A parent calls a clinic and reports to a nurse that his 2-month-old infant is hungry more than usual but is projectile vomiting immediately after eating. Which of the following responses should the nurse make?
Give your infant an oral rehydration solution.
Bring your baby in to the clinic today.
Try switching to a different formula.
Burp your baby more frequently during feedings.
The Correct Answer is B
Choice A rationale
Giving an oral rehydration solution is not appropriate without first assessing the infant. Projectile vomiting in a 2-month-old could indicate a serious condition such as pyloric stenosis, which requires medical evaluation.
Choice B rationale
Bringing the baby to the clinic today is the appropriate response. Projectile vomiting in an infant can be a sign of a serious condition that requires prompt medical evaluation and treatment.
Choice C rationale
Switching to a different formula is not appropriate without first assessing the infant. Projectile vomiting could indicate a serious condition that needs to be evaluated by a healthcare provider.
Choice D rationale
Burping the baby more frequently during feedings may help with minor feeding issues, but it is not appropriate advice for projectile vomiting. The infant needs to be evaluated by a healthcare provider to determine the cause of the vomiting.
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Correct Answer is D
Explanation
Choice A rationale
A storybook about a child who has diabetes can be helpful in educating the child about their condition and normalizing their experience. However, it may not be as effective in addressing the immediate distress caused by an insulin injection. Therapeutic play that directly involves the injection experience can be more beneficial in helping the child cope with their fear and anxiety.
Choice B rationale
A period of play in the playroom can provide a distraction and help the child relax. However, it does not specifically address the child’s distress related to the insulin injection. Therapeutic play that involves role-playing the injection process can be more effective in helping the child understand and cope with the procedure.
Choice C rationale
A video game can serve as a distraction and help the child relax. However, it does not directly address the child’s fear and anxiety related to the insulin injection. Therapeutic play that involves role-playing the injection process can be more effective in helping the child understand and cope with the procedure.
Choice D rationale
Using a needleless syringe and a doll allows the child to engage in therapeutic play that simulates the experience of receiving an insulin injection. This type of play helps the child understand the procedure, reduces fear and anxiety, and provides a sense of control over the situation. It is a direct and effective way to help the child cope with the distress caused by the injection.
Correct Answer is ["A","C","E"]
Explanation
Choice A rationale
Daytime symptoms occurring more than twice a week is an expected finding in mild persistent asthma. This indicates that the asthma is not well-controlled and requires regular use of a controller medication.
Choice B rationale
Nighttime symptoms occurring approximately twice a month is more characteristic of intermittent asthma, not mild persistent asthma.
Choice C rationale
Minor limitations with normal activity are expected in mild persistent asthma. This indicates that the asthma is affecting the child’s daily activities to some extent.
Choice D rationale
Symptoms that are continuous throughout the day are indicative of severe persistent asthma, not mild persistent asthma.
Choice E rationale
A peak expiratory flow (PEF) greater than or equal to 80% of the predicted value is an expected finding in mild persistent asthma. This indicates that the child’s lung function is relatively well-preserved.