Question 1

The nurse is working with the family of a baby born with a cleft lip and cleft palate. The family has shown a lot of negative feelings toward the baby and seems preoccupied with the baby's appearance. Which of the following actions by the nurse would be best?

Accepted Answer

Providing support, modeling accepting behaviors, and encouraging touching and holding can help the family bond with the baby, fostering acceptance and love despite the baby's physical condition. This approach addresses the emotional needs of both the baby and the family, promoting a positive environment for the baby's growth and development.

Question 2

For several days, the nurse has been working with the parents of a baby with a cleft lip and cleft palate. The parents seem to have a lot of fears related to the care of their child and the child's future. How could the nurse best help these parents?

Accepted Answer

Showing before and after photographs of successful surgeries can provide tangible hope and evidence of positive outcomes, while offering to arrange conversations with other parents who have gone through similar experiences can provide emotional support and practical advice, addressing the parents' fears in a constructive and empathetic manner.

Question 3

The mother of a newborn with a cleft lip says to the nurse, "Well, I guess I will have to give up the idea of breastfeeding and do bottle feeding." Which of the following is the nurse's best response?

Accepted Answer

Breastfeeding can often be successfully accomplished with babies who have a cleft lip because the breast can mold to fit the baby's mouth, allowing for an effective latch and feeding. This response encourages and supports the mother's desire to breastfeed, providing accurate information and reassurance.

Question 4

A mother wants to breastfeed her baby born with a cleft lip and a cleft palate and asks the nurse if this will be possible. Which of the following is the nurse's best response?

Accepted Answer

Breastfeeding a baby with a cleft lip and palate can be challenging, but it is not impossible. The nurse's response in option C is supportive and informative, offering a solution that includes attempting breastfeeding while also suggesting the use of a breast pump and special nipples if direct breastfeeding proves to be difficult. This approach provides a balanced and realistic perspective on feeding options for the baby.

Question 5

In working with the breastfeeding mother of an infant with a cleft lip or cleft palate, the nurse will teach the mother to do which of the following before having the infant latch on?

Accepted Answer

A warm washcloth will help to stimulate the milk flow and make it easier for the infant to latch on.

Question 6

When the mother of a newborn with a cleft lip or a cleft palate decides to bottle feed, the nurse will have the mother to first try:

Accepted Answer

The answer of When the mother of a newborn with...

Question 7

When the caregiver uses standard nipples and bottles for a baby with cleft lip and cleft palate, the nurse will teach the ESSR method. The ESSR method involves:

Accepted Answer

The ESSR method stands for Enlarge, Stimulate, Swallow, and Rest, which is a feeding technique used to help babies with cleft lip and palate feed more effectively.

Question 8

When infants with a cleft lip or cleft palate are nursing from a bottle, they will signal a need for a rest before they choke or gag. Which of the following is a signal from the infant to take a break?

Accepted Answer

Elevating eyebrows and wrinkling the forehead is a common non-verbal cue infants use to indicate discomfort or the need for a pause, such as when they need a break from feeding due to difficulties associated with conditions like cleft lip or palate.

Question 9

When a caregiver has tried standard nipples, preemie nipples, and all kinds of special nipples without much success, the best plan is to teach feeding with which of the following types of equipment?

Accepted Answer

An Asepto syringe with a rubber tip is often recommended for feeding when standard and special nipples have not been successful. It allows for controlled, gentle feeding, which can be especially helpful for infants or individuals with feeding difficulties.

Question 10

Which of the following is the first question the nurse asks on accepting an assignment to care for a mother and a baby who has a cleft lip and a cleft palate?

Accepted Answer

The answer of Which of the following is the first...

Question 11

In the period immediately after a baby has had surgery for cleft lip repair, the nurse will do which of the following things?

Accepted Answer

After cleft lip repair, it's important to protect the surgical site. A Logan bow or a butterfly adhesive strip is often applied across the lip area to minimize tension on the suture line, helping the site heal properly and reducing the risk of scarring.

