A nurse is assessing a newborn on the first day of life. Which of the following is an expected finding? (Select All that Apply.)
Fusion of labia in female genitalia
Erythema toxicum on newborn's skin
Hypospadias is noted in the male newborn
Presence of syndactyly in extremities
Negative Ortolani sign
Correct Answer : B,E
A) Fusion of labia in female genitalia:
Fusion of the labia in a female newborn is not an expected finding. This could indicate a condition such as labial adhesion or an abnormality in the development of the genitalia. Normally, the labia in a female newborn are separated. Any signs of fusion would require further evaluation by the healthcare provider.
B) Erythema toxicum on newborn's skin:
Erythema toxicum is a common and expected finding in newborns, usually appearing within the first 2–3 days of life. It consists of small, red papules or pustules on a red base, often described as a "flea-bitten" appearance. This rash is benign and resolves on its own within a few days to weeks. It is not associated with any infection or underlying health issues.
C) Hypospadias is noted in the male newborn:
Hypospadias, a condition where the urethral opening is located on the underside of the penis rather than at the tip, is not an expected finding in all newborn males. While it occurs in a small percentage of male infants, it is a congenital anomaly that would require further assessment and possibly surgical correction. It is not considered a normal finding in a newborn.
D) Presence of syndactyly in extremities:
Syndactyly, the condition where two or more fingers or toes are fused together, is not a normal finding in newborns. While it is a congenital anomaly that can occur in some infants, it is not expected and requires further evaluation and possibly surgical intervention depending on the severity.
E) Negative Ortolani sign:
A negative Ortolani sign is an expected and normal finding in a newborn. The Ortolani maneuver is used to assess for hip dislocation, and a negative result indicates that the hip is stable and not dislocated. If the Ortolani sign were positive, it would suggest the presence of a developmental hip dysplasia, which would require further diagnostic evaluation. A negative sign is considered typical and reassuring.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Goodell’s sign:
Goodell's sign refers to the softening of the cervix that occurs early in pregnancy, typically around 4–6 weeks. It is a probable sign of pregnancy due to increased vascularity and hormonal changes. However, it does not describe the movement of the fetus or the sensation felt by the provider when pressure is applied to the cervix.
B) Lightening:
Lightening refers to the sensation of the fetus dropping or descending into the pelvic cavity, which typically happens in the later stages of pregnancy (around 36 weeks or later). It is not related to the fetal movement felt by the provider through upward pressure on the cervix, but rather to the physical repositioning of the fetus as it prepares for labor.
C) Ballottement:
Ballottement is the correct term for the movement of the fetus that can be felt by the provider when upward pressure is applied to the cervix. This technique involves a gentle tapping or pushing on the cervix, causing the fetus to rise and then "bounce" back. This is a probable sign of pregnancy, typically noticeable between 16 and 18 weeks gestation.
D) Chadwick's sign:
Chadwick’s sign refers to the bluish discoloration of the cervix, vagina, and vulva due to increased blood flow and is often an early sign of pregnancy. It does not relate to the movement of the fetus felt by the provider, but rather to changes in the color of the genital tissues.
Correct Answer is D
Explanation
A) Palmer grasp reflex:
The palmer grasp reflex is a primitive reflex in which a newborn will grasp an object placed in their hand. While this reflex is present at birth, it typically disappears by 5-6 months of age, not by 3-4 months. The Moro reflex, which is more related to startle and sudden movements, is the correct answer in this case.
B) Babinski reflex:
The Babinski reflex, in which the toes fan out when the sole of the foot is stroked, is present at birth but typically disappears by 12 months. This reflex is an indicator of neurological development, and its presence beyond the first year could suggest neurological concerns, but it is not the reflex in question here.
C) Rooting reflex:
The rooting reflex occurs when the newborn turns their head and opens their mouth in response to cheek stimulation, typically to find the nipple for breastfeeding. This reflex is present at birth and usually disappears by 3-4 months, which is similar to the timing mentioned in the question.
D) Moro reflex:
The Moro reflex is a startle reflex in which the infant spreads their arms and then pulls them back in when they feel a sudden loss of support or a loud noise. This reflex is present at birth and typically disappears by 3-4 months of age. It is considered a classic primitive reflex that fades as the infant's nervous system matures.
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