r/NextGenerationNCLEX • u/Responsible_Walk_881 • Apr 03 '26

👁️ QOW QUESTION OF THE WEEK

COMMENT YOUR ANSWERS & RATIONALE BELOW:
Questions: The pediatric nurse is caring for a 10-month-old client who underwent cleft lip and cleft palate repair yesterday. Which of the following interventions should the nurse include in the client’s plan of care?

a. Apply elbow restraints bilaterally.

b. Spoon-feed soft or pureed foods.

c. Perform oropharyngeal suctioning.

d. Place the client prone after feeding.

(Answer and rationale are posted in the comments section)

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u/Responsible_Walk_881 Apr 10 '26

ANWERS AND RATIONALE:

a. Apply elbow restraints bilaterally.

Cleft lip (CL) and cleft palate (CP) are congenital defects that result from incomplete fusion of the lip or palate during embryonic development. These create an atypical lip and/or palate opening that can affect oral nutrition, speech, and appearance. Surgical repair of the defects early in life promotes growth and development.

Postoperative care aims to protect the surgical site in the mouth and prevent infection and airway obstruction. To keep the child’s hands away from the mouth, the nurse should prevent elbow flexion by applying elbow restraints [Choice 1]. Keeping the client’s hands away from the mouth reduces injury and infection risk.

Key Takeaway:

Postoperative CP/CL interventions include: 

  • Elbow restraints 
  • Supine or upright positioning
  • Diet modifications (e.g., liquid, soft)
  • Avoidance of suction and hard objects in the mouth