A nurse is collecting data on a newborn who has experienced Duchenne-Erb (Erb's) palsy.
Which of the following manifestations should the nurse expect?
Absent Moro reflex, arm extended at the elbow and positioned against body with decreased grasp on affected side.
Asymmetry of the face during crying and drooping of the corner of the mouth on affected side.
Asymmetry of Moro reflex, arm externally rotated, and grasp reflex absent on affected side.
Asymmetry of Moro reflex, crepitus, no movement, swelling, and tenderness on palpation of affected arm.
The Correct Answer is A
Choice A rationale
Duchenne-Erb (Erb's) palsy is a type of brachial plexus injury that commonly results in an absent Moro reflex on the affected side, an extended arm at the elbow, and decreased grasp. These symptoms arise from injury to the fifth and sixth cervical nerves, leading to motor deficits.
Choice B rationale
This describes facial nerve palsy, not Erb's palsy. Facial nerve palsy affects the muscles of the face, leading to asymmetry during crying and drooping of the mouth's corner on the affected side.
Choice C rationale
While asymmetry of the Moro reflex is accurate, this choice incorrectly states that the arm is externally rotated and the grasp reflex is absent, which aligns more with a total brachial plexus injury rather than Erb's palsy.
Choice D rationale
Crepitus, no movement, swelling, and tenderness on palpation are indicative of a fracture rather than Erb's palsy. These symptoms suggest bone injury rather than nerve damage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Feeding the newborn water during the procedure is incorrect because water does not provide effective pain relief during procedures.
Choice B rationale
Placing the newborn's arms and legs in flexion and close to the midline of the torso is correct as this position, known as facilitated tucking, provides comfort and can help reduce pain.
Choice C rationale
Placing the newborn supine during the procedure is incorrect because it does not provide any specific pain relief benefits.
Choice D rationale
Elevating the newborn's head during the procedure is not specifically related to pain relief but is more about positioning for ease of access. .
Correct Answer is D
Explanation
Choice A rationale
An occult cord prolapse occurs when the umbilical cord is hidden but not necessarily within the vagina. It is often compressed alongside the fetus, causing a risk for decreased oxygenation.
Choice B rationale
An occult prolapsed cord is not characterized by being wrapped around the fetal neck; that condition is known as a nuchal cord.
Choice C rationale
A compound prolapsed cord does not involve the cord being felt through the cervix inside an intact amniotic sac. Instead, it involves the cord alongside the fetal presenting part.
Choice D rationale
An overt prolapsed cord occurs when the umbilical cord comes through the cervix ahead of the presenting part, posing significant risk due to potential cord compression and interruption of blood flow to the fetus.
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