A nurse is completing a newborn assessment and notices small white nodules on the roof of the newborn’s mouth. This finding is characteristic of which of the following conditions?

Erythema toxicum

Mongolian spots

Epstein’s pearls

Milia spots

Answer and Explanation

The Correct Answer is C

Choice A rationale
Erythema toxicum is a common rash seen in newborns, characterized by blotchy red spots on the skin with overlying white or yellow papules or pustules. It does not present as small white nodules on the roof of the mouth.
Choice B rationale
Mongolian spots are a type of birthmark that are flat, blue, or blue-gray. They appear at birth or in the first or second week of life. They look similar to bruises and are most often found on the buttocks or lower back, but are never found on the roof of the mouth.
Choice C rationale
Epstein pearls are small, harmless white or yellow nodules that may appear along your newborn baby’s gums or on the roof of their mouth. They are common and usually go away within three months after birth.
Choice D rationale
Milia spots are tiny white bumps that appear across a baby’s nose, chin or cheeks. Milia are common in newborns but can occur at any age. Unlike Epstein pearls, they do not appear on the roof of the mouth.

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Correct Answer is A

Explanation

Choice A rationale
The nurse should be concerned about a client with an 18kg (4 lb) weight gain in her first trimester. This is because the expected weight gain for a client in the first trimester is usually around 1.8 kg (4 lb)1. A weight gain of 18 kg in the first trimester significantly exceeds this expectation, which could indicate a potential health issue such as gestational diabetes or multiple pregnancies. It’s important for the nurse to report this finding to the healthcare provider for further evaluation and management.
Choice B rationale
A client with a 68 kg (15 lb) weight gain in her second trimester does not necessarily pose a concern. Weight gain during pregnancy varies among individuals and can be influenced by factors such as the mother’s body mass index (BMI) before pregnancy, the baby’s growth rate, and the mother’s diet and lifestyle. However, it’s always important to monitor weight gain throughout pregnancy to ensure it’s within a healthy range.
Choice C rationale
A client with a 13 kg (25 lb) weight gain in her third trimester does not necessarily pose a concern. Weight gain during the third trimester can be influenced by factors such as the baby’s growth rate, amniotic fluid volume, and the mother’s increased blood volume. However, it’s always important to monitor weight gain throughout pregnancy to ensure it’s within a healthy range.
Choice D rationale
A client with a 3.6 kg (8 lb) weight gain in her first trimester does not necessarily pose a concern. This is within the expected weight gain range for the first trimester. However, it’s always important to monitor weight gain throughout pregnancy to ensure it’s within a healthy range.

A. Perform nasopharyngeal suctioning for a maximum of 5 seconds. B. Position the infant in a knee-chest position. C. Administer morphine via IV bolus. D. Provide 100% oxygen by face mask.

Correct Answer is B

Explanation

Choice A rationale
Performing nasopharyngeal suctioning for a maximum of 5 seconds is not a recommended action for an infant diagnosed with Tetralogy of Fallot. This procedure is typically used to clear the airway in infants with respiratory distress, not heart conditions.
Choice B rationale
Positioning the infant in a knee-chest position can help increase blood flow to the lungs, which is beneficial for an infant with Tetralogy of Fallot. This condition involves a combination of heart defects that affect the normal flow of blood through the heart.
Choice C rationale
Administering morphine via IV bolus is not a recommended action for an infant diagnosed with Tetralogy of Fallot. While morphine is a powerful pain reliever, it is not typically used in the management of this condition.
Choice D rationale
Providing 100% oxygen by face mask is not a recommended action for an infant diagnosed with Tetralogy of Fallot. While supplemental oxygen can help increase the amount of oxygen in the blood, it does not address the underlying heart defects associated with this condition.

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A nurse is completing a newborn assessment and notices small white nodules on the roof of the newborn’s mouth. This finding is characteristic of which of the following conditions?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a prenatal clinic is attending to a group of clients. Which client’s weight gain should the nurse be concerned about?

Correct Answer is A

Explanation

Given the medical history and nurses’ notes of an infant diagnosed with Tetralogy of Fallot, which of the following actions should the nurse take?

Correct Answer is B

Explanation

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A nurse is completing a newborn assessment and notices small white nodules on the roof of the newborn’s mouth. This finding is characteristic of which of the following conditions?

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A nurse is providing care for a newborn suspected of having neonatal abstinence syndrome. Which symptom would support this diagnosis?

A nurse is caring for an infant diagnosed with Tetralogy of Fallot. The infant has been feeding poorly and has difficulty gaining weight. What actions should the nurse plan to take? (Select all that apply.)