A nurse is assessing a full-term newborn upon admission to the nursery. Which of the following clinical findings should the nurse report to the provider?

Rust-stained urine.

Single palmar creases.

Subconjunctival hemorrhage.

Transient circumoral cyanosis

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. Single palmar creases.

Choice A rationale:

Rust-stained urine is typically due to urate crystals and is common in newborns. It usually resolves on its own and is not a cause for concern.

Choice B rationale:

Single palmar creases can be associated with certain genetic conditions, such as Down syndrome. This finding should be reported to the provider for further evaluation.

Choice C rationale:

Subconjunctival hemorrhage is a common finding in newborns due to the pressure changes during delivery. It usually resolves without intervention and is not typically a cause for concern.

Choice D rationale:

Transient circumoral cyanosis is often seen in newborns and can occur when the baby is crying or feeding. It usually resolves on its own and is not typically a cause for concern.

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Correct Answer is D

Explanation

Preparing a toddler for a new sibling can be challenging, but there are some strategies that can help ease the transition and reduce the risk of jealousy or resentment. One of these strategies is to make any major changes in the toddler's routine or environment well before the baby arrives, such as moving to a new bed, starting preschool, or toilet training. This can help the toddler adjust to the change without feeling displaced or threatened by the baby. It can also prevent the toddler from associating the change with the baby and blaming the baby for it¹².

Moving a toddler to a new bed 2 months before the baby comes home is a good example of this strategy. It gives the toddler enough time to get used to sleeping in a diﬀerent place and feeling comfortable and secure in it. It also avoids making the toddler feel like they are being kicked out of their bed to make room for the baby. The toddler may even feel proud of having a big-kid bed and being more independent¹².

The other options are not appropriate responses by the nurse because they may have negative eﬀects on the toddler's adjustment to the new sibling:

a) "Let your toddler see you carrying the baby into the home for the first time." This is not a good idea because it may make the toddler feel left out or replaced by the baby. The toddler may not understand why they were not with you when you brought the baby home and may feel hurt or angry. A better option is to have someone else carry the baby into the home while you greet your toddler with a hug and a smile. Then, you can introduce your toddler to their new sibling and involve them in welcoming and caring for the baby¹³.

b) "Avoid bringing your toddler to prenatal visits." This is not a good idea because it may make the toddler feel excluded or curious about what is going on. Bringing your toddler to some of your prenatal visits can help them learn more about the baby and feel more connected to them. You can show your toddler pictures of the baby's development, let them hear the baby's heartbeat, or ask them to help you choose clothes or toys for the baby. However, you should also be prepared for your toddler's possible boredom or impatience during long or boring appointments and bring some snacks or activities to keep them entertained¹⁴.

c) "Require scheduled interactions between the toddler and the baby." This is not a good idea because it may make the toddler feel pressured or resentful toward the baby. Forcing your toddler to interact with the baby when they are not ready or interested can backfire and cause more conﬂict or distance between them. A better option is to follow your toddler's cues and let them decide how much and when they want to interact with the baby. You can also praise your toddler for any positive interactions they have with the baby, such as giving them a gentle kiss, sharing a toy, or singing a song¹³.

A. Increased respiratory rate B. Increased fetal movement C. Increased urinary output D. Increased muscle weakness

Correct Answer is D

Explanation

When caring for a client with preeclampsia receiving magnesium sulfate, the nurse should instruct the client to report any increased muscle weakness. Magnesium sulfate is a medication commonly used to prevent and treat seizures in clients with preeclampsia. However, one of the side eﬀects of magnesium sulfate is muscle weakness. If the client experiences an increase in muscle weakness, it could indicate magnesium toxicity, which requires immediate medical attention.

Option a) Increased respiratory rate is not typically associated with magnesium sulfate administration. However, respiratory depression is a potential side eﬀect, so a decreased respiratory rate should be reported.

Option b) Increased fetal movement is generally considered a positive sign of fetal well-being and is not a concern that needs to be reported.

Option c) Increased urinary output is not typically a concerning finding. In fact, maintaining adequate urine output is desired in clients with preeclampsia to ensure proper kidney function. However, a sudden decrease in urinary output or signs of dehydration should be reported.

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A nurse is assessing a full-term newborn upon admission to the nursery. Which of the following clinical findings should the nurse report to the provider?

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Naxlex Comprehensive Predictor Exams

A nurse in a clinic is caring for a client who is in her second trimester of pregnancy. The client expresses concern about preparing her 2-year-old child for a new sibling. Which of the following is an appropriate response by the nurse?

Correct Answer is D

Explanation

A nurse is caring for a client who has preeclampsia and is receiving magnesium sulfate. Which of the following clinical findings should the nurse instruct the client to report?

Correct Answer is D

Explanation

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