After surgery for the correction of bilateral congenital clubfeet, an infant returns with bilateral long-leg casts. The toes on both feet are edematous, yet there is color, sensitivity, and movement. What is the most appropriate action by the nurse?

Apply a warm, moist pack to the feet.

Call the healthcare provider to report the edema.

Elevate the legs on pillows.

Encourage movement of the toes.

Answer and Explanation

The Correct Answer is C

Choice A reason: Applying a warm, moist pack is not the most appropriate action as it may increase swelling and does not address the underlying cause of the edema.

Choice B reason: While it is important to report significant changes to the healthcare provider, mild edema post-surgery can be expected and managed with elevation.

Choice C reason: Elevating the legs on pillows can help reduce edema by promoting venous return and decreasing swelling.

Choice D reason: Encouraging movement of the toes is beneficial for circulation and preventing stiffness, but it is not the primary intervention for edema. Elevation is more effective in this scenario.

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Correct Answer is C

Explanation

Choice A reason: Escorting the parents out of the room may increase their anxiety and distress, as they may want to be close to their child during such a critical time.

Choice B reason: Allowing one parent to sit on the bed may interfere with the medical team's efforts and is not typically recommended during active resuscitation.

Choice C reason: Allowing the parents to stay in the room can provide them with some comfort, knowing they are near their child, and may help in the grieving process if the outcome is unfavorable, as long as they do not interfere with the medical procedures.

Choice D reason: Bringing additional family members into the room during resuscitation can create a chaotic environment and may hinder the medical team's ability to work efficiently. It is better to have a controlled number of people in the room.

A. "Down syndrome is a condition caused by an extra chromosome; the cause of it is unknown." B. "Down syndrome is a condition that is carried on the X chromosome, so it came from the mother." C. "Down syndrome is caused by birth trauma, not by genetics." D. "Down syndrome is a condition that is genetically transmitted from both the father and the mother."

Correct Answer is A

Explanation

Choice A reason: This response is the most appropriate as it correctly identifies Down syndrome as a genetic condition caused by an extra chromosome and acknowledges that the exact cause of the chromosomal abnormality is unknown.

Choice B reason: This choice is incorrect because Down syndrome is not carried on the X chromosome nor is it inherited from the mother alone.

Choice C reason: This statement is false; Down syndrome is not caused by birth trauma but is a genetic disorder.

Choice D reason: This choice is misleading; while genetics play a role in Down syndrome, it is not typically inherited from both parents in the way this choice suggests.

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After surgery for the correction of bilateral congenital clubfeet, an infant returns with bilateral long-leg casts. The toes on both feet are edematous, yet there is color, sensitivity, and movement. What is the most appropriate action by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which nursing intervention is most appropriate for a school-age child with congenital heart block who codes in the emergency department (ED), while the parents witness the resuscitation scene?

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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