Exhibit 1. Nurses' Notes.
Today, 1000: Exhibit 2. Infant here at the provider's office for a scheduled visit.
The infant is in their parent's arms, grimacing.
S1 and S2 auscultated, no murmur noted.
Respirations are symmetric and unlabored with abdominal movement.
Abdomen is soft and flat, bowel sounds present.
Current weight is 4.1 kg (9 lb) The parent states they have exclusively breast- and bottle-fed breastmilk to the infant since birth.
The parent states the infant sometimes chokes with bottle feedings.
The parent noticed that the infant recently started "spitting up" during the night and after feeds, and cries excessively.
They state the infant has been vomiting more forcefully and has become disinterested in feeding.
Today, 1010: Exhibit 3. Provider assessed infant and discussed gastroesophageal reflux with parent.
Education provided.
1 month later: Infant here for follow-up visit.
Infant is calm and alert in parent's arms.
Parent states infant is sleeping through the night.
Parent states infant continues to spit up. States they have been thickening bottle feedings and the infant has taken them well.
Current weight is 5 kg (11 lb)
What is the most notable change observed in the infant's condition during the one-month follow-up visit?
Sleeping pattern.
Irritability.
Weight.
Regurgitation.
Heart rate.
Bottle feeding.
Correct Answer : C,D,F
Choice A rationale:
The sleeping pattern is mentioned, but it does not provide relevant information regarding the infant's condition. The fact that the infant is sleeping through the night does not address the concerns related to gastroesophageal reflux.
Choice B rationale:
Irritability is mentioned in the notes, but it is not a parameter that directly reflects the improvement or worsening of the infant's condition. While irritability can be a symptom of discomfort due to reflux, it's not a parameter to monitor progress over time.
Choice C rationale:
Monitoring the infant's weight is crucial in this scenario. Weight gain is a significant indicator of the infant's overall health and nutritional status. A decrease in weight gain could indicate feeding difficulties or other health issues. In this case, the weight has increased, suggesting improvement in the infant's condition.
Choice D rationale:
Regurgitation is one of the main symptoms of gastroesophageal reflux. Monitoring the frequency and severity of regurgitation is essential to assess the effectiveness of interventions, such as thickened feedings. The persistence of regurgitation in this case indicates that the condition has not completely resolved.
Choice E rationale:
Heart rate is not mentioned in the provided information, and it does not provide relevant information about the infant's condition in this context.
Choice F rationale:
Bottle feeding is mentioned, specifically the thickening of feedings. This information is crucial in assessing the effectiveness of interventions for gastroesophageal reflux. Thickened feedings are often recommended to reduce regurgitation, and the fact that the parents have been thickening the feedings suggests an attempt to manage the condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choiced. Human papillomavirus (HPV).
Choice A rationale:
Varicella (chickenpox) vaccine is typically administered to younger children, usually between 12-15 months and again at 4-6 years of age.
Choice B rationale:
The Diphtheria, Tetanus, and Pertussis (DTaP) vaccine is also given to younger children in a series of shots starting at 2 months and continuing until 4-6 years of age.At 12 years, a booster called Tdap (Tetanus, diphtheria, and pertussis) is recommended instead.
Choice C rationale:
Hepatitis A vaccine is generally given to children at 12-23 months of age in two doses, six months apart.It is not typically administered at 12 years old unless the child missed the earlier doses.
Choice D rationale:
The Human papillomavirus (HPV) vaccine is recommended for preteens aged 11-12 years to protect against cancers caused by HPV. This is the appropriate age for the first dose of the HPV vaccine.
Correct Answer is B
Explanation
Choice A rationale:
Administering acyclovir PO (by mouth) is not the appropriate treatment for impetigo. Acyclovir is an antiviral medication used to treat viral infections, such as herpes simplex virus infections. Impetigo is a bacterial skin infection and is typically treated with topical or oral antibiotics targeting the responsible bacteria.
Choice B rationale:
Applying bactericidal ointment to lesions is the correct choice. Impetigo is a bacterial skin infection caused by Staphylococcus aureus or Streptococcus pyogenes. Topical antibiotics, such as mupirocin, are effective in treating impetigo. These medications help eliminate the bacteria, promoting healing of the skin lesions.
Choice C rationale:
Soaking hairbrushes in boiling water for 10 minutes is not a relevant instruction for impetigo management. Impetigo is primarily spread through direct contact with the infected skin lesions, not through contaminated objects like hairbrushes. The focus should be on maintaining good hygiene, such as regular handwashing, to prevent the spread of the infection.
Choice D rationale:
Sealing soft toys in a plastic bag for 14 days is not a necessary measure for impetigo management. Impetigo is primarily spread through direct contact with the infected skin lesions, not through soft toys. The key prevention strategies include proper
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