The nurse is caring for an infant whose cleft lip was repaired. What important aspects of this infant’s postoperative care should be included?
Cleansing the suture line, upright position, arm restraints
Mouth irrigations, prone position, cleansing the suture line
Frequent oral suction, spoon feed, give them a teething toy
Arm restraints, postural drainage, mouth irrigations
The Correct Answer is A
Choice A reason:
Cleansing the suture line, maintaining an upright position, and using arm restraints are crucial aspects of postoperative care for an infant after cleft lip repair. Cleansing the suture line helps prevent infection and promotes healing. Keeping the infant in an upright position reduces the risk of aspiration and helps with breathing. Arm restraints prevent the infant from touching or rubbing the surgical site, which could disrupt the healing process.
Choice B Reason:
Mouth irrigations and a prone position are not recommended for postoperative care after cleft lip repair. Mouth irrigations can be too harsh for the delicate surgical site, and a prone position (lying face down) can increase the risk of aspiration and breathing difficulties. Cleansing the suture line is important, but the other aspects of this choice are not suitable.
Choice C Reason:
Frequent oral suction and spoon feeding are not appropriate for an infant after cleft lip repair. Oral suction can be too aggressive and may damage the surgical site. Spoon feeding is not recommended as it can put pressure on the healing lip. Giving a teething toy is also not advisable as it can cause the infant to put objects in their mouth, potentially harming the surgical site.
Choice D Reason:
Arm restraints are indeed necessary to prevent the infant from touching the surgical site. However, postural drainage and mouth irrigations are not suitable for postoperative care after cleft lip repair. Postural drainage is not relevant to this condition, and mouth irrigations can be too harsh for the healing tissue.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
Peanuts are not recommended for infants, especially those under one year of age, due to the risk of choking and potential allergies. Additionally, peanuts are not a significant source of iron and would not be effective in preventing iron deficiency anemia in infants. Therefore, this choice is not appropriate for preventing iron deficiency anemia in a 6-month-old infant.
Choice B reason:
Iron (ferrous sulfate) tablets are not typically recommended for infants unless prescribed by a healthcare provider. Infants who are exclusively breastfed or partially breastfed should receive iron supplementation starting at 4-6 months of age, but this is usually in the form of liquid drops rather than tablets. It is important to follow the guidance of a healthcare provider when administering iron supplements to infants.
Choice C reason:
Sautéed liver is a rich source of iron, but it is not suitable for a 6-month-old infant. Introducing solid foods to infants should be done gradually, starting with iron-fortified cereals and pureed fruits and vegetables. Liver can be introduced later as part of a balanced diet, but it is not the first choice for preventing iron deficiency anemia in a young infant.
Choice D reason:
Iron-fortified baby cereal is the recommended choice for preventing iron deficiency anemia in a 6-month-old infant who is still breastfeeding. These cereals are specifically designed to provide the necessary iron that infants need as they transition to solid foods. Starting with iron-fortified cereals helps ensure that the infant receives adequate iron to support healthy growth and development.

Correct Answer is C
Explanation
Choice A reason:
Foster self-care activities: Encouraging self-care activities is important for children with hemiplegic cerebral palsy as it promotes independence and self-esteem. However, it is not the highest priority compared to ensuring the child’s safety and accessibility in their home environment.
Choice B Reason:
Improve the child’s communication skills: Enhancing communication skills is crucial for the child’s social and emotional development. Effective communication can significantly improve the child’s quality of life. However, while important, it is not the most immediate priority compared to modifying the home environment for safety.
Choice C Reason:
Modify the home environment for safety and accessibility: Ensuring the home environment is safe and accessible is the top priority. Children with hemiplegic cerebral palsy may have mobility challenges, and a safe environment can prevent injuries and promote independence. This modification directly impacts the child’s daily life and overall well-being.
Choice D Reason:
Provide respite services for the parents: Offering respite services is beneficial for the parents’ mental and emotional health, allowing them to take breaks and recharge. While this is important, it is not the primary concern compared to the child’s immediate safety and accessibility needs.
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