The nurse admits to the clinic a 7-month-old infant whose parents report that the baby has not had a bowel movement in 4 days.
What is the nurse’s best action?
Administer a glycerin suppository as prescribed.
Administer magnesium hydroxide as prescribed.
Encourage watchful waiting for 24 hours.
Encourage feeding supplementation with free water.
The Correct Answer is A
Glycerin suppositories are safe and effective for infants with constipation. They work by lubricating and softening the stool, and stimulating the rectal muscles to contract.
Choice B is wrong because magnesium hydroxide is not recommended for infants under 6 months of age, and may cause diarrhea, electrolyte imbalance, or magnesium toxicity.
Choice C is wrong because watchful waiting for 24 hours may not be enough to relieve the infant’s discomfort and may lead to further complications such as fecal impaction or dehydration.
Choice D is wrong because feeding supplementation with free water may not be sufficient to treat constipation, and may dilute the infant’s intake of nutrients and electrolytes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Thyroid-stimulating hormone (TSH) is a hormone produced by the anterior pituitary gland that stimulates the thyroid gland to release its own hormones, triiodothyronine (T) and thyroxine (T).12 If the anterior pituitary gland is dysfunctional, it will not produce enough TSH, leading to low levels of T and T. This condition is called secondary or pituitary hypothyroidism.123
Choice A is wrong because tetraiodothyronine is another name for thyroxine (T), which is a hormone produced by the thyroid gland, not the anterior pituitary gland.14
Choice C is wrong because triiodothyronine (T) is also a hormone produced by the thyroid gland, not the anterior pituitary gland.14
Normal ranges for TSH are 0.4 to 4.0 mIU/L, for T are 100 to 200 ng/dL, and for T are 4.5 to 11.2 mcg/dL.1
Correct Answer is A
Explanation
The nurse should ask this question because the client is taking a chemical stimulant laxative, which can cause dehydration and electrolyte imbalance, especially in combination with medications for heart failure and osteoarthritis that may also affect fluid and electrolyte balance. The nurse should assess the client’s hydration status and risk of hypovolemia or hypotension.
Choice B. Timing of medication administration is wrong because it is not the priority question in this situation.
The nurse should ask this question later to determine if the client is taking the medications as prescribed and if there are any drug interactions or adverse effects.
Choice C. Previous effectiveness of laxatives is wrong because it is not relevant to the client’s current condition.
The nurse should ask this question later to evaluate the client’s bowel habits and history of constipation.
Choice D. The amount of fiber intake is wrong because it is not the priority question in this situation.
The nurse should ask this question later to educate the client about dietary measures to prevent constipation and promote bowel health.
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