A nurse is assessing a newborn who was born at 42.5 weeks of gestation. Which of the following findings should the nurse expect?
Increased subcutaneous fat
Dry, cracked skin
Scant scalp hair
Copious vernix
The Correct Answer is B
Choice A reason: Increased subcutaneous fat is not a typical finding in a newborn who was born at 42.5 weeks of gestation, because it is more characteristic of a term or preterm newborn. A postterm newborn tends to have less subcutaneous fat, and may appear thin and wasted.
Choice B reason: Dry, cracked skin is a common finding in a newborn who was born at 42.5 weeks of gestation, because the skin has been exposed to the amniotic fluid for a prolonged period. The skin may also appear peeling, wrinkled, or leathery.
Choice C reason: Scant scalp hair is not a usual finding in a newborn who was born at 42.5 weeks of gestation, because it is more characteristic of a preterm newborn. A postterm newborn tends to have more scalp hair, and may also have long nails and abundant lanugo.
Choice D reason: Copious vernix is not a specific finding in a newborn who was born at 42.5 weeks of gestation, because it is more characteristic of a term or preterm newborn. A postterm newborn tends to have little or no vernix, which is a white, cheesy substance that protects the skin in utero.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Disseminated intravascular coagulation (DIC) syndrome is not the correct answer, as it is a coagulation disorder that causes widespread clotting and bleeding in the body. DIC can occur as a complication of severe preeclampsia, but it is not indicated by the laboratory results. DIC would cause a low platelet count, but also a prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), and a low fibrinogen level.
Choice B reason: Eclampsia is not the correct answer, as it is a seizure disorder that occurs in clients with severe preeclampsia. Eclampsia can occur as a complication of severe preeclampsia, but it is not indicated by the laboratory results. Eclampsia would cause a high blood pressure, but also a proteinuria, edema, and hyperreflexia.
Choice C reason: Hemolysis, elevated liver enzyme levels, and low platelet levels (HELLP) syndrome is the correct answer, as it is a variant of severe preeclampsia that affects the blood and the liver. HELLP syndrome is indicated by the laboratory results, as it causes a low platelet count, an elevated AST level, and a falling hematocrit. HELLP syndrome would also cause a high blood pressure, a proteinuria, and a right upper quadrant pain.
Choice D reason: Idiopathic thrombocytopenia is not the correct answer, as it is an autoimmune disorder that causes the destruction of platelets by antibodies. Idiopathic thrombocytopenia can affect pregnant women, but it is not related to severe preeclampsia or the laboratory results. Idiopathic thrombocytopenia would cause a low platelet count, but not an elevated AST level or a falling hematocrit.
Correct Answer is C
Explanation
Choice A reason: Physiological jaundice is not the correct answer, as it is a normal and benign condition that occurs in about 60% of term newborns, and usually appears after the first 24 hours of life. Physiological jaundice is caused by the breakdown of fetal hemoglobin and the immature liver function, and resolves within a few days.
Choice B reason: Maternal cocaine abuse is not the correct answer, as it is a maternal risk factor that can cause various complications in the newborn, such as low birth weight, prematurity, intrauterine growth restriction, or congenital anomalies. Maternal cocaine abuse does not cause jaundice in the newborn, unless it leads to hepatic or renal dysfunction.
Choice C reason: Maternal/newborn blood group incompatibility is the correct answer, as it is a maternal-fetal condition that can cause hemolytic disease of the newborn, which is a severe form of jaundice that can appear within the first 24 hours of life. Maternal/newborn blood group incompatibility occurs when the mother's blood type is Rh negative and the newborn's blood type is Rh positive, or when the mother's blood type is O and the newborn's blood type is A or B. The maternal antibodies cross the placenta and attack the newborn's red blood cells, causing hemolysis, anemia, and hyperbilirubinemia.
Choice D reason: Absence of vitamin K is not the correct answer, as it is a nutritional deficiency that can cause hemorrhagic disease of the newborn, which is a bleeding disorder that can occur within the first week of life. Absence of vitamin K is due to the lack of intestinal flora and the low vitamin K content in breast milk, and can cause bleeding in the skin, mucous membranes, or internal organs. Absence of vitamin K does not cause jaundice in the newborn, unless it leads to hepatic or biliary dysfunction.
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