An Asian woman noticed some bluish-green marks on her newborn girl's buttocks.
She asks the nurse what happened to her daughter.
The nurse explains that these marks are called:
Congenital dermal melanocytosis.
Nevus flammeus.
Vascular nevi.
Lanugo.
The Correct Answer is A
Choice A rationale
Congenital dermal melanocytosis, previously called Mongolian spots, are benign, flat, slate-grey, or bluish-green dermal melanocytic lesions typically found on the sacrum, buttocks, or lower back of newborns, more common in Asian, Black, or Hispanic infants. They result from melanocytes being trapped deep in the dermis during their migration from the neural crest to the epidermis, where they are usually found, causing the distinct color due to the Tyndall effect. They generally fade spontaneously within the first few years of life.
Choice B rationale
Nevus flammeus, commonly known as a port-wine stain, is a capillary malformation resulting from a localized defect in the formation of dermal capillaries, leading to a permanent dilation of post-capillary venules. This birthmark appears as a flat, pink, red, or purple patch on the skin, often unilaterally, and does not fade with time; it may even darken and thicken. It is not characterized by the bluish-green markings on the buttocks described.
Choice C rationale
Vascular nevi is a general term encompassing various birthmarks arising from abnormal blood vessel development, including hemangiomas and vascular malformations like nevus flammeus. Hemangiomas are typically raised, bright red, or deep blue/purple tumors of proliferating endothelial cells, often appearing days or weeks after birth, unlike the described flat marks. This term is too non-specific for the precise description.
Choice D rationale
Lanugo is the term for the fine, soft, downy hair that covers the body of a fetus, beginning around the fourth or fifth month of gestation. It is often still present on the newborn, especially premature infants, but it is hair, not a skin marking or lesion. Its function is believed to be related to temperature regulation and adherence of the vernix caseosa; it is shed within the first few weeks of life. —.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While drying does remove blood and amniotic fluid, the primary scientific rationale is thermoregulation. Removing superficial contaminants is secondary to preventing cold stress. Allowing the wet skin to air dry would cause rapid, dangerous cooling, a more significant threat than the mere presence of maternal blood.
Choice B rationale
The drying and vigorous stimulation do not specifically increase blood flow to the distal extremities (hands and feet). The initial drying is the first step in preventing evaporative heat loss, which is paramount to maintaining the infant's core body temperature and promoting stable transition to extrauterine life.
Choice C rationale
Stimulating the infant by rubbing the back or soles of the feet does encourage crying, which helps expand the lungs and clear fluid. However, the most immediate and critical scientific reason for thorough drying is to prevent significant evaporative heat loss, which accounts for a large percentage of neonatal heat loss.
Choice D rationale
Water on the skin surface rapidly evaporates, and because a significant amount of heat is required to change water from liquid to vapor (latent heat of vaporization), this evaporation causes rapid and significant body heat loss. Thorough, immediate drying eliminates the largest source of cold stress for a newborn, preventing a drop in core temperature.
Correct Answer is D
Explanation
Choice A rationale
Diaphragmatic breathing is the predominant pattern, but chest retraction is an abnormal finding, signifying increased respiratory effort or distress, often due to decreased lung compliance or airway obstruction, and is not a characteristic of a normal, healthy full-term newborn's breathing. Normal respiratory rate is 30-60 breaths/minute.
Choice B rationale
Newborn breathing is often characterized by periodic (irregular) breathing, including short pauses (apnea) of less than 15 seconds, making a consistently regular rhythm an inaccurate description. Deep breathing is also not the usual description; respirations are typically shallow and relatively even.
Choice C rationale
Nasal flaring is a sign of respiratory distress, indicating the newborn is using accessory muscles to decrease airway resistance and is not a normal observation in a healthy newborn. Normal breathing relies mainly on the diaphragm, with chest movement being secondary and synchronous.
Choice D rationale
A full-term newborn typically breathes using their diaphragm and abdominal muscles, resulting in observable abdominal movement. The chest walls are flexible, causing synchronous or passive movements with the abdominal effort, which defines the normal and predominant breathing pattern. —.
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