The correct injection technique for infants of mothers who are known carriers of hepatitis B virus is to:

Correct Answer: A

Rationale: The correct answer is A) Avoid all intramuscular injections until 1 month of age. This is the correct injection technique for infants of mothers who are known carriers of hepatitis B virus because newborns of HBV-positive mothers should receive both the hepatitis B vaccine and hepatitis B immune globulin (HBIG) within 12 hours of birth, followed by the vaccine series. Giving intramuscular injections to these infants can increase the risk of transmission of the virus, as HBV is a bloodborne pathogen. Option B) Diluting intramuscular injections with added normal saline is incorrect because dilution does not mitigate the risk of HBV transmission. Option C) Mixing all injections that the infant will need in a single syringe is incorrect as it can lead to contamination and inaccurate dosing. Option D) Bathing the area where the infant will receive injections is irrelevant to preventing HBV transmission and does not address the specific risk posed by intramuscular injections in HBV-positive infants. In an educational context, understanding the correct injection technique for infants born to HBV-positive mothers is crucial for healthcare providers working in maternal and child health settings to prevent the transmission of infectious diseases. Implementing proper protocols in such cases can significantly impact the health outcomes of newborns at risk.

Correct Answer: D

Rationale: Rationale: The correct response is option D) Notify the charge nurse of possible malabsorption. An increasing abdominal girth in a child with a ventriculoperitoneal shunt for hydrocephalus could indicate shunt malfunction, leading to increased intracranial pressure and subsequent hydrocephalus. Malabsorption may result from inadequate absorption of nutrients due to increased intracranial pressure affecting gastrointestinal function. This can lead to poor growth and development in the child. Option A) Elevating the child's head is not the priority in this situation as it does not address the potential underlying issue of shunt malfunction and malabsorption. Option B) Checking bowel sounds is important for gastrointestinal assessment but may not directly address the specific concern of increasing abdominal girth related to shunt malfunction. Option C) Recording retention of feeding does not address the urgent need to investigate and address the potential complications associated with the VP shunt and its impact on the child's overall health. In an educational context, understanding the complications associated with VP shunts and their potential effects on various body systems is crucial for nurses caring for pediatric patients with hydrocephalus. Recognizing signs of shunt malfunction early and taking appropriate action can prevent serious consequences and improve patient outcomes. Regular monitoring and prompt reporting of changes in the child's condition are essential in providing safe and effective care.

Correct Answer: A

Rationale: In the context of infants with a surgical repair for a cleft lip, the correct answer is A) "We are feeding the baby with a dropper for 2 weeks." This statement indicates that the parents understand the specific feeding technique required for an infant with a cleft lip. This method allows for controlled feeding and reduces the risk of aspiration, ensuring the baby receives adequate nutrition while minimizing potential complications. Using a dropper helps regulate the flow of milk and prevents it from entering the nasal cavity, which can be a concern post-surgery. Option B) "We resumed bottle feeding after discharge" is incorrect because bottle feeding may not be suitable for infants with a cleft lip due to the risk of milk entering the nasal cavity. Option C) "We started the baby on solid food yesterday" is incorrect as solid foods are not appropriate for an infant who has undergone cleft lip surgery and would pose a choking hazard. Option D) "The baby is drinking well from a straw" is incorrect as using a straw may not be the recommended feeding method for infants with a cleft lip, as it can lead to difficulty in controlling the flow of liquid and increase the risk of aspiration. Educationally, understanding the appropriate feeding techniques for infants with specific conditions like cleft lip is crucial for healthcare providers and parents to ensure optimal care and support for the infant's health and well-being. Parents must be educated on proper feeding techniques to prevent complications and promote the infant's growth and development.

Correct Answer: B

Rationale: The correct answer is B) After 2 to 3 days for testing for phenylketonuria in newborns. Phenylketonuria (PKU) is an inborn error of metabolism that requires early detection and intervention to prevent developmental delays. Testing for PKU is typically done after 24 hours of life because newborns need to have some protein intake before accurate screening can occur. Option A) In the first 24 hours of life is incorrect because newborns need to consume protein-containing feeds before testing for PKU to be accurate. Option C) At 4 to 6 weeks of age and option D) At 2 months of age are both too late for PKU testing as early detection is crucial for timely intervention and management. In an educational context, it is essential for healthcare providers working with mothers and newborns to understand the importance of timely newborn screening tests like PKU screening. By recognizing the optimal timing for these tests, healthcare professionals can ensure early detection of conditions like PKU, allowing for prompt interventions and improved outcomes for newborns.

Correct Answer: D

Rationale: In the context of a toddler who has just had a body spica cast applied, changing the child's position frequently (Option D) is the most appropriate instruction for parents. This is because maintaining the same position for extended periods can lead to discomfort, pressure sores, and potential complications such as decreased circulation or respiratory problems. By changing the child's position regularly, parents can help prevent these issues and promote comfort and well-being. Option A, propping the child upright with pillows for meals, may not provide adequate support and stability required for a child in a spica cast. This position could potentially lead to instability and risk of injury. Option B, using the bar between the legs to turn the child, is not recommended as it could cause discomfort, pain, or even damage to the cast or the child's body. Option C, putting the child on her abdomen to sleep, is not advisable as it may lead to increased pressure on the cast, discomfort, and potential breathing difficulties for the child. Educationally, it is essential for parents to understand the importance of frequent position changes to ensure the child's comfort, safety, and overall well-being while in a spica cast. Teaching parents proper positioning techniques can help prevent complications and promote optimal healing and recovery for the child.