While teaching the parents of a newborn about infant care and feeding, which instruction by the nurse is the most appropriate?

Correct Answer: A

Rationale: The correct answer is A: Delay supplemental foods until the infant is 4 to 6 months old. This instruction aligns with the current recommendations from major health organizations like the American Academy of Pediatrics. Introducing solid foods too early can increase the risk of allergies, obesity, and other health issues. Delaying until 4 to 6 months allows the infant's digestive system to mature, reducing the likelihood of food allergies and digestive problems. Choice B is incorrect because weight alone is not a reliable indicator of an infant's readiness for solid foods. Choice C is incorrect as introducing diluted fruit juice at 2 months can be harmful due to the sugar content and lack of essential nutrients. Choice D is incorrect as adding rice cereal to address sleep issues is not recommended and may increase the risk of choking or overfeeding.

Correct Answer: B

Rationale: The correct answer is B: Peripheral hypoxia. Clubbing of fingers is commonly seen in conditions with chronic hypoxia, such as tetralogy of Fallot. The lack of oxygen in the blood causes changes in the blood vessels leading to clubbing. Anemia (choice A) may cause tissue hypoxia but is not directly related to clubbing. Delayed physical growth (choice C) is not a known cause of clubbing. Destruction of bone marrow (choice D) is unrelated to clubbing.

Correct Answer: B

Rationale: The correct answer is B: Congestive heart failure. A cardiac defect causing left-to-right shunting leads to increased blood volume in the right side of the heart, causing volume overload and eventually congestive heart failure. Cyanosis (choice A) occurs with right-to-left shunting, not left-to-right shunting. Decreased pulmonary blood flow (choice C) would be more likely with a defect causing right-to-left shunting. Bounding pulses in upper extremities (choice D) are not directly related to left-to-right shunting but can be seen in conditions like aortic regurgitation.

Correct Answer: A

Rationale: The correct answer is A because Kawasaki disease is characterized by high fever, irritability, and mucous membrane changes. The child's irritability can make nursing care challenging due to difficulties in assessing and managing their symptoms and needs effectively. The other choices are incorrect because: B - Kawasaki disease has an unpredictable course with potential complications; C - Antibiotics are not the primary treatment for Kawasaki disease; D - Requests for food are not typically a significant challenge in caring for a child with this condition. In summary, the correct answer highlights the primary symptom that can complicate nursing care, while the other choices are not directly related to the challenges of managing Kawasaki disease.

Correct Answer: D

Rationale: The correct answer is D: white pulp. White pulp is a component of the spleen and is not directly associated with mucosal surfaces. Mucosal surfaces are lined with mucus-secreting goblet cells (A) that provide a protective barrier. Lysozyme (B) is an enzyme found in tears, saliva, and mucus that helps defend against bacterial infections on mucosal surfaces. M cells (C) are specialized cells in the mucosa-associated lymphoid tissue that transport antigens from the gut lumen to immune cells. In summary, white pulp is not part of mucosal surfaces, making it the correct answer.