What should the nurse suggest to the parents of an infant who has a prolonged need for middle-of-the-night feedings?

Correct Answer: C

Rationale: The nurse should suggest to the parents to offer the last feeding as late as possible at night for an infant who has a prolonged need for middle-of-the-night feedings. By ensuring that the infant gets a full feeding closer to bedtime, it can potentially help the baby stay fuller for a longer period during the night, reducing the need for frequent nighttime feedings. This approach can help the parents establish a bedtime routine that supports longer stretches of sleep for both the infant and themselves. It is important to note that decreasing daytime feedings, allowing the child to go to sleep with a bottle, and putting the infant to bed after they are already asleep from rocking are not recommended strategies for addressing prolonged middle-of-the-night feedings.

Correct Answer: C

Rationale: The best place to assess for jaundice in a dark-skinned newborn is in the sclera, conjunctiva, and oral mucosa. Jaundice, which is caused by elevated levels of bilirubin in the blood, is more easily seen in these areas compared to the skin. While jaundice is commonly assessed on the skin in light-skinned individuals, it may not be as readily apparent in dark-skinned newborns. Therefore, examining the sclera, conjunctiva, and oral mucosa for a yellowish discoloration provides a more reliable indication of jaundice in dark-skinned infants. This approach ensures that healthcare providers can accurately detect and monitor jaundice in newborns of all skin tones.

Correct Answer: B

Rationale: Newborns are highly susceptible to infection due to their diminished nonspecific and specific immunity. Nonspecific immunity includes physical barriers such as intact skin and mucous membranes, as well as components of the innate immune system like phagocytes and complement proteins. Specific immunity refers to the adaptive immune response involving B and T cells. In newborns, both these arms of the immune system are not fully developed or mature, leading to increased susceptibility to infections. Additionally, newborns have lower levels of immunoglobulins like IgA and IgM compared to adults, further contributing to their vulnerability to infections.

Correct Answer: C

Rationale: Using open-ended questions encourages parents to freely express their feelings and thoughts without feeling constrained by yes or no answers. Open-ended questions allow for a more open and extensive conversation, encouraging parents to share their emotions and concerns more effectively. This approach can help parents feel understood and supported, ultimately fostering more honest and meaningful discussions about their child's illness.

Correct Answer: C

Rationale: When performing a physical assessment on a toddler, it is important for the nurse to use minimal physical contact initially. Toddlers are in a stage of development where they may be wary of strangers and new situations. By starting with minimal physical contact, such as by engaging the child in conversation or play first, the nurse can help establish trust with the toddler. This approach can help reduce the child's anxiety and resistance during the physical assessment, making the process smoother and more effective. It is essential to build rapport and establish a sense of safety and security before proceeding with the assessment to ensure the toddler's cooperation and comfort.