A six-month-old infant is hospitalized for repair of a ventricular septal defect. As you are doing his physical exam, you note that the infant's extremities are cool, he has weak peripheral pulses, and his urine output is diminished. These clinical findings are suggestive of which of the following?

Choice A reason: This statement is correct, as asking about the child's contacts over the last three weeks can help the nurse identify the possible source of infection and the risk of transmission. Rubella is a viral infection that spreads through respiratory droplets or direct contact with an infected person. The incubation period of rubella is 14 to 21 days, meaning that the child could have been exposed to the virus up to three weeks before developing symptoms.

Choice B reason: This statement is incorrect, as asking about the child's immunizations is not the most effective way to determine how the child was exposed to the virus. Although immunization can prevent rubella infection, it is not 100% effective, and some children may still get the disease despite being vaccinated. The nurse should also consider other factors, such as the child's medical history, travel history, and exposure to other people with rash or fever.

Choice C reason: This statement is incorrect, as asking about the medications given to the child is not the most effective way to determine how the child was exposed to the virus. Medications can help relieve the symptoms of rubella, such as fever, rash, or joint pain, but they do not affect the transmission or the course of the infection. The nurse should focus on the epidemiological aspects of the disease, such as the mode of transmission, the incubation period, and the contagious period.

Choice D reason: This statement is incorrect, as asking about the onset of the rash is not the most effective way to determine how the child was exposed to the virus. The rash of rubella usually appears 14 to 17 days after exposure, and lasts for about three days. However, the child can be contagious from seven days before to seven days after the rash appears, meaning that the child could have been exposed to the virus up to four weeks before or after the rash. The nurse should ask about the child's contacts during this period, not just the rash.

Choice A reason: The squeeze bottle and ESSR method of feeding are recommended for infants with cleft lip and palate as they allow for better control of the flow and volume of the formula, prevent air swallowing and aspiration, and promote oral stimulation and development.

Choice B reason: Supplemental feeding through an N/G tube is not usually necessary for infants with cleft lip and palate unless they have severe feeding difficulties, failure to thrive, or other complications. The goal is to promote oral feeding as much as possible.

Choice C reason: Adding rice cereal to the formula is not advised for infants with cleft lip and palate as it can increase the risk of aspiration, choking, and infection. Rice cereal can also interfere with the absorption of iron and other nutrients from the formula.

Choice D reason: Infants with cleft lip and palate usually have a hard time breastfeeding as they cannot create a proper seal and suction with the nipple. Breastfeeding may be possible with some modifications and support, but it is not the norm.