Health Problems of Infants

1. Recent studies indicate that a deficiency of which of the following vitamins correlates with increased morbidity and mortality in children with measles? a. A
b. C

c. Niacin
d. Folic acid

ANS: A
Vitamin A deficiency is correlated with increased morbidity and mortality in children with measles. This vitamin deficiency also is associated with complications from diarrhea, and infections are often increased in infants and children with vitamin A deficiency.

DIF: Cognitive Level: Comprehension REF: Page 378
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:BasicCareandComfort

2. Which of the following vitamins is recommended for all women of childbearing age to reduce the risk of neural tube defects such as spina bifida?
a. A
b. C

c. Niacin
d. Folic acid

ANS: D
The vitamin supplement that is recommended for all women of childbearing age is a daily dose of 0.4 mg of folic acid. Folic acid taken before conception and during pregnancy can reduce the risk of neural tube defects by 70%.

DIF: Cognitive Level: Comprehension REF: Page 379
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:BasicCareandComfort

3. Which of the following vitamins increases the absorption of iron? a. A

b. C
c. D
d. Biotin

Pub Review 11-2

ANS: B
Vitamin C increases the absorption of iron for hemoglobin formation.

DIF: Cognitive Level: Knowledge REF: Page 380
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:BasicCareandComfort

4. Which of the following vitamins is administered prophylactically to all newborns to ensure adequate blood clotting?
a. A
b. K

c. Niacin
d. Folic acid

ANS: B
Vitamin K is a catalyst for the production of prothrombin and the liver clotting factors II, VII, IX, and X.

DIF: Cognitive Level: Knowledge REF: Page 392
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:PharmacologicTherapies

5. Rickets is caused by a deficiency in: a. vitamin A.

b. vitamin C.
c. vitamin D and calcium. d. folic acid and iron.

ANS: C
Fat-soluble vitamin D and calcium are necessary in adequate amounts to prevent the development of rickets.

DIF: Cognitive Level: Knowledge REF: Page 379
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:ReductionofRiskPotential

6. Which of the following factors will decrease iron absorption and therefore should not be given at the same time as an iron supplement?
a. Milk
b. Multivitamin

c. Fruit juice
d. Meat, fish, poultry

ANS: A
Many foods interfere with iron absorption and should be avoided when the iron is consumed. These foods include phosphates found in milk, phytates found in cereals, and oxalates found in many vegetables.

Pub Review 11-3

DIF: Cognitive Level: Comprehension REF: Page 380
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:PharmacologicTherapies

7. Which of the following foods should the nurse recommend as a good source of potassium for a child receiving diuretics?
a. Carrots
b. Bananas

c. Dairy products
d. Dark green vegetables

ANS: B
Potassium supplementation is required with the use of some diuretics. Bananas, citrus fruits, bran, legumes, and peanut butter are some of the foods that are significant sources of potassium.

DIF: Cognitive Level: Comprehension REF: Page 394
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Physiologic Integrity: Basic Care and Comfort

8. The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for their children. Which of the following is most likely lacking in their particular diet?
a. Fat

b. Protein
c. Vitamins C and A d. Complete protein

ANS: D
The vegetarian diet can be extremely healthy, meeting the overall nutrition objectives for Healthy People 2010. Parents should be taught about food preparation to ensure that complete proteins are available for growth. When parents use a strict vegetarian diet, likelihood exists of inadequate protein for growth and calories for energy.

DIF: Cognitive Level: Application REF:
TOP: Integrated Process: Teaching/Learning
MSC: AreaofClientNeeds:PhysiologicIntegrity:BasicCareandComfort

9. Marasmus is which of the following?
a. Deficiency of protein with an adequate supply of calories
b. Not confined to geographic areas where food supplies are inadequate
c. Syndrome that results solely from vitamin deficiencies
d. Characterized by thin, wasted extremities and a prominent abdomen resulting

from edema (ascites) ANS: B

Page 380

Pub Review 11-4

Marasmus is a syndrome of emotional and physical deprivation. It is not confined to geographic areas were food supplies are inadequate.

DIF: Cognitive Level: Comprehension REF: Page 383
TOP: Integrated Process: Nursing Process: Problem Identification
MSC: AreaofClientNeeds:PhysiologicIntegrity:ReductionofRiskPotential

10. Although infants may be allergic to a variety of foods, the most common allergens are:

fruit and eggs.
fruit, vegetables, and wheat.
cow’s milk and green vegetables.
eggs, cow’s milk, and wheat.

ANS: D
Milk products, eggs, and wheat are three of the most common food allergens. Ingestion of these products can cause sensitization and, with subsequent exposure, an allergic reaction.

DIF: Cognitive Level: Comprehension REF: Page 385 | Page 386 TOP: Integrated Process: Nursing Process: Problem Identification
MSC: AreaofClientNeeds:PhysiologicIntegrity:BasicCareandComfort

11. Lactose intolerance is diagnosed in a 14-month-old child. Which of the following should the nurse recommend as a substitute for milk?
a. Yogurt
b. Ice cream

c. Fortified cereal
d. Cow’s milk formula

ANS: A
Yogurt contains the inactive lactase enzyme, which is activated by the temperature and pH of the duodenum. This lactase activity substitutes for the lack of endogenous lactase.

