A nurse is caring for a newborn who was born at 39 weeks gestation and weighs 3350 g. Based on the weight and gestational age, what is the most appropriate way to document the findings?

Small for gestational age (SGA).

Appropriate (average) for gestational age (AGA).

Low birth weight.

Large for gestational age (LGA).

Answer and Explanation

The Correct Answer is B

Choice A rationale

Small for gestational age (SGA) refers to newborns whose birth weight is below the 10th percentile for their gestational age.

Choice B rationale

Appropriate for gestational age (AGA) refers to newborns whose birth weight is between the 10th and 90th percentiles for their gestational age. A newborn weighing 3350 g at 39 weeks gestation falls within this range.

Choice C rationale

Low birth weight is defined as a birth weight of less than 2500 g, which does not apply to this newborn.

Choice D rationale

Large for gestational age (LGA) refers to newborns whose birth weight is above the 90th percentile for their gestational age.

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Correct Answer is C

Explanation

Choice A rationale

Wiping the cord daily with alcohol prep pads is not recommended. Current guidelines suggest keeping the cord clean and dry without the use of alcohol, as it can delay the natural drying and falling off process.

Choice B rationale

Keeping the cord moist is not recommended. The cord should be kept dry to promote natural drying and separation. Moisture can increase the risk of infection.

Choice C rationale

Folding the top of the diaper underneath the cord is recommended to keep the cord exposed to air and prevent irritation from urine or stool. This helps the cord dry out and fall off naturally.

Choice D rationale

Applying petroleum jelly to the cord stump is not recommended. The cord should be kept dry, and the use of ointments or creams can interfere with the natural drying process. .

A. “This is erythema toxicum, which is a transient condition.”. B. “A caput succedaneum occurs due to prolonged pressure of the head against the cervix.”. C. “Mongolian spots can be found on the skin of many newborns.”. D. “This is a cephalhematoma, which can occur spontaneously.”. .

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. .

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A nurse is caring for a newborn who was born at 39 weeks gestation and weighs 3350 g. Based on the weight and gestational age, what is the most appropriate way to document the findings?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is teaching a newborn’s parent to care for the umbilical cord stump.Which of the following instructions should the nurse include?

Correct Answer is C

Explanation

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

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