A nurse is completing a full assessment of a newborn at 4 hours of life.
For each of the assessment findings below, click to specify if this is an expected (normal) newborn finding or an abnormal finding.
Note: each column must have at least one response option selected.
Milia
Barrel-shaped chest
Respiratory rate 66/min
Acrocyanosis present
Polydactyly
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"B"}}
A. Milia: Expected (normal) finding.
B. Barrel-shaped chest: Expected (normal) finding.
C. Respiratory rate 66/min: Abnormal finding.
D. Acrocyanosis present: Expected (normal) finding.
E. Polydactyly: Abnormal finding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Microcephaly is not typically associated with an increased risk of unconjugated bilirubin and jaundice.
Choice B rationale
Polydactyly is a congenital condition involving extra fingers or toes and is not associated with an increased risk of unconjugated bilirubin and jaundice.
Choice C rationale
Caput succedaneum is a condition involving swelling of the scalp in a newborn and is not typically associated with an increased risk of unconjugated bilirubin and jaundice.
Choice D rationale
Cephalohematoma is a collection of blood between a baby’s scalp and the skull bone. It is associated with an increased risk of unconjugated bilirubin and jaundice due to the breakdown of red blood cells in the hematoma. .
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. .
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