DIF: Cognitive Level: Application REF:
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Basic Care and Comfort

12. Which of the following terms refers to the return of undigested food from the stomach, usually accompanied by burping?
a. Spitting up
b. V omiting

c. Rumination d. Regurgitation

ANS: D

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Pub Review 11-5

Regurgitation is the return of undigested food from the stomach, usually accompanied by burping.

DIF: Cognitive Level: Comprehension REF: Page 395
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Basic Care and Comfort

13. A parent of an infant with colic tells the nurse, “All this baby does is scream at me; it is a constant worry.” The nurse’s best action is which of the following?
a. Encourage parent to verbalize feelings.
b. Encourage parent not to worry so much.

c. Assess parent for other signs of inadequate parenting.
d. Reassure parent that colic rarely lasts past age 9 months.

ANS: A
Colic is multifactorial, and no single treatment is effective for all infants. The parent is verbalizing concern and worry. The nurse should allow the parent to put these feelings into words. An empathic, gentle, and reassuring attitude, in addition to suggestions about remedies, will help alleviate the parent’s anxieties.

DIF: Cognitive Level: Application REF:
TOP: Integrated Process: Teaching/Learning
MSC: AreaofClientNeeds:PsychosocialIntegrity:TherapeuticCommunication

14. Parent guidelines for relieving colic in an infant include which of the following? a. Avoid touching abdomen.
b. Avoid using a pacifier.
c. Change infant’s position frequently.

d. Place infant where family cannot hear the crying.

ANS: C
Changing the infant’s position frequently may be beneficial. The parent can walk holding the child face down and with the child’s chest across the parent’s arm. The parent’s hand can support the child’s abdomen, applying gentle pressure.

DIF: Cognitive Level: Analysis REF:
TOP: Integrated Process: Teaching/Learning
MSC: AreaofClientNeeds:PhysiologicIntegrity:BasicCareandComfort

15. Clinical manifestations of nonorganic failure to thrive include which of the following?

a. Avoidance of eye contact
b. An associated malabsorption defect
c. Weight that falls below the 15th percentile
d. Normal achievement of developmental landmarks

ANS: A

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Pub Review 11-6

One of the clinical manifestations of nonorganic failure to thrive is the child’s avoidance of eye contact with the health professional.

DIF: Cognitive Level: Comprehension REF: Page 399
TOP: Integrated Process: Nursing Process: Assessment
MSC: AreaofClientNeeds:PhysiologicIntegrity:ReductionofRiskPotential

16. Which of the following is an important nursing consideration when caring for an infant with failure to thrive?
a. Establish a structured routine and follow it consistently.
b. Maintain a nondistracting environment by not speaking to child during feeding. c. Place child in an infant seat during feedings to prevent overstimulation.

d. Limit sensory stimulation and play activities to alleviate fatigue.

ANS: A
The infant with failure to thrive should have a structured routine that is followed consistently. Disruptions in other activities of daily living can have a great impact on feeding behaviors. Bathing, sleeping, dressing, playing, and feeding are structured.

DIF: Cognitive Level: Comprehension REF: Page 399
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:ReductionofRiskPotential

17. An important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS) would be which of the following?
a. Explain how SIDS could have been predicted and prevented.

b. Interview parents in depth concerning the circumstances surrounding the child’s death.

c. Discourage parents from making a last visit with the infant.
d. Make a follow-up home visit to parents as soon as possible after the child’s

death.

ANS: D
A competent, qualified professional should visit the family at home as soon as possible after the death and provide the family with printed information about SIDS.

DIF: Cognitive Level: Analysis REF: Page 404
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PsychosocialIntegrity:CopingandAdaptation

18. Which of the following is an appropriate action when an infant becomes apneic? a. Shake vigorously.
b. Roll head side to side.
c. Hold by feet upside down with head supported.

d. Gently stimulate trunk by patting or rubbing. ANS: D

Pub Review 11-7

If the infant is apneic, the infant’s trunk should be gently stimulated by patting or rubbing. If the infant is prone, turn onto the back.

DIF: Cognitive Level: Comprehension REF: Page 406
TOP: Integrated Process: Nursing Process: Implementation
MSC: AreaofClientNeeds:PhysiologicIntegrity:PhysiologicAdaptation

MULTIPLE RESPONSE

1. After the introduction of the Back to Sleep campaign in 1992, an increased incidence has been noted of which of the following pediatric disorders? (Select all that apply.) a. SIDS
b. Torticollis

c. Failure to thrive d. Apnea of infancy e. Plagiocephaly

ANS: B, E
Plagiocephaly is a misshapen head caused by the prolonged pressure on one side of the skull. If that side becomes misshapen, facial asymmetry may result. The sternocleidomastoid muscle may tighten on the affected side, causing torticollis.

DIF: Cognitive Level: Comprehension REF: Page 400
TOP: Integrated Process: Nursing Process: Assessment
MSC: AreaofClientNeeds:PhysiologicIntegrity:ReductionofRiskPotential