A one-month-old infant admitted to the hospital with dehydration and failure to thrive receives a prescription for enteral feedings.
To maintain normal growth and development of the infant, which action should the nurse include?

Offer a pacifier for non-nutritive sucking.

Use sterile technique during feedings.

Ensure placement of the nasogastric tube with an abdominal x-ray.

Speak to the healthcare provider about instituting physical therapy.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Non-nutritive sucking, such as with a pacifier, can be soothing and calming for infants. It helps in the development of oral motor skills and provides comfort during enteral feedings, ensuring that the infant’s need for sucking is met even when they are not feeding.

Choice B rationale

Sterile technique is essential for preventing infections during invasive procedures, but enteral feeding typically does not require such stringent measures. Clean technique is usually sufficient unless the infant has a compromised immune system or other specific medical conditions requiring sterile precautions.

Choice C rationale

While verifying tube placement is critical, it is often done using methods such as pH testing of gastric contents or external marking rather than routine x-rays. Overuse of x-rays exposes infants to unnecessary radiation. X-rays are used primarily when other methods are inconclusive.

Choice D rationale

Instituting physical therapy for a one-month-old infant would not be developmentally appropriate as their primary needs are centered around nutrition, comfort, and growth. Physical therapy is more relevant for older children with developmental or mobility issues rather than infants receiving enteral feedings. .

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Correct Answer is C

Explanation

Choice A rationale

Jarisch-Herxheimer reaction is seen in spirochete infections like syphilis or Lyme disease, not typically in pelvic inflammatory disease (PID) treated with antibiotics like levofloxacin and metronidazole.

Choice B rationale

Serial anaerobic cultures are not routine for PID management. Diagnosis and management focus more on clinical symptoms and empirical antibiotic therapy rather than continuous culture monitoring.

Choice C rationale

Supervised parenteral antibiotic protocols ensure proper dosage and administration, crucial for severe infections requiring hospitalization. Monitoring treatment in a controlled environment increases effectiveness and reduces complications.

Choice D rationale

While infection control is important, PID typically spreads through sexual contact, and hospital admission for infection control is not the primary reason. The focus is more on effective treatment delivery in severe cases. .

A. Obtain bedside trays for intubation or tracheotomy by the healthcare provider. B. Schedule the child for a STAT magnetic resonance imaging (MRI) of the neck. C. Provide a nebulizer treatment with bronchodilators. D. Begin prescribed intravenous antibiotic administration.

Correct Answer is A

Explanation

Choice A rationale

The child’s symptoms suggest epiglottitis, a medical emergency requiring readiness for intubation or tracheotomy to secure the airway. Immediate preparation for these procedures is crucial to prevent airway obstruction and respiratory arrest.

Choice B rationale

Although imaging can provide diagnostic information, it is not the immediate priority. The priority is to secure the airway to prevent acute respiratory failure, making this choice less appropriate.

Choice C rationale

Nebulizer treatments can help with lower airway obstructions but are ineffective for upper airway conditions like epiglottitis. The child’s symptoms indicate upper airway obstruction, making this choice less appropriate.

Choice D rationale

While antibiotics are essential for treating infections causing epiglottitis, the immediate priority is to ensure the airway is not compromised. Securing the airway takes precedence over initiating antibiotic therapy in this acute situation.

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A one-month-old infant admitted to the hospital with dehydration and failure to thrive receives a prescription for enteral feedings. To maintain normal growth and development of the infant, which action should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

A preschool-aged child who is experiencing respiratory distress is brought to the emergency department by the parents.The child is anxious, has a temperature of 102.8°F (39.3°C), and is drooling from the mouth while leaning forward when sitting. Which action should the nurse implement next?

Correct Answer is A

Explanation

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A one-month-old infant admitted to the hospital with dehydration and failure to thrive receives a prescription for enteral feedings.
To maintain normal growth and development of the infant, which action should the nurse include?