A nurse is assessing a newborn's gestational age using the New Ballard Scale.

Which of the following signs would indicate prematurity?

Thin and transparent skin

Well-developed breast buds

Creases on the bottom of feet

Developed labia.

Answer and Explanation

The Correct Answer is A

Thin and transparent skin is a sign of prematurity in newborns. The New Ballard Scale is a scale that estimates the gestational age of a newborn infant based on physical and neuromuscular characteristics.

The other choices are signs of maturity or postmaturity in newborns:

• Choice B: Well-developed breastbuds indicate a gestational age of 38 to 44 weeks.

• Choice C: Creases on the bottom of feet indicate a gestational age of 32 to 44 weeks.

• Choice D: Developed labia indicate a gestational age of 40 to 44 weeks.

The normal range for gestational age is 37 to 42 weeks. Premature infants are those born before 37 weeks, and postmature infants are those born after 42 weeks.

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Correct Answer is A

Explanation

Carbon monoxide poisoning.

This is because the client reports having a headache and vertigo after turning on his furnace for the first time this season.These are common symptoms of carbon monoxide poisoning, which can occur when carbon monoxide, a colorless and odorless gas, builds up in the blood due to exposure to combustion fumes.

The furnace may have been a source of carbon monoxide if it was not well vented or maintained.

The other statements are wrong because:

Meniere’s disease is a disorder of the inner ear that causes vertigo, hearing loss, tinnitus and ear fullness. It is not related to carbon monoxide exposure or furnace use.

Migraine is a type of headache that causes throbbing pain, nausea, sensitivity to light and sound, and sometimes visual disturbances. It is not caused by carbon monoxide exposure or furnace use, but by genetic and environmental factors.

Benign paroxysmal positional vertigo (BPPV) is a condition that causes brief episodes of vertigo triggered by changes in head position. It is caused by tiny crystals in the inner ear that become dislodged and stimulate the balance sensors. It is not related to carbon monoxide exposure or furnace use.

A. White patches on the tongue B. Bleeding of the gums C. Darkening of the mucosa D. Red spots on the hard palate.

Correct Answer is D

Explanation

Darkening of the mucosa.This is an expected variation for an older adult client because the melanin production increases with age.

Some possible explanations for the other choices are:

• Choice A.White patches on the tongue could indicate candidiasis, an oral fungal infection.

• Choice B.Bleeding of the gums could indicate gingivitis, periodontitis, or vitamin C deficiency.

• Choice C.Red spots on the hard palate could indicate petechiae, which are small hemorrhages caused by trauma, infection, or bleeding disorders.

Normal ranges for oral mucosa color vary depending on the skin tone and ethnicity of the client.Generally, the oral mucosa should be pink and moist without lesions or discolorations.

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A nurse is assessing a newborn's gestational age using the New Ballard Scale. Which of the following signs would indicate prematurity?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who reports that he has a headache and vertigo after turning on his furnace for the first time this season. The nurse suspect which of the following?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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A nurse is assessing a newborn's gestational age using the New Ballard Scale.

Which of the following signs would indicate prematurity?