When nutritional rehabilitation has begun for a malnourished child, all the following are true EXCEPT

Correct Answer: D

Rationale: In the context of nutritional rehabilitation for a malnourished child, the correct answer is D) iron supplements are recommended. Iron supplements are not typically required at the beginning of nutritional rehabilitation but may be needed later if laboratory tests show iron deficiency. Option A is incorrect because a gradual increase in caloric intake, typically starting at 10% to 20% per day, is a safe approach to prevent refeeding syndrome. Option B is incorrect because caloric intake should not be increased to the point of initiating catch-up growth too quickly, as this can lead to complications like refeeding syndrome. Option C is incorrect because while protein needs may increase as anabolism begins, this does not happen right at the start of nutritional rehabilitation. It usually occurs later in the process as the child's nutritional status improves. Educationally, understanding the nuances of nutritional rehabilitation in malnourished children is crucial for nurses and healthcare providers working in pediatric settings. It is essential to monitor and adjust nutritional interventions carefully to prevent complications and promote optimal growth and development in these vulnerable patients.

Correct Answer: C

Rationale: The best management for the 6-week-old preterm infant with anemia, elevated reticulocyte count, and thrombocytosis is to give folic acid (Option C). This infant likely has hemolytic anemia due to an underlying cause such as a deficiency in folic acid. Folic acid supplementation helps in the production of red blood cells and can aid in the treatment of anemia in this case. Option A is incorrect because anemia, elevated reticulocyte count, and thrombocytosis indicate a more serious condition that requires intervention rather than just reassurance. Option B, giving packed cell blood, is not the first-line treatment for this type of anemia. Option D, repeating the CBC in 2 weeks, delays necessary treatment for the infant's condition. Educationally, understanding the underlying pathophysiology of anemia in infants is crucial for nurses and healthcare providers caring for pediatric patients. Recognizing the signs and symptoms of different types of anemia and knowing the appropriate interventions, such as folic acid supplementation in this case, is essential for providing safe and effective care to pediatric patients with hematologic disorders.

Correct Answer: B

Rationale: The correct answer is B) vitamin C deficiency. Osteoporosis in childhood is typically associated with factors such as inadequate calcium and vitamin D intake, sedentary lifestyle, certain medical conditions, and medications like corticosteroids. Protein-calorie malnutrition (option A) can lead to osteoporosis due to lack of essential nutrients for bone growth and maintenance. Zinc deficiency (option C) can also contribute to bone health issues as zinc is important for bone formation and mineralization. Steroid therapy (option D) can cause bone loss by interfering with calcium absorption and bone formation. In an educational context, it is crucial for healthcare professionals, especially those working with pediatric patients, to understand the risk factors for pediatric osteoporosis to provide appropriate prevention and management strategies. By knowing the factors that contribute to bone health issues in children, healthcare providers can offer holistic care to promote optimal skeletal development and overall well-being.

Correct Answer: B

Rationale: The correct answer is B) 95 gm/day for the total digestible carbohydrates in a nine-month-old boy. In infants, carbohydrates are a crucial source of energy for their rapid growth and development. The AI for carbohydrates at this age is around 95 gm/day, which meets the energy requirements of a growing infant. Option A) 60 gm/day is too low for a nine-month-old's carbohydrate needs, potentially leading to inadequate energy intake for growth and development. Option C) 120 gm/day and Option D) 170 gm/day are both too high for a nine-month-old's carbohydrate requirements. Excessive carbohydrate intake at this age can lead to issues like obesity and disrupted metabolic functions. Educationally, understanding the specific nutrient needs of different age groups is crucial for providing appropriate care and promoting optimal growth and development in pediatric patients. By knowing the recommended intakes, healthcare providers can guide parents and caregivers in making informed decisions about their child's nutrition.

Correct Answer: D

Rationale: In this question, option D is the correct answer. The rationale behind this is that cow's milk is not a good source of bioavailable iron for infants. In fact, cow's milk can lead to iron deficiency in infants due to its low iron content and the presence of certain proteins that can inhibit iron absorption. Option A is true because breast milk indeed provides optimal protein intake for children, containing the right balance of proteins necessary for their growth and development. Option B is also true as iron in breast milk is more easily absorbed by the infant's body compared to iron from animal sources, making it a superior source of iron for infants. Option C is incorrect as iron supplements actually do not interfere with zinc absorption. It is important to educate about the benefits of breast milk as the ideal nutrition for infants due to its perfect composition of nutrients tailored for their needs. Understanding the unique properties of breast milk can help healthcare professionals and parents make informed decisions regarding infant nutrition.