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

Answer and Explanation

The Correct Answer is A

- A: Subconjunctival hemorrhage is generally a benign condition in newborns, often caused by the pressure changes during birth and does not typically require intervention.
- B: Rust-stained urine could indicate urate crystals, which are common in newborns and not usually a concern unless accompanied by other symptoms.
- C: Transient circumoral cyanosis can occur normally in newborns due to immature circulation but should resolve quickly; persistent or severe cases may require further evaluation.
- D: Single palmar creases may be associated with certain genetic conditions and warrant further investigation and reporting to a healthcare provider.

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Correct Answer is D

Explanation

Rationale:

A. Administering oxygen via a nonrebreather mask may be indicated for fetal distress, but the priority in this situation is to protect the umbilical cord from compression and minimize fetal compromise.

B. Cover the umbilical cord with a sterile saline-saturated towel is an appropriate action to prevent the cord from drying out and to reduce infection butimmediate focus should be on relieving pressure on the umbilical cord to ensure adequate fetal perfusion.

C. Initiate an infusion of IV fluids for the client can help stabilize maternal hemodynamics, but it does not directly address the umbilical cord compression. Relieving the pressure on the cord is the immediate intervention to prevent fetal hypoxia.

D. Perform a vaginal examination by applying upward pressure on the presenting part is the priority intervention. In cases of umbilical cord prolapse, the nurse must perform a vaginal examination and apply upward manual pressure on the presenting part (usually the fetal head) to lift it off the umbilical cord. This action relieves compression on the cord and restores blood flow and oxygen delivery to the fetus until an emergency delivery can be performed.

A. A client who is at 36 weeks of gestation and reports back pain following intercourse B. A client who is at 8 weeks of gestation and reports severe vomiting C. A client who is at 10 weeks of gestation and reports frequent urination D. A client who is at 24 weeks of gestation and reports periodic tingling of the fingers

Correct Answer is B

Explanation

Rationale:

A. Back pain following intercourse at 36 weeks of gestation may be common and is not typically indicative of an urgent issue.

B. Severe vomiting in early pregnancy could indicate hyperemesis gravidarum, which may require immediate assessment and intervention to prevent dehydration and electrolyte imbalances.

C. Frequent urination at 10 weeks of gestation is common due to hormonal changes and increased pressure on the bladder from the growing uterus, but it does not typically require immediate assessment unless accompanied by other concerning symptoms.

D. Periodic tingling of the fingers at 24 weeks of gestation could be due to carpal tunnel syndrome, which is common in pregnancy but does not usually require urgent assessment unless severe or accompanied by other symptoms.

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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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