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A nurse is caring for a newborn and calculating the Apgar score.

At 1 minute after delivery, the following findings are noted: heart rate of 110/min; slow, weak cry; flexed extremities; cries in response to suctioning of the nares; body pink in color with blue extremities.

Calculate the newborn’s Apgar score.

Answer and Explanation

The Correct Answer is ["7"]

The newborn’s Apgar score is 7.

Step 1: Heart rate of 110/min = 2 points.

Step 2: Slow, weak cry = 1 point.

Step 3: Flexed extremities = 1 point.

Step 4: Cries in response to suctioning of the nares = 2 points.

Step 5: Body pink in color with blue extremities = 1 point. Total Apgar score = 2 + 1 + 1 + 2 + 1 = 7.

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Correct Answer is B

Explanation

Choice A rationale

Erythema toxicum is a common, benign rash in newborns but does not cause swelling that crosses suture lines.

Choice B rationale

A caput succedaneum is swelling of the scalp that crosses suture lines and is caused by prolonged pressure on the head during delivery.

Choice C rationale

Mongolian spots are benign, flat, congenital birthmarks with wavy borders and irregular shapes, typically found on the lower back and buttocks, not the head.

Choice D rationale

A cephalhematoma is a collection of blood between the skull bone and its periosteum that does not cross suture lines. .

A. Xiphoid process. B. Fifth intercostal space. C. Sternal notch. D. Nipple line.

Correct Answer is D

Explanation

Choice A rationale

The xiphoid process is not the correct anatomical landmark for measuring chest circumference in newborns. It is located at the lower end of the sternum and does not provide a consistent measurement point.

Choice B rationale

The fifth intercostal space is not used for measuring chest circumference in newborns. This space is located between the ribs and is not a reliable landmark for consistent measurements.

Choice C rationale

The sternal notch is not the correct landmark for measuring chest circumference. It is located at the top of the sternum and does not provide a consistent measurement point.

Choice D rationale

The nipple line is the correct anatomical landmark for measuring chest circumference in newborns. This method ensures that the measurement is taken at a consistent and reproducible location, providing an accurate assessment of the chest size relative to growth and development standards.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a newborn delivered by vaginal birth after 3 hours of pushing.The newborn’s mother asks about the swollen area on her son’s head.After palpation and identification that the swelling does cross the suture line, which of the following is an appropriate response by the nurse?

Correct Answer is B

Explanation

A nurse is completing the admission assessment of a newborn.Which of the following anatomical landmarks should the nurse use when measuring the newborn’s chest circumference?

Correct Answer is D

Explanation

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