A nurse is caring for a client who is at 20 weeks of gestation and asks what could cause the infant to have a cleft lip. Which of the following responses should the nurse give?
A cleft lip is caused by the Epstein-Barr virus (EBV)."
"A cleft lip is due to an abnormal autoimmune response."
"A cleft lip is due to advanced maternal age.”
"A cleft lip has a genetic component."
The Correct Answer is D
A. Epstein-Barr virus (EBV) is not associated with cleft lip formation.
B. Cleft lip is not caused by an autoimmune response.
C. Advanced maternal age is associated with other congenital anomalies but not specifically with cleft lip.
D. Cleft lip and palate often have a genetic component and can be influenced by environmental factors during early pregnancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Ishihara plates test for color blindness, not visual acuity.
B. Tracking items assesses eye movement, not visual acuity.
C. Identifying items in a book evaluates near vision but not distance vision, which is the reported problem.
D. The Snellen eye chart is used to assess distance visual acuity, which is appropriate for the child's complaint.
Correct Answer is C
Explanation
A. Cuff size recommendations vary based on the child’s arm circumference, not a specific range for all school-aged children.
B. The cuff should fit snugly around the child's arm, not loosely, to obtain an accurate reading.
C. Blood pressure is typically measured over the brachial artery using a manual or automated cuff.
D. Routine blood pressure screening usually begins at age 3 unless there are specific indications to begin earlier.
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