A nurse is caring for an infant who is postoperative following repair of a cleft palate. Which of the following is an appropriate action by the nurse?

Gently cleanse the surgical site with sterile gauze.

Place the infant in a supine position.

Apply elbow immobilizers to both arms.

Offer a pacifier with glucose syrup.

Answer and Explanation

The Correct Answer is C

A. Cleansing the surgical site is not typically recommended as it can interfere with healing and cause trauma to the area. The surgical site should be kept clean and dry according to the surgeon's instructions.
B. Placing the infant in a supine position is not recommended as it can increase the risk of aspiration and disrupt the surgical site. Positioning should be done to protect the surgical repair.
C. Applying elbow immobilizers to both arms prevents the infant from touching or putting their hands in their mouth, which helps to protect the surgical site from injury and allows it to heal properly.
D. Offering a pacifier with glucose syrup is not appropriate as sucking on a pacifier can disrupt the surgical site and glucose syrup is not necessary in this situation.

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Correct Answer is D

Explanation

A. Bedrest is not specifically required for children with varicella; activity should be based on the child's energy levels and comfort.
B. Bathing can be done carefully even with crusted lesions. Good hygiene can help prevent secondary infections.
C. If the guardian has had chickenpox, they are usually immune and do not need to wear a mask. The concern is more for immunocompromised individuals.
D. The child is no longer contagious once all the lesions have crusted over, making it safe to take them to the playroom.

A. Encourage active range of motion of the extremity. B. Elevate the extremity above the level of the heart. C. Wrap the extremity loosely with an elastic bandage. D. Apply warm compresses to the extremity.

Correct Answer is B

Explanation

A. Encouraging active range of motion of the extremity can increase swelling and is not recommended immediately after a sprain.
B. Elevating the extremity above the level of the heart helps reduce swelling by promoting venous return.
C. Wrapping the extremity loosely with an elastic bandage provides some support but is not the most effective way to reduce swelling.
D. Applying warm compresses can increase blood flow and swelling; cold compresses are recommended during the first 24 hours.

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A nurse is caring for an infant who is postoperative following repair of a cleft palate. Which of the following is an appropriate action by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is B

Explanation

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