A nurse is planning care for an infant who has spina bifida and is to undergo surgical closure of the myelomeningocele sac. Which of the following interventions should the nurse include in the plan of care?

Limit visitors to immediate family members.

Maintain the infant in the supine position.

Provide a latex-free environment.

Initiate contact precautions.

Answer and Explanation

The Correct Answer is C

Infants with spina biﬁda are at an increased risk of developing a latex allergy
due to repeated exposure to latex products during medical procedures.
Providing a latex-free environment can help prevent the development of an allergy.
Choice A is not correct because limiting visitors to immediate family members is not necessary for the care of an infant undergoing surgical closure of the myelomeningocele sac.
Choice B is not correct because maintaining the infant in the supine position is not necessary for this procedure.
Choice D is not correct because initiating contact precautions is not necessary for this procedure.

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Correct Answer is C

Explanation

Activated charcoal should be given as soon as possible to help absorb the acetylsalicylic acid in the gastrointestinal tract.
Choice A is not an answer because N-acetylcysteine is used to treat acetaminophen overdose, not acetylsalicylic acid overdose.
Choice B is not an answer because chelation therapy with deferoxamine is used to treat iron poisoning, not acetylsalicylic acid overdose.
Choice D is not an answer because inducing vomiting with syrup of ipecac is no longer recommended for the treatment of poisoning due to the potential for harm and lack of evidence of beneﬁt.

A. Teach caregivers to change diapers when wet. B. Have caregivers administer 16 oz of water after each diarrhea stool. C. Cleanse the diaper area with soap and water. D. Collect nasal drainage for culture and sensitivity. F. Teach caregivers to apply talcum powder to creases. G. Use a nasal aspirator after feedings.

Correct Answer is ["C","D","E"]

Explanation

Choice C, cleanse diaper area with soap and water, is important to maintain hygiene and prevent diaper rash. This should be done at each diaper change.
Choice E, instruct caregivers to apply zinc oxide with each diaper change, is important to prevent diaper rash and promote healing if a rash is present.
Choice D, collect nasal drainage for culture and sensi vity, is important to determine if there is a bacterial infec on present, which could explain theinfant's high fever during the first provider visit.
Choice A, teach caregivers to change diaper when wet, is not necessary as it is already expected that caregivers will change the diaper when wet.
Choice B, have caregivers administer 16 oz of water a er each diarrhea stool, is not necessary as there is no indica on of diarrhea in the scenario.
Choice F, teach caregivers to apply talcum powder to creases, is not necessary as talcum powder has been associated with respiratory problems in infants and should not be used.
Choice G, use a nasal aspirator a er feedings, is not necessary as there is no indica on of nasal conges on in the scenario.

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A nurse is planning care for an infant who has spina bifida and is to undergo surgical closure of the myelomeningocele sac. Which of the following interventions should the nurse include in the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who ingested a large amount of acetylsalicylic acid. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

Correct Answer is ["C","D","E"]

Explanation

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