A ten-month-old infant has been diagnosed with HIV. The nurse knows that:

The mother must be mandatorily tested.

The infant should begin ART after turning 12 months old.

The infant should be immediately placed on antiretroviral therapy, or ART.

Once the infant has a clinical manifestation of AIDS, then ART should begin.

Answer and Explanation

The Correct Answer is C

Choice A reason: This is not a correct statement. The mother should be offered testing, but not forced to do so. However, the nurse should explain the benefits of testing and treatment for the mother and the infant.

Choice B reason: This is not a correct statement. The infant should not wait until 12 months old to begin ART. According to the World Health Organization, all infants diagnosed with HIV should start ART as soon as possible, regardless of their age or clinical stage¹.

Choice C reason: This is the correct statement. The infant should be immediately placed on ART to reduce the risk of disease progression, opportunistic infections, and mortality. Early initiation of ART can also improve the infant's growth, development, and quality of life.

Choice D reason: This is not a correct statement. The infant should not wait until they have a clinical manifestation of AIDS to begin ART. Delaying ART can increase the risk of irreversible damage to the immune system, organ failure, and death.

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Correct Answer is B

Explanation

Choice A reason: Informing the family that supplemental feeding through an N/G tube will probably be needed is not a correct feeding instruction for a newborn with cleft lip and palate. An N/G tube is a nasogastric tube that is inserted through the nose into the stomach to provide nutrition. It is usually used for infants who have severe feeding difficulties or other medical conditions that require tube feeding. However, most infants with cleft lip and palate can be fed orally with proper techniques and equipment, and do not need an N/G tube.

Choice B reason: Demonstrating feeding the infant using the squeeze bottle and ESSR method of feeding is a correct and helpful feeding instruction for a newborn with cleft lip and palate. A squeeze bottle is a special bottle that has a soft nipple and a valve that allows the caregiver to control the flow of milk by squeezing the bottle. The ESSR method stands for Enlarge nipple opening, Stimulate the suck reflex, Swallow, and Rest. It is a technique that helps the infant to suck and swallow effectively, and to prevent choking or aspiration. The nurse should show the family how to use the squeeze bottle and the ESSR method, and let them practice under supervision.

Choice C reason: Instructing the parents to add rice cereal to the formula is not a necessary or advisable feeding instruction for a newborn with cleft lip and palate. Rice cereal is sometimes added to the formula to thicken it and reduce the risk of reflux or regurgitation. However, it is not recommended for infants younger than four months, as it may cause constipation, overfeeding, or allergic reactions. It may also interfere with the absorption of iron and other nutrients. Rice cereal is not a substitute for proper feeding techniques and equipment for infants with cleft lip and palate.

Choice D reason: Infants with cleft lip and palate usually have an easy time breastfeeding is a false and misleading feeding instruction for a newborn with cleft lip and palate. Breastfeeding is the ideal way of feeding a newborn, as it provides optimal nutrition, immunity, and bonding. However, breastfeeding can be challenging for infants with cleft lip and palate, as they may have difficulty creating a seal, latching on, or sucking effectively. Some infants may be able to breastfeed with the help of a nipple shield, a breast pump, or a supplemental nursing system. However, others may need to be fed with a bottle or a cup. The nurse should support the mother's choice of feeding method, and provide education and resources to help her succeed.

A. Surgery will be necessary. B. Dietary restrictions will be required throughout childhood. C. Slow feeding will be necessary for a few months. D. Chromosomal mutation is the cause.

Correct Answer is A

Explanation

Choice A reason: Surgery is the definitive treatment for hypertrophic pyloric stenosis, which is a condition in which the muscle of the pylorus (the outlet of the stomach) becomes thickened and blocks the passage of food into the small intestine. The surgery, called pyloromyotomy, involves cutting the muscle to widen the opening and allow food to pass through. The surgery is usually done laparoscopically, with small incisions and a camera, and has a high success rate and low complication rate¹.

Choice B reason: Dietary restrictions are not required throughout childhood for infants with hypertrophic pyloric stenosis. After the surgery, the infant can resume normal feeding, usually within a few hours or days. The infant may have some vomiting or spitting up for a short period, but this usually resolves without any special diet.

Choice C reason: Slow feeding is not a necessary intervention for infants with hypertrophic pyloric stenosis. Slow feeding may help reduce the amount of vomiting, but it does not address the underlying problem of the pyloric obstruction. Slow feeding may also cause the infant to become frustrated, hungry, or tired. The infant should be fed according to his or her appetite and cues, and burped frequently to prevent air swallowing.

Choice D reason: Chromosomal mutation is not the cause of hypertrophic pyloric stenosis. The exact cause of this condition is unknown, but it is likely influenced by both genetic and environmental factors. Some studies have found an association between hypertrophic pyloric stenosis and certain genes, but no single gene mutation has been identified as the cause. Other risk factors include being male, firstborn, premature, exposed to certain antibiotics, or having a family history of the condition².

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A ten-month-old infant has been diagnosed with HIV. The nurse knows that:

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Naxlex Comprehensive Predictor Exams

The nurse providing feeding instructions to a family with a newborn with cleft lip and palate will include:

Correct Answer is B

Explanation

The mother of an infant with hypertrophic pyloric stenosis asks the nurse many questions about the problem. When answering these questions, the nurse should convey the idea that:

Correct Answer is A

Explanation

Parents tell the nurse that their toddler daughter eats little at mealtimes, only sits at the table with the family briefly, and wants snacks "all the time". The nurse should recommend that the parents:

You are discussing prevention of infective endocarditis with parents of a child with a complex congenital heart defect. A critical teaching point to emphasize includes:

A mother who intended to breastfeed has given birth to an infant with a cleft palate. Which nursing interventions should be included in the plan of care?

Which should the nurse consider when preparing a school-age child and the family for heart surgery?

Nurses must be alert for increased fluid requirements when a child has:

An infant is brought to the emergency department with poor skin turgor, weight loss, irritability, and tachycardia. The nurse analyzes the data to suggest:

The nurse is providing phone advice to the father of a 7-year-old child who has lice. The nurse recommends:

A child weighing 20 kg with rule out sepsis is admitted to the hospital. Cefotaxime 700 mg IV q6 hrs is ordered. Safe dose is 50-200 mg/kg/day. Is this a safe dose? True means it is safe; false means it is not safe.