In assessing a 1-day-old male newborn, the nurse observes that the scrotal sac is large, swollen, smooth, and taut. Which assessment technique should the nurse perform to determine if the newborn has a hydrocele?
Grasp high on the sac and gently palpate downward to feel each testis present.
Observe daily for the resolution of scrotal edema influenced by placental hormones.
Palpate for a soft, mushy structure that is nontender and distinct from a normal testis.
Perform transillumination of the scrotal sac to visualize a red glow of fluid around the testes.
The Correct Answer is D
Rationale:
A. Grasp high on the sac and gently palpate downward to feel each testis present: This technique helps assess for undescended testes but does not confirm the presence of fluid characteristic of a hydrocele.
B. Observe daily for the resolution of scrotal edema influenced by placental hormones: While some neonatal swelling may resolve spontaneously, observation alone does not provide an immediate method to differentiate a hydrocele from other causes of scrotal swelling.
C. Palpate for a soft, mushy structure that is nontender and distinct from a normal testis: Palpation can identify abnormalities in consistency, but distinguishing hydrocele fluid from testicular tissue is challenging without additional assessment methods like transillumination.
D. Perform transillumination of the scrotal sac to visualize a red glow of fluid around the testes: Transillumination is the most effective technique to confirm a hydrocele. A hydrocele allows light to pass through the fluid-filled sac, producing a red glow, which differentiate it from solid masses or other scrotal abnormalities.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Notify the operating room team: While notifying the OR team for an emergent cesarean delivery is crucial, immediate maternal positioning to relieve pressure on the prolapsed cord takes priority to prevent fetal hypoxia.
B. Administer a fluid bolus of 500 mL: Giving IV fluids can help maintain maternal blood pressure and perfusion, but it does not relieve compression of the prolapsed umbilical cord, which is the most immediate threat to the fetus.
C. Place the client in Trendelenburg: Placing the client in Trendelenburg (head down, hips elevated) helps relieve pressure of the presenting fetal part on the prolapsed cord, improving fetal oxygenation. This is the priority emergency action to prevent hypoxia.
D. Administer oxygen via face mask: Providing supplemental oxygen increases fetal oxygenation indirectly but does not remove the mechanical compression of the cord. It should be done immediately after maternal positioning.
Correct Answer is D
Explanation
Rationale:
A. ABO blood group and Rh status: Knowing the client’s blood type and Rh factor is important in preparation for potential transfusion or Rh immunoglobulin administration but it is not the most urgent information to review initially when assessing acute vaginal bleeding.
B. Ultrasound report to confirm gestational age: Confirming gestational age is useful for overall assessment and planning, but it does not provide immediate guidance for managing active, bright red bleeding.
C. Hemoglobin and hematocrit drawn at 28-weeks: Previous hemoglobin and hematocrit values provide a baseline for assessing blood loss, but these values are outdated and do not reflect the client’s current status in the context of acute bleeding.
D. Location of placenta on ultrasound report: The location of the placenta is critical to determine if the client may have placenta previa, which is a leading cause of painless, bright red vaginal bleeding in the third trimester.
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