A nurse is assisting with the care of a 2-month-old infant who has a subdural hematoma. Which of the following findings should the nurse expect?

Depressed fontanels

Decreased temperature

Difficult to arouse

Weak cry

Answer and Explanation

The Correct Answer is C

Choice A reason:

A subdural hematoma may not directly affect the fontanels. Depressed fontanels can be a sign of dehydration or other underlying conditions, but they are not specifically associated with a subdural hematoma.

Choice B reason:

A subdural hematoma would not typically cause a decrease in body temperature. This finding may be related to other factors, but it is not a characteristic sign of a subdural hematoma.

Choice C reason:

Correct. A subdural hematoma is a collection of blood between the dura mater and the brain. This can lead to increased intracranial pressure and result in the infant being difficult to arouse.

Choice D reason:

While a weak cry can be an indication of distress or illness in an infant, it is not a specific sign of a subdural hematoma. Other assessments, including neurological signs, are crucial in evaluating the infant's condition.

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Correct Answer is C

Explanation

Choice A reason:

Giving the infant a bottle immediately before bedtime can actually exacerbate gastroesophageal reflux, as lying down right after feeding can increase the likelihood of regurgitation.

Choice B reason:

Switching to a soy-based formula is not the first-line intervention for gastroesophageal reflux. Additionally, soy-based formulas are not recommended for all infants and should be used under specific circumstances.

Choice C reason:

This statement is correct. Keeping the infant at a 30° angle for 1 hour following each feeding can help reduce the likelihood of gastroesophageal reflux. This position helps gravity keep the stomach contents from flowing back up into the esophagus.

Choice D reason:

Limiting formula feedings to every 6 hours may not be appropriate for a 2-month-old infant, as they typically require more frequent feedings for proper growth and development.

A. Collect a stool specimen for occult blood. B. Conduct a tape test. C. Obtain a stool specimen for culture. D. Draw a blood culture.

Correct Answer is C

Explanation

Choice A reason:

Collecting a stool specimen for occult blood is not the most relevant test for suspected

Clostridium difficile infection. Stool culture or testing for C. difficile toxins is more appropriate.

Choice B reason:

Conducting a tape test is used to diagnose pinworms, not Clostridium difficile infection.

Choice C reason:

This statement is correct. Obtaining a stool specimen for culture, specifically for C. difficile, is the appropriate action for suspected infection.

Choice D reason:

Drawing a blood culture is not the primary diagnostic test for Clostridium difficile. Stool culture or testing for C. difficile toxins is more appropriate.

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A nurse is assisting with the care of a 2-month-old infant who has a subdural hematoma. Which of the following findings should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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