A nurse is providing teaching about infant nutrition to a group of parents and guardians. Which of the following statements should the nurse include?
"Introduce solid foods when the infant reaches 3 months of age."
"Offer 1 tablespoon as a serving size for the infant's solid food."
"Add 1 teaspoon of honey to the infant's bottle of formula if constipation occurs."
"Introduce the infant to a new solid food every other day."
The Correct Answer is B
A. "Introduce solid foods when the infant reaches 3 months of age." Solid foods should be introduced around 4 to 6 months of age, when the infant shows signs of readiness (e.g., sitting with support, loss of tongue-thrust reflex).
B. "Offer 1 tablespoon as a serving size for the infant's solid food." A general guideline is 1 tablespoon of food per year of age per serving, so for an infant just starting solids, 1 tablespoon is appropriate per meal.
C. "Add 1 teaspoon of honey to the infant's bottle of formula if constipation occurs." Honey should not be given to infants under 1 year old due to the risk of botulism.
D. "Introduce the infant to a new solid food every other day." New foods should be introduced one at a time, every 3 to 5 days, to monitor for potential allergic reactions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Heart rate – No data regarding heart rate is provided in the exhibit, so this is not a relevant option.
B. HbA1c – The child's HbA1c level is 8.5%, which is elevated above the normal range (4% to 5.9%). This indicates poor glycemic control, suggesting the development of cystic fibrosis-related diabetes (CFRD), a common complication of cystic fibrosis. This should be reported to the provider for further evaluation and management.
C. WBC count – The WBC count is 9,600/mm³, which is within the normal range (5,000 to 10,000/mm³), so it does not require reporting.
D. Oxygen saturation – No data regarding oxygen saturation is provided in the exhibit, making this option irrelevant.
Correct Answer is D
Explanation
A. "Temperature 38.6° C (101.5° F)." A fever is not an indicator of improved hydration or effective fluid resuscitation. It may be related to an underlying infection, which could contribute to hypovolemia.
B. "Sunken anterior fontanel." A sunken fontanel is a sign of dehydration, indicating that the fluid replacement was not fully effective. If the treatment were successful, the fontanel should be normal (flat and soft).
C. "Tachycardia." Tachycardia is a sign of ongoing hypovolemia or distress. If fluid resuscitation was effective, the heart rate should return to normal for the infant's age.
D. "Capillary refill is 2 seconds." A capillary refill time of 2 seconds or less indicates adequate peripheral perfusion and improved circulation, showing that the fluid bolus was effective in restoring blood volume and perfusion.
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