A new mother is changing the diaper of her 12-hour-old newborn and asks why the stool is black and sticky. Which response by the nurse would be most appropriate?

"This is meconium stool and is normal for a newborn."

"You probably took iron during your pregnancy and that is what causes this type of stool."

“ This is unusual, and I need to report this to your pediatrician."

I'll take a sample and check it for possible bleeding"

Answer and Explanation

The Correct Answer is A

A. "This is meconium stool and is normal for a newborn." is the correct and most appropriate response. Meconium is the newborn’s first stool, typically passed within the first 24 to 48 hours of life. It is black, tarry, and sticky in appearance and consists of materials the baby ingested while in the womb, such as amniotic fluid, mucus, and cells. It is completely normal and expected.

B. "You probably took iron during your pregnancy and that is what causes this type of stool." is incorrect. While iron supplements can darken adult stools, meconium is unrelated to maternal iron intake and is a normal physiological occurrence in all newborns.

C. “This is unusual, and I need to report this to your pediatrician." is incorrect and would be alarming to the parent unnecessarily. This is a normal finding, not something requiring physician notification.

D. "I'll take a sample and check it for possible bleeding" is also inappropriate unless there are other signs of concern (e.g., blood in stool later on). Meconium is not indicative of bleeding and does not warrant testing under normal circumstances.

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Correct Answer is C

Explanation

A. Ferning is a test to detect ferning patterns in amniotic fluid under a microscope. A positive result indicates the presence of amniotic fluid but does not suggest infection.

B. Yellow-green fluid may suggest meconium-stained amniotic fluid, which is often associated with fetal distress, but it does not directly indicate infection. However, it can increase the risk of infection if the meconium is aspirated by the baby.

C. Foul odor is a key sign that infection may be present, particularly in the case of chorioamnionitis, an infection of the fetal membranes. A foul odor in the amniotic fluid suggests the presence of bacteria and should raise concern for infection, requiring prompt intervention.

D. Blue color on Nitrazine testing indicates that the amniotic fluid is alkaline, which is expected and normal, as amniotic fluid typically has a pH of 7-7.5. This test is used to confirm the rupture of membranes, not infection.

A. Advance maternal age B. Polyhydramnios C. Macrosomia D. Preterm birth

Correct Answer is C

Explanation

A. Advanced maternal age may increase the risk of certain pregnancy complications, but it is not specifically associated with shoulder dystocia. Other factors, such as fetal size, are more directly related to shoulder dystocia.

B. Polyhydramnios (excess amniotic fluid) can sometimes be associated with complications during labor, but it is not the primary risk factor for shoulder dystocia. The condition most often involves difficulties with the fetal position or size rather than the amount of fluid.

C. Macrosomia (a large baby, typically defined as a birth weight over 8 pounds 13 ounces or 4000g) is the primary risk factor for shoulder dystocia. Shoulder dystocia occurs when the baby’s shoulders become stuck during delivery, often due to the larger size of the baby. The baby’s shoulders may be too broad to pass through the birth canal easily, which increases the likelihood of this complication.

D. Preterm birth is not a significant risk factor for shoulder dystocia. Preterm babies are typically smaller and less likely to encounter the same birth canal obstruction issues associated with shoulder dystocia.

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A new mother is changing the diaper of her 12-hour-old newborn and asks why the stool is black and sticky. Which response by the nurse would be most appropriate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is conducting an assessment of a woman who has experienced PROM. Which amniotic fluid finding would lead the nurse to suspect infection as the cause of a client's PROM?

Correct Answer is C

Explanation

The nurse knows that the occurrence of shoulder dystocia during labor is most likely related to which of the following?

Correct Answer is C

Explanation

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