenario describes a 2-year-old male with one non-palpable testicle, which is the hallmark of cryptorchidism. Risk factors include prematurity and low birth weight.
Choice B rationale
An inguinal hernia is a protrusion of abdominal contents through the inguinal canal. While it can present as a swelling in the groin area, it is distinct from a missing testicle in the scrotum. Examination would typically reveal a palpable mass that may reduce with gentle pressure.
Choice C rationale
A hydrocele is a collection of fluid within the tunica vaginalis, the sac surrounding the testicle. It typically presents as a painless swelling of the scrotum. The testicle is usually palpable within the fluid-filled sac.
Choice D rationale
Testicular torsion is a medical emergency involving the twisting of the spermatic cord, which cuts off blood supply to the testicle. It presents with sudden, severe scrotal pain, swelling, and often nausea and vomiting. The examination would reveal a tender, firm, and retracted testicle. .
Correct Answer is A
Explanation
Choice A rationale
Urinary tract infections can cause bladder irritation and dysfunction, leading to symptoms such as frequency, urgency, and nocturia, which can manifest as enuresis, especially secondary enuresis (bedwetting that starts after a period of dryness). Therefore, assessing for a UTI is a crucial first step to rule out a treatable medical cause. Normal urine specific gravity ranges from 1.005 to 1.030, and a urinalysis can detect the presence of bacteria, white blood cells, or nitrites indicative of infection.
Choice B rationale
Psychological stressors can contribute to enuresis, particularly secondary enuresis. Anxiety, family changes, or school-related stress can manifest physically. While important to explore, medical causes like UTIs should be ruled out first.
Choice C rationale
Sleep patterns are relevant in the context of enuresis, as bedwetting occurs during sleep. However, assessing for a medical cause like a UTI should precede a detailed evaluation of sleep habits.
Choice D rationale
A family history of enuresis can suggest a genetic predisposition. However, the immediate nursing priority is to assess for and rule out treatable underlying medical conditions, such as a urinary tract infection.
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