A nurse is providing newborn discharge teaching to a client whose newborn recently had a circumcision done in the hospital.

Exhibits

Which of the following statements should the nurse include when providing discharge teaching for the parent about circumcision care? For each statement made by the nurse, click to specify whether the statement is essential or contraindicated.

“The glans penis will appear red and have a yellow crust as it heals. Do not remove this.”

“Ensure the diaper is really tight to keep the gauze attached to the penis.”

“Notify your pediatrician if your baby has not voided in 24 hours.”

“Coat the glans penis with petroleum jelly and cover with gauze.”

“Check for bleeding every 4 hours for the first 24 hours and notify your pediatrician if there is bleeding at the circumcision site.”

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}

“The glans penis will appear red and have a yellow crust as it heals. Do not remove this.”
- Essential: This is a normal part of the healing process.
“Ensure the diaper is really tight to keep the gauze attached to the penis.”
- Contraindicated: The diaper should be loose to avoid pressure on the circumcision site.
“Notify your pediatrician if your baby has not voided in 24 hours.”
- Essential: This could indicate a problem that needs medical attention.
“Coat the glans penis with petroleum jelly and cover with gauze.”
- Essential: This helps prevent the diaper from sticking to the circumcision site and aids in healing.
“Check for bleeding every 4 hours for the first 24 hours and notify your pediatrician if there is bleeding at the circumcision site.”
- Essential: Monitoring for bleeding is crucial to ensure there are no complications.

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Correct Answer is C

Explanation

Choice A rationale

Faint red marks on the plantar surface are more common in preterm infants and are not typically seen in post-term infants.

Choice B rationale

Copious vernix is usually seen in preterm infants. Post-term infants often have little to no vernix.

Choice C rationale

Dry, cracked skin is a common finding in post-term infants due to prolonged exposure to the amniotic fluid.

Choice D rationale

Scant scalp hair is more common in preterm infants. Post-term infants usually have more developed hair.

A. Ask another nurse to verify the heart rate as this is an abnormal finding. B. Call the provider and request they come to the hospital immediately for this abnormal finding to further assess the neonate. C. Prepare the newborn for transport to the NICU for further cardiac observation. D. Document the expected finding.

Correct Answer is D

Explanation

Choice A rationale

An apical pulse rate of 124 bpm is within the normal range for a neonate (110-160 bpm). There is no need to ask another nurse to verify the heart rate as it is not an abnormal finding.

Choice B rationale

Calling the provider for an apical pulse rate of 124 bpm is unnecessary as it is within the normal range for a neonate. This action would be appropriate if the heart rate were significantly outside the normal range.

Choice C rationale

Preparing the newborn for transport to the NICU for an apical pulse rate of 124 bpm is not warranted. The heart rate is within the normal range, and there is no indication for further cardiac observation.

Choice D rationale

Documenting the expected finding is the appropriate action. An apical pulse rate of 124 bpm is within the normal range for a neonate, and no further action is needed.

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a newborn who was born at 42.5 weeks of gestation.Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

A nursery nurse is admitting a neonate and is performing the neonatal assessment.The apical pulse is auscultated with a rate of 124 bpm, after one full minute of listening.What is the next appropriate action should the nurse take?

Correct Answer is D

Explanation

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