The parents of a newborn male ask the nurse about circumcision.
They are undecided as to what to do. Which response by the nurse is best?
Circumcision is best because it will prevent the baby from obtaining a sexually transmitted disease.
If you do not circumcise your baby, he will have difficulty maintaining adequate hygiene.
It is best not to circumcise your baby because the procedure is very painful for newborns.
I recommend you discuss the pros and cons of circumcision with the newborn's health care provider.
The Correct Answer is D
Choice A rationale
Circumcision is a surgical procedure that removes the foreskin of the penis. While it is associated with a lower risk of acquiring some sexually transmitted infections like HIV, it does not prevent all of them, making condom use and safe sexual practices the primary preventive measures. Furthermore, this statement is not a balanced, educational response for undecided parents, who require comprehensive information on risks and benefits.
Choice B rationale
Maintaining adequate hygiene is possible in both circumcised and uncircumcised males. For uncircumcised males, proper hygiene involves gently retracting the foreskin daily after infancy to cleanse the glans, preventing the accumulation of smegma. This statement presents an exaggerated and often incorrect difficulty, failing to provide factual, unbiased information to the parents.
Choice C rationale
While the procedure is associated with pain, standard practice involves administering appropriate pain management, such as a dorsal penile nerve block or topical anesthetic, along with non-pharmacologic measures like sucrose solution and non-nutritive sucking. Therefore, the pain is controllable, and this statement is insufficient to guide a final parental decision.
Choice D rationale
The nurse's role is to provide objective information and support the parents' decision-making process, not to give a personal recommendation or push a specific viewpoint. Recommending a discussion with the healthcare provider ensures the parents receive a detailed, evidence-based review of both the potential medical benefits and risks associated with the procedure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Cerebrospinal fluid (CSF) appearing cloudy or turbid is highly consistent with bacterial meningitis because the high concentration of white blood cells (pleocytosis), specifically neutrophils, and bacteria present in the CSF cause the fluid to lose its normal clear, colorless appearance. This visual change is a strong immediate indicator of severe infection.
Choice B rationale
In bacterial meningitis, the large accumulation of exudate, inflammation, and increased vascular permeability within the central nervous system usually leads to increased CSF production and decreased reabsorption, resulting in elevated or increased CSF pressure, not decreased pressure. Decreased pressure is rarely associated with acute bacterial infection.
Choice C rationale
An analysis consistent with bacterial meningitis typically shows a significantly elevated number of leukocytes (pleocytosis), especially polymorphonuclear neutrophils, reflecting the body's aggressive inflammatory response to the bacterial invasion. Few leukocytes (a normal range is 0-5 mononuclear cells/mm³) would be inconsistent with a bacterial infection.
Choice D rationale
Bacterial meningitis is characterized by bacteria consuming glucose for energy, leading to a markedly decreased CSF glucose level (hypoglycorrhachia), which is often less than 40 mg/dL or less than two-thirds of the concurrent blood glucose level. An increased glucose level in the CSF is usually not a finding in this condition.
Correct Answer is D
Explanation
Choice A rationale
While voiding is expected, the normal range for the first void is typically within the first 24 to 48 hours of life. A newborn not voiding at exactly 24 hours warrants continued monitoring, but it is not an immediate emergency unless there are other signs of distress or an obvious obstruction.
Choice B rationale
Acrocyanosis is a normal, transient condition in the newborn characterized by a bluish discoloration of the hands and feet due to sluggish peripheral circulation. It is common for up to 24 hours after birth and does not require immediate intervention, only ongoing assessment to ensure central color is pink.
Choice C rationale
Most healthy newborns pass meconium, the first stool, within the first 24 hours of life, with almost all passing it by 48 hours. A lack of meconium passage at 24 hours requires investigation for potential intestinal issues, such as Hirschsprung's disease or meconium plug, but an elevated temperature signals more acute distress.
Choice D rationale
A temperature of 100.5 degrees F (38.1 degrees C) in a newborn, which is above the normal range (typically 97.7 to 99.5 degrees F or 36.5 to 37.5 degrees C), is a serious finding. Newborns are susceptible to rapid temperature changes, and hyperthermia can indicate sepsis, dehydration, or environmental issues requiring immediate assessment and intervention.
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