Question 12

The nurse will teach the family of an infant who has had a cleft lip repair how to clean the suture line after feeding. The nurse will instruct the family to:

Accepted Answer

The answer of The nurse will teach the family of...

Question 13

The mother of a newborn with esophageal atresia asks the nurse to explain this condition to her. The best response by the nurse would be to say that esophageal atresia is:

Accepted Answer

Esophageal atresia is characterized by the incomplete formation of the esophagus, where it ends in a pouch and does not connect to the stomach, preventing passage of food from the mouth to the stomach.

Question 14

Infants born with esophageal atresia with tracheoesophageal fistula are more often:

Accepted Answer

Infants born with esophageal atresia with tracheoesophageal fistula are more often lower-than-average birth weight.

Question 15

When the nurse is working with a new mother whose child was born with esophageal atresia with tracheoesophageal fistula, the mother says: "He looks perfect, and I am glad he only has these two things wrong because they can be fixed." In responding therapeutically to the mother, the nurse keeps in mind which of the following as a finding with babies born with esophageal atresia and tracheoesophageal fistula?

Accepted Answer

One-half of the children born with esophageal atresia and tracheoesophageal fistula have other anomalies. This is important for healthcare providers to consider when planning care and support for the child and family.

Question 16

In assessing a newborn, the nurse notices a large amount of fine, frothy bubbles of mucus in the mouth. Even then the nurse suctions the bubbles, they soon return. The baby has a rattling sound to the respirations and has a choking episode and becomes a little cyanotic. Which of the following conditions will the nurse suspect?

Accepted Answer

The symptoms described, such as a large amount of fine, frothy bubbles of mucus in the mouth, a rattling sound to the respirations, and episodes of choking and cyanosis, are indicative of esophageal atresia. This condition involves a malformation where the esophagus does not form properly and is not connected to the stomach as it should be, leading to difficulty swallowing and breathing issues.

Question 17

The nurse is with a newborn that is having radiographic studies to determine if the newborn has esophageal atresia and if the newborn also has tracheoesophageal fistula. When the radiopaque nasogastric tube is passed through the nose to the stomach, it stops at 10 centimeters and the radiographic studies show air in the stomach. The nurse is aware that these finding indicate which of the following conditions?

Accepted Answer

The presence of air in the stomach, despite the nasogastric tube stopping at 10 centimeters, suggests that there is a connection between the trachea and the stomach (tracheoesophageal fistula) allowing air to pass into the stomach. The tube stopping at 10 centimeters indicates esophageal atresia, where the esophagus does not form properly and ends in a pouch rather than connecting to the stomach. Together, these findings indicate esophageal atresia with tracheoesophageal fistula.

Question 18

Prior to the surgical repair of an esophageal atresia with tracheoesophageal fistula, the nursing interventions are mainly focused on which of the following things?

Accepted Answer

Preventing aspiration pneumonia is a primary nursing intervention prior to the surgical repair of an esophageal atresia with tracheoesophageal fistula. This condition can allow food and saliva to enter the lungs, leading to aspiration pneumonia, so keeping the airway clear is crucial.

Question 19

The nurse is caring for a baby who has just had a surgical repair of an esophageal atresia with tracheoesophageal fistula. It is most important for the nurse to position the gastrostomy tube in which of the following ways?

Accepted Answer

Elevating the gastrostomy tube helps prevent reflux of gastric contents, which is especially important after surgical repair of esophageal atresia with tracheoesophageal fistula to reduce the risk of aspiration and promote healing.

Question 20

The nurse, assessing a baby who is in the immediate postoperative period after a surgical repair of an esophageal atresia with tracheoesophageal fistula, is observing for early signs of airway obstruction. In addition to abnormal breath sounds, what would the nurse find if the baby begins to have airway obstruction?

Accepted Answer

Anxious expression and tachypnea (rapid breathing) are early signs of airway obstruction, indicating the baby is struggling to breathe and becoming increasingly anxious due to the difficulty.

Quiz 23: Gastrointestinal Alterations