A new mother is preparing for discharge from the birthing center and relays to the nurse her concerns about how she will handle the baby's episodes of crying. What is the nurse's best response?

Correct Answer: A

Rationale: The correct answer is A) "I hear your concern. Is there someone in the household who cannot tolerate hearing a baby cry?" This response demonstrates empathetic listening and addresses the mother's concerns while also assessing potential risks to the baby's well-being. Option B is incorrect as advising a parent to let a baby cry can lead to increased stress for both the baby and parent, and contradicts current evidence-based practices that emphasize responsive caregiving. Option C is incorrect as it oversimplifies the reasons for infant crying, which can be due to a variety of factors beyond hunger or gas. Suggesting that the mother modify her diet to reduce gas-producing foods is not appropriate advice in this context. In an educational context, it is important for nurses to support parents in understanding and responding to their baby's needs, especially in the context of infant crying, which can be distressing for both the baby and caregivers. Teaching parents about normal infant behavior, soothing techniques, and when to seek help can help promote a positive parent-child relationship and infant well-being.

Correct Answer: A

Rationale: The correct answer is A because encouraging a baby to consume the entire amount of formula prepared for each feeding may lead to overeating, regurgitation, and possible aspiration. It is important for the infant to stop suckling when full. The other statements show appropriate knowledge about bottle feeding, including preparing formula in advance, holding the baby correctly, and feeding based on hunger cues rather than a strict schedule.

Correct Answer: D

Rationale: In the context of caring for a small for gestational age (SGA) newborn experiencing respiratory distress, the most crucial nursing action is to prevent hypoglycemia with early and frequent feedings (option D). This is because SGA infants are at a higher risk for hypoglycemia due to their decreased glycogen stores and limited ability to regulate blood sugar levels. Providing timely and regular feedings helps maintain adequate glucose levels, supporting the baby's metabolic needs and overall well-being. Option A, promoting bonding, while important for overall infant development, is not the priority in the immediate care of an SGA newborn in respiratory distress. Option B, observing for and preventing dehydration, is also significant but addressing hypoglycemia takes precedence due to its potential for serious consequences in SGA infants. Option C, observing for respiratory distress syndrome, is relevant but not specific to the needs of an SGA newborn who is already experiencing respiratory distress. Educationally, understanding the unique needs and vulnerabilities of SGA newborns is essential for nurses providing care in neonatal settings. Prioritizing interventions based on the individualized needs of each infant is crucial for optimizing outcomes and ensuring safe, effective care delivery. By recognizing the significance of preventing hypoglycemia in SGA newborns with respiratory distress, nurses can tailor their interventions to address the specific challenges these infants may face.

Correct Answer: C

Rationale: When there is mixing of blood in the right side of the heart, it leads to excessive blood flow to the lungs and pulmonary congestion, resulting in signs of congestive heart failure. Cyanosis is more common with right-to-left shunts, diuresis is not typically seen with cardiac defects, and increased oxygenation of the tissues is not expected in this scenario.

Correct Answer: B

Rationale: In pediatric respiratory distress, understanding the pathogens causing pneumonia is crucial for appropriate nursing interventions. The correct answer is B) Mycoplasma pneumoniae. Mycoplasma pneumoniae is a common cause of atypical pneumonia in children aged 5 years and older. It presents with milder symptoms compared to bacterial pneumonia. Option A) Streptococcus pneumoniae is a common cause of bacterial pneumonia in children, particularly in younger age groups. However, it is not the most frequent pathogen in children aged 5 years and older. Option C) Group A streptococci are more commonly associated with strep throat and skin infections rather than pneumonia in children. Option D) H. influenzae (type b, nontypable) is more commonly associated with respiratory tract infections such as epiglottitis and meningitis in children, rather than being a leading cause of pneumonia in children aged 5 years and older. Educationally, understanding the age-specific pathogens causing pneumonia helps nurses tailor their care plans effectively. By recognizing Mycoplasma pneumoniae as a frequent pathogen in older children, nurses can anticipate atypical presentations and provide appropriate treatment and monitoring, thereby improving patient outcomes.