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?
Subconjunctival hemorrhage
Rust-stained urine
Transient circumoral cyanosis
Single palmar creases
The Correct Answer is D
A. Subconjunctival hemorrhage is common in newborns due to birth trauma and usually resolves without intervention. It does not typically require reporting.
B. Rust-stained urine in the first few days of life is caused by uric acid crystals and is considered a normal finding during neonatal adaptation.
C. Transient circumoral cyanosis (bluish discoloration around the mouth) can occur immediately after birth due to immature peripheral circulation and generally resolves quickly with warming and oxygenation.
D. A single palmar crease, especially if present on one hand, can be associated with chromosomal abnormalities such as trisomy 21 (Down syndrome). This finding warrants further evaluation and should be reported to the provider for assessment and potential diagnostic follow-up.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale:
A. A temperature of 37.4°C (99.3°F) may be within the normal range, but it can also indicate a fever, which is common with endometritis.
B. A WBC count of 9,000/mm3 is within the normal range, but it may be elevated in response to infection such as endometritis.
C. Scant lochia is not typically associated with endometritis; instead, clients with endometritis may have increased or foul-smelling lochia.
D. Uterine tenderness is a common finding in clients with endometritis, as the infection causes inflammation and discomfort in the uterine lining.
Correct Answer is D
Explanation
Rationale:
A. Limiting the length of breastfeeding to 5 minutes per breast is not recommended and may lead to inadequate milk transfer and supply issues.
B. Instructing the client to wait 4 hours between daytime feedings may result in insufficient milk intake for the newborn and could impact breastfeeding success.
C. Offering supplemental formula between feedings may interfere with establishing breastfeeding and could decrease the client's milk supply.
D. Assessing the newborn's latch while breastfeeding is the appropriate action for addressing sore nipples. Poor latch is a common cause of nipple soreness in breastfeeding mothers. Ensuring the newborn has a proper latch can help alleviate discomfort and prevent further nipple trauma.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.