Which of the following feeding techniques is most appropriate for an infant with a cleft palate?
Encourage the infant to breastfeed without any adjustments.
Use a standard bottle with a regular nipple.
Position the infant upright while cradling the head and use a specialized bottle with a one-way valve.
Feed the infant while lying flat to ease the feeding process.
The Correct Answer is C
This scenario requires understanding infant anatomy and physiology regarding cleft palates. Knowledge of suction mechanics, airway protection, and specialized feeding equipment is necessary to prevent aspiration and ensure adequate caloric intake while managing the structural deficit between the oral and nasal cavities.
Choice A rationale
Direct breastfeeding is often difficult due to the inability to create a vacuum. The structural gap prevents effective suctioning of milk from the breast, leading to fatigue and poor weight gain without specific lactation support or modifications.
Choice B rationale
Standard nipples require strong suction that infants with palatal defects cannot generate. This leads to ineffective feeding, excessive air ingestion, and potential exhaustion as the infant struggles to pull liquid through a traditional nipple opening without vacuum.
Choice C rationale
An upright position uses gravity to prevent nasal regurgitation. One-way valves, like in the Haberman feeder, allow milk to flow with compression rather than suction, compensating for the infant's inability to create the necessary intraoral negative pressure.
Choice D rationale
Lying flat significantly increases the risk of liquid entering the Eustachian tubes or being aspirated into the lungs. Gravity causes milk to flow into the nasal cavity through the cleft, potentially causing choking, coughing, or middle ear infections.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Intussusception involves the telescoping of one intestinal segment into another, causing lymphatic and venous obstruction. Knowledge of gastrointestinal manifestations is critical to identify life-threatening ischemia and bowel necrosis in infants presenting with sudden abdominal pain and stool changes.
Choice A rationale
Projectile vomiting is a characteristic clinical finding of hypertrophic pyloric stenosis, not intussusception. It results from gastric outlet obstruction due to muscular thickening, occurring without the presence of bile, typically seen in infants aged three to six weeks.
Choice B rationale
Severe diarrhea typically indicates infectious gastroenteritis or malabsorption syndromes. In intussusception, the bowel is obstructed by the invagination process, which usually prevents the passage of normal diarrheal stools as the intestinal lumen becomes physically blocked and compressed.
Choice C rationale
Currant-jelly stools contain a mixture of blood and mucus, occurring as the compressed intestinal mucosa sheds. This classic hallmark reflects venous congestion and ischemia within the intussusceptum, indicating a high risk for impending bowel perforation and necrosis.
Choice D rationale
Bilious vomiting suggests a distal intestinal obstruction but is not specific to intussusception. While it can occur as the condition progresses, it lacks the diagnostic specificity of the vascular-related stool changes that define the classic clinical presentation.
Correct Answer is D
Explanation
Identifying specific clinical manifestations of head trauma is essential for neurosurgical nursing. This question requires knowledge of cranial anatomy and the localized signs of base-of-skull injuries. Recognizing these signs allows for the timely assessment of potential cerebrospinal fluid leaks or hemorrhage.
Choice A rationale
The halo sign occurs when cerebrospinal fluid separates from blood on absorbent material, forming a ring. This confirms the presence of a CSF leak from the ears or nose but does not describe mastoid bruising specifically.
Choice B rationale
Cheyne-Stokes respirations involve an abnormal pattern of breathing characterized by progressively deeper and sometimes faster breathing followed by apnea. This indicates severe brainstem injury or increased intracranial pressure rather than a specific fracture location.
Choice C rationale
Raccoon eyes, or periorbital ecchymosis, result from blood tracking into the soft tissue around the eyes. While this indicates a basilar skull fracture, it specifically involves the anterior fossa rather than the mastoid process area.
Choice D rationale
Battle's sign is the classic clinical indicator of a fracture in the posterior cranial fossa. It involves ecchymosis over the mastoid bone. This sign typically appears several days after the initial injury due to vascular extravasation.
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