Question

A nurse is caring for an 8-month-old child who starts to cry when his parents leave. Which of the following statements should the nurse make to the parents?

Answer 1

Correct Answers:

"You should expect your child to be upset when you leave.”.

Rationale :

🟢 Separation anxiety is normal in infants around 8 months old.

🟢 Crying when parents leave shows healthy attachment and social development.

🟢 Parents should be reassured that this is expected behavior.

🟢 Helps parents avoid unnecessary worry about their child’s emotional health.

🟢 The nurse’s response normalizes the experience for the family.

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Answer 2

Correct Answers:

“I will check my baby’s skin three times each day.”.

Rationale :

🔵 Frequent skin checks help prevent breakdown and irritation from the harness.

🔵 The harness is not adjusted by parents; only by the provider.

🔵 Lotions can increase moisture and risk of skin breakdown.

🔵 Diaper should go under the harness, not over.

🔵 Proper care promotes healing and avoids complications.

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Answer 3

Correct Answers:

Observe for skin irritation.
Keep cast uncovered to allow drying.
Assess color of toes.
Check toes for capillary refill.

Rationale :

🟣 Skin checks prevent pressure sores from the cast.

🟣 Leaving the cast uncovered ensures proper drying and reduces odor/infection risk.

🟣 Checking toe color monitors for adequate blood flow.

🟣 Capillary refill assessment detects circulatory compromise early.

🟣 Leg should be elevated, not lowered, to reduce swelling.

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Answer 4

Correct Answers:

Asymmetric thigh folds.

Rationale :

🟠 Uneven thigh folds are a classic sign of developmental dysplasia of the hip.

🟠 May also see limited hip abduction on affected side.

🟠 Other findings could include shortened limb or positive Ortolani/Barlow test.

🟠 Early detection is crucial for best outcomes.

🟠 Assessment guides referral for treatment.

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Answer 5

Correct Answers:

Position the syringe to the side of the infant’s tongue.

Rationale :

🟡 Placing the syringe at the side of the tongue helps prevent aspiration and gagging.

🟡 Avoids triggering the swallowing reflex prematurely.

🟡 Never add meds to formula unless directed—may alter dose.

🟡 Supine position increases aspiration risk; hold baby semi-upright.

🟡 Ensures safe and effective medication delivery.

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Answer 6

Correct Answers:

Iron-fortified cereal.

Rationale :

🟢 Iron-fortified cereal is the first recommended solid food because it provides essential iron needed at 4–6 months as infant stores become depleted.

🟢 Introducing single-grain cereals helps identify possible food allergies early and minimizes risk.

🟢 Cereal is easy to digest and can be mixed with breast milk or formula for familiar taste and consistency.

🟢 It serves as a gentle introduction to spoon feeding and new textures.

🟢 Introducing iron-rich foods helps prevent iron deficiency anemia in infancy.

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Answer 7

Correct Answers:

The infant does not sit steadily without support.

Rationale :

🔵 By 10 months, a typically developing infant should sit unassisted.

🔵 Not being able to sit steadily suggests a possible gross motor delay that needs prompt evaluation.

🔵 Early detection of developmental delays allows for early intervention and support.

🔵 Some lack of fine motor (turning book pages) or cognitive skills (object naming) can still be normal, but sitting is a milestone.

🔵 Reporting to the provider ensures appropriate follow-up and assessment.

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Answer 8

Correct Answers:

Calculate the safe dosage.
Offer juice after the medication.
Ask the toddler to pick a toy to hold during administration.

Rationale :

🟣 Calculating dosage ensures medication is within the safe therapeutic range for age and weight, preventing toxicity or undertreatment.

🟣 Offering juice helps mask unpleasant taste and increases cooperation.

🟣 Allowing choice of toy gives toddler a sense of control and reduces anxiety.

🟣 Identification must be by comparing armband or record, not just asking caregiver.

🟣 The nurse, not the caregiver, should administer the medication for safety and documentation.

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Answer 9

Correct Answers:

Ear infections.

Rationale :

🟠 Ear infections in infants with cleft palate can quickly lead to hearing loss and speech delays due to abnormal Eustachian tube function.

🟠 Prompt reporting allows for evaluation and possible placement of ear tubes.

🟠 Early intervention minimizes risk for chronic issues and ensures optimal language development.

🟠 Other symptoms (facial paralysis, drooling) are less common or less urgent than otitis media.

🟠 Monitoring for fever, irritability, and ear pulling is essential in these infants.

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Answer 10

Correct Answers:

Pushes away stimuli.
Loud cry.
Rigid body.
Furrowed eyebrows.

Rationale :

🟡 Pain in infants is shown by behaviors like pushing away, indicating discomfort with touch.

🟡 A loud cry is a universal pain sign and signals distress.

🟡 Rigid body posture is a physical response to acute pain.

🟡 Furrowed eyebrows are a classic facial cue of discomfort in infants.

🟡 Pursed lips is less specific; grimacing, fussiness, and altered sleep patterns are also pain clues.

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QLexNursing

1 :
A nurse is caring for an 8-month-old child who starts to cry when his parents leave. Which of the following statements should the nurse make to the parents?

2 :
A nurse is reinforcing teaching with the mother of a 2-month-old infant whose provider applied a Pavlik harness 1 week earlier for the treatment of developmental hip dysplasia. Which of the following statements by the mother indicates an understanding of the teaching.

3 :
What would be included in the plan of care for a child just returned to the floor from surgery in which a clubfoot was repaired? Select all that apply.

4 :
A nurse is collecting data from an infant who has developmental dysplasia of the hip (DDH). Which of the following findings should the nurse expect?

5 :
A nurse is preparing to administer an oral elixir to a 3-month-old infant using an oral medication syringe. Which of the following actions should the nurse take?

6 :
A nurse is reinforcing teaching to the parent of an infant about the introduction of solid foods. The nurse should recommend that which of the following foods be introduced first?

7 :
A nurse is collecting data from a 10-month-old infant. Which of the following findings should the nurse report to the provider?

8 :
A nurse is preparing to administer medication to a toddler. Which of the following actions should the nurse take? Select all that apply.

9 :
The nurse is educating parents of a child with a cleft palate. What should the nurse instruct the parents to report immediately?

10 :
A nurse is collecting data from an infant who has otitis media. Which of the following findings should the nurse identify as manifestations of pain in an infant? (Select all that apply)

QLexNursing

1 : A nurse is caring for an 8-month-old child who starts to cry when his parents leave. Which of the following statements should the nurse make to the parents?

2 : A nurse is reinforcing teaching with the mother of a 2-month-old infant whose provider applied a Pavlik harness 1 week earlier for the treatment of developmental hip dysplasia. Which of the following statements by the mother indicates an understanding of the teaching.

3 : What would be included in the plan of care for a child just returned to the floor from surgery in which a clubfoot was repaired? Select all that apply.

4 : A nurse is collecting data from an infant who has developmental dysplasia of the hip (DDH). Which of the following findings should the nurse expect?

5 : A nurse is preparing to administer an oral elixir to a 3-month-old infant using an oral medication syringe. Which of the following actions should the nurse take?

6 : A nurse is reinforcing teaching to the parent of an infant about the introduction of solid foods. The nurse should recommend that which of the following foods be introduced first?

7 : A nurse is collecting data from a 10-month-old infant. Which of the following findings should the nurse report to the provider?

8 : A nurse is preparing to administer medication to a toddler. Which of the following actions should the nurse take? Select all that apply.

9 : The nurse is educating parents of a child with a cleft palate. What should the nurse instruct the parents to report immediately?

10 : A nurse is collecting data from an infant who has otitis media. Which of the following findings should the nurse identify as manifestations of pain in an infant? (Select all that apply)

1 :
A nurse is caring for an 8-month-old child who starts to cry when his parents leave. Which of the following statements should the nurse make to the parents?

2 :
A nurse is reinforcing teaching with the mother of a 2-month-old infant whose provider applied a Pavlik harness 1 week earlier for the treatment of developmental hip dysplasia. Which of the following statements by the mother indicates an understanding of the teaching.

3 :
What would be included in the plan of care for a child just returned to the floor from surgery in which a clubfoot was repaired? Select all that apply.

4 :
A nurse is collecting data from an infant who has developmental dysplasia of the hip (DDH). Which of the following findings should the nurse expect?

5 :
A nurse is preparing to administer an oral elixir to a 3-month-old infant using an oral medication syringe. Which of the following actions should the nurse take?

6 :
A nurse is reinforcing teaching to the parent of an infant about the introduction of solid foods. The nurse should recommend that which of the following foods be introduced first?

7 :
A nurse is collecting data from a 10-month-old infant. Which of the following findings should the nurse report to the provider?

8 :
A nurse is preparing to administer medication to a toddler. Which of the following actions should the nurse take? Select all that apply.

9 :
The nurse is educating parents of a child with a cleft palate. What should the nurse instruct the parents to report immediately?

10 :
A nurse is collecting data from an infant who has otitis media. Which of the following findings should the nurse identify as manifestations of pain in an infant? (Select all that apply)