Which bone in an infant may be broken during a shoulder dystocia?

Femur

Humerus

Clavicle

Skull

Answer and Explanation

The Correct Answer is C

A. Femur: The femur is not typically involved in birth-related trauma during shoulder dystocia. This long bone is located in the thigh and is relatively well protected during delivery, making it an unlikely site for injury in this context.

B. Humerus: While the humerus can occasionally be fractured during difficult deliveries, especially if excessive traction is applied, it is less commonly injured than the clavicle during shoulder dystocia. Fractures of the humerus are usually secondary to more forceful maneuvers or malpositioning.

C. Clavicle: During shoulder dystocia, the baby's anterior shoulder gets stuck behind the mother's pubic bone. The clavicle is the most commonly fