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Parents of a newborn with a unilateral cleft lip are concerned about having the defect repaired. The nurse explains that a child with a cleft lip usually undergoes surgical repair at which time?
- A. Immediately after birth
- B. By 3 months of age
- C. After 12 months of age
- D. Varies in every case
Correct Answer: B
Rationale: A cleft lip is repaired by 3 months of age when weight gain is established and the infant is free of infection.
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The nurse is obtaining intake information on a new patient being seen for preconception care and notes a family history of neural tube defectsW. hat interventions can the nurse suggest to this woman to help prevent neural tube anomalies in a developing fetus?
- A. Avoid drug use.
- B. Follow a low-calorie, low-protein diet.
- C. Take a folic acid supplement every day.
- D. Exercise daily.
- E. Maintain bed rest during the first trimester.
Correct Answer: A,C
Rationale: Avoiding drug use and taking a daily folic acid supplement (0.4 mg) until the 12th week of pregnancy reduces the risk of neural tube defects.
What is the priority preoperative nursing care of this newborn?
- A. Keep the sac dry.
- B. Diaper snugly.
- C. Position prone in an incubator.
- D. Move from side to side every hour.
Correct Answer: C
Rationale: The infant with meningomyelocele is placed prone in a humidified incubator with the sac covered with sterile saline dressings to protect the lesion.
What is the most appropriate response?
- A. Elevate the child's head.
- B. Check bowel sounds.
- C. Record retention of feeding.
- D. Notify the charge nurse of possible malabsorption.
Correct Answer: D
Rationale: An increasing abdominal girth in a child with a ventriculoperitoneal shunt may indicate malabsorption of cerebrospinal fluid, requiring immediate notification.
What will the nurse instruct the parents to report immediately?
- A. Facial paralysis
- B. Ear infections
- C. Increased intracranial pressure (ICP)
- D. Drooling
Correct Answer: B
Rationale: Children with cleft palate are at risk for ear infections; parents should report signs of earache immediately to the healthcare provider.
What assessment madThe nurse is caring for a macrosomic newborn of a woman diagnosed with gestational diabetes immediately after birth.e by the nurse would lead the nurse to suspect hip dysplasia?
- A. Asymmetrical gluteal folds
- B. Limited adduction of the affected side
- C. Foot turned inward
- D. Deep inguinal creases
Correct Answer: A
Rationale: Asymmetrical gluteal folds indicate hip dysplasia due to the femur slipping out of the acetabulum.