For which reason would a nurse in the well-baby nursery report to the neonatologist that a newborn appears to be preterm?
The baby has a square window angle of 90 degrees.
The baby has leathery and cracked skin.
The baby has a popliteal angle of 90 degrees.
The baby has pronounced plantar creases.
The Correct Answer is A
Choice A is correct. The square window angle, formed by the intersection of the ear and the jawline, is an important physical assessment finding in neonates. In full-term babies, this angle is typically greater than 90 degrees, appearing more rounded. However, in preterm babies, the angle is often closer to 90 degrees, appearing more square due to underdeveloped facial features and subcutaneous tissue.
Choice B is incorrect. While leathery and cracked skin can be present in both term and preterm babies, it's not a specific indicator of prematurity alone. It can be caused by various factors like intrauterine growth restriction, dehydration, or underlying skin conditions.
Choice C is incorrect. The popliteal angle, formed by flexing the knee and measuring the angle between the thigh and lower leg, is not a reliable indicator of prematurity. It can vary even among term babies and is influenced by other factors like muscle tone and positioning.
Choice D is incorrect. Pronounced plantar creases, the lines on the soles of the feet, are also not specific to prematurity. While they may be deeper in some preterm babies, they can also be present in full-term infants and their depth can vary greatly between individuals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Giving an infant with a positive PKU test a high protein diet is not recommended. This is because phenylalanine, which cannot be broken down by individuals with PKU, is found in high-protein foods.
Choice B rationale
Parents of infants with a positive PKU test should provide the infant with a diet containing small amounts of phenylalanine. This is because while phenylalanine is harmful in large amounts to individuals with PKU, it is still an essential amino acid that the body needs in small amounts.
Choice C rationale
Early introduction of cow’s milk is not necessary before 1 year of age for infants with a positive PKU test. In fact, cow’s milk is high in phenylalanine and should be avoided.
Choice D rationale
Following up with a pediatric cardiologist is not specifically related to the dietary management of PKU. While regular medical supervision is important for children with PKU, it does not necessarily have to be with a cardiologist.
Correct Answer is A
Explanation
Choice A rationale
If a patient in active labor has a recent outbreak of genital herpes with verified lesions on the perineum, the nurse should prepare the patient for a cesarean delivery. This is to prevent transmission of the herpes virus to the baby during delivery.
Choice B rationale
While taking a culture of the lesions could help verify the involved organism, it would not change the immediate plan of care for this patient. The presence of active lesions necessitates a cesarean delivery regardless of the specific strain of the virus.
Choice C rationale
Asking the patient if she has had unprotected sex since her outbreak would not directly impact the plan of care in this situation. The primary concern is preventing transmission of the virus to the baby during delivery.
Choice D rationale
Using internal electronic fetal surveillance to determine a baseline fetal heart rate is generally avoided in patients with active genital herpes lesions, as this could potentially increase the risk of transmitting the virus to the baby.
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