A nurse is assessing the fontanels of a crying newborn and notes that the posterior fontanel pulsates and briefly bulges. What do these findings indicate?
Increased intracranial pressure
Dehydration
Overhydration
These are normal findings
The Correct Answer is D
A. Increased intracranial pressurE. Pulsation and bulging of the fontanel may be signs of
increased intracranial pressure in infants. However, it is important to differentiate between normal fontanel characteristics and abnormal signs of elevated intracranial pressure. In this case, the pulsation and bulging are likely normal responses to crying and changes in intracranial pressure during the newborn period.
B. Dehydration: Dehydration typically presents with sunken fontanels rather than pulsation and bulging. Dehydration is a serious condition that requires prompt assessment and intervention, but it is not indicated by the findings described in the scenario.
C. Overhydration: Overhydration is not typically associated with pulsation and bulging of the fontanel. Overhydration may lead to fluid overload and edema but does not directly affect fontanel characteristics.
D. These are normal findings: Pulsation and brief bulging of the fontanel in response to crying are considered normal findings in newborns. Fontanels allow for the flexibility of the skull bones during childbirth and provide space for brain growth during infancy. Pulsation and bulging may occur temporarily during crying or changes in intracranial pressure and are not necessarily
indicative of pathology.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Is beginning to tie her own shoelaces: The ability to begin tying shoelaces is a fine motor skill milestone that is typically achieved around 5 to 6 years of age. This finding indicates appropriate motor skill development.
B. Can copy a square on another piece of paper: Copying shapes is a visual-motor integration skill that develops during early childhood. The ability to copy a square is an appropriate
milestone for a 5-year-old.
C. Draws a person with three body parts: By age 5, most children can draw a person with more body parts, typically including a head, trunk, arms, legs, and facial features. Drawing a person with only three body parts may suggest a delay in fine motor or cognitive development and could be a cause for concern.
D. Can dress and undress herself without help: Independence in dressing and undressing is a self- care skill that is typically achieved by 5 years of age and indicates appropriate motor
development.
Correct Answer is C
Explanation
A. Poisoning: While poisoning can be a significant concern among adolescents, it is not the
leading cause of death in this age group. Poisoning deaths may occur due to accidental ingestion of toxic substances or intentional overdose, but it is not as common as other causes of death
among adolescents.
B. Drowning: Drowning is a concern, especially during recreational activities such as swimming, but it is not the leading cause of death among adolescents. Proper water safety practices and supervision can help prevent drowning incidents.
C. Unintentional injuries: Unintentional injuries, including motor vehicle accidents, falls, and other accidents, are the leading cause of death among adolescents. Risk-taking behaviors, lack of experience, and peer influence contribute to the high rate of unintentional injuries in this age group.
D. Diseases: While diseases such as cancer, heart disease, and respiratory disorders can affect adolescents, they are not the leading cause of death in this age group. Unintentional injuries,
including those resulting from accidents and trauma, are more common causes of death among adolescents.
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