Nokea
The parent of an infant with a cleft lip and palate asks the nurse when the infant's cleft palate will be repaired. The nurse should respond that the first repair of a cleft palate is usually done at which of the following times?
- A. Before the eruption of teeth.
- B. When the child weighs approximately 10 kg (22 lb).
- C. Before the development of speech.
- D. After the child learns to drink from a cup.
Correct Answer: C
Rationale: Cleft palate repair is typically performed before speech development (around 12-18 months) to optimize speech outcomes.
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The nurse teaches the mother of a young child with Duchenne's muscular dystrophy about the disease and its management. Which of the following statements by the mother indicates successful teaching?
- A. My son will probably be unable to walk independently by the time he is 9 to 11 years old.'
- B. Muscle relaxants are effective for some children; I hope they can help my son.'
- C. When my son is a little older, he can have surgery to improve his ability to walk.'
- D. I need to help my son be as active as possible to prevent progression of the disease.'
Correct Answer: A
Rationale: Children with Duchenne's muscular dystrophy typically lose the ability to walk independently by ages 9 to 11 due to progressive muscle weakness.
The nurse assesses a 6-month-old for vaccination readiness. Which finding would most likely indicate the need to delay administering the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine?
- A. A family history of sudden infant death syndrome (SIDS).
- B. A fever of 38.5°C following the 4-month vaccinations.
- C. An acute bilateral ear infection.
- D. Living with a family member who is immunosuppressed.
Correct Answer: C
Rationale: An acute infection is a contraindication for vaccination due to the risk of adverse reactions.
When teaching the parents of an older infant with cystic fibrosis (CF) about the type of diet the child should consume, which of the following would be appropriate?
- A. Low-protein diet.
- B. High-fat diet.
- C. Low-carbohydrate diet.
- D. High-calorie diet.
Correct Answer: D
Rationale: A high-calorie diet is appropriate for an infant with cystic fibrosis to meet increased energy needs due to malabsorption and chronic respiratory issues.
A 14-year-old has just had a plaster cast placed on his lower left leg. To provide safe cast care, the nurse should?
- A. Petal the cast as soon as it is put on.
- B. Keep the child in the same position for 24 hours until the cast is dry.
- C. Use only the palms of the hand when handling the cast.
- D. Notify the physician if the client complains of heat.
Correct Answer: C
Rationale: Using only the palms prevents indentations in the wet cast, which could cause pressure points or alter the cast's shape.
When developing the teaching plan for the parents of a 12-month-old infant with hypospadias and chordee repair, which of the following should the nurse expect to include as most important?
- A. Assisting the child to become familiar with his dressings so he will leave them alone.
- B. Encouraging the child to ambulate as soon as possible by using a favorite push toy.
- C. Forcing fluids to at least 2,500 mL/day by offering his favorite juices.
- D. Preventing the child from disrupting the catheters by using soft restraints.
Correct Answer: D
Rationale: Restraining prevents dislodgment of catheters.