An African American woman noticed some bruises on her newborn girl's buttocks.
She asks the nurse who spanked her daughter.
The nurse explains that these marks are called:
Mongolian spots.
Lanugo.
Nevus flammeus.
Vascular nevus.
The Correct Answer is A
Choice A rationale
Mongolian spots are benign, flat bluish or bluish-gray birthmarks that commonly appear on the buttocks, lower back, or thighs of newborns, particularly those with darker skin tones, including African Americans, Asians, and Hispanics. They are caused by the entrapment of melanocytes (pigment-producing cells) deep within the dermis during fetal development. These spots typically fade spontaneously within a few years and are not indicative of any underlying medical condition or trauma.
Choice B rationale
Lanugo is fine, downy hair that covers the body of some newborns, especially preterm infants. It is usually shed within the last few weeks of gestation or shortly after birth and is unrelated to bruising or pigmented spots on the buttocks.
Choice C rationale
Nevus flammeus, also known as a port-wine stain, is a vascular malformation of the skin that appears as a flat, pink, red, or purple birthmark. It is caused by dilated capillaries and does not typically occur as bluish spots on the buttocks. Port-wine stains are usually permanent and may darken with age.
Choice D rationale
Vascular nevus, also known as a strawberry hemangioma, is a raised, red, bumpy birthmark composed of extra blood vessels. While it is a type of birthmark, it does not present as flat, bluish spots on the buttocks. Hemangiomas typically grow rapidly in the first few months of life and then gradually shrink over several years.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Fetal hypoxemia, a deficiency in oxygen reaching the fetal tissues, typically manifests as late decelerations in the fetal heart rate tracing, which reflect uteroplacental insufficiency. While severe hypoxemia can lead to various FHR patterns, variable decelerations are more directly associated with mechanical factors affecting the umbilical cord.
Choice B rationale
Altered fetal cerebral blood flow can be a consequence of various factors, including hypoxemia and cord compression, and can influence the fetal heart rate. However, variable decelerations are specifically caused by events that directly impede blood flow through the umbilical vessels rather than a generalized alteration in cerebral circulation.
Choice C rationale
Uteroplacental insufficiency, a condition where the placenta is unable to deliver an adequate supply of oxygen and nutrients to the fetus, typically results in late decelerations, indicating fetal distress due to chronic hypoxia. Variable decelerations, in contrast, have a more abrupt onset and recovery, reflecting acute changes in umbilical cord blood flow.
Choice D rationale
Umbilical cord compression occurs when the umbilical cord, which carries oxygen and nutrients to the fetus, is squeezed or constricted. This compression leads to a transient decrease in fetal blood flow and oxygenation, resulting in a rapid drop and subsequent return of the fetal heart rate, which is characteristic of variable decelerations. The shape, timing, and abrupt nature of variable decelerations directly correlate with the intermittent pressure on the umbilical cord.
Correct Answer is B
Explanation
Choice A rationale
The stepping reflex, also known as the walking or dancing reflex, is elicited by holding the infant upright with their feet touching a flat surface. The infant will make stepping or dancing movements. This is not elicited by stroking the lateral sole of the foot.
Choice B rationale
The Babinski reflex is elicited by stroking the lateral sole of the infant's foot from the heel upward and across the ball of the foot. A positive Babinski sign is characterized by dorsiflexion of the great toe and fanning out of the other toes. This reflex is normal in infants and typically disappears by 12 to 24 months of age.
Choice C rationale
The tonic neck reflex, also known as the fencing reflex, is elicited by turning the infant's head to one side. The arm and leg on the turned side extend, while the arm and leg on the opposite side flex. Stroking the sole of the foot does not elicit this reflex.
Choice D rationale
The plantar grasp reflex is elicited by placing a finger or object across the base of the infant's toes. The toes will curl downward and grasp the object. This reflex is different from the response elicited by stroking the lateral sole of the foot. .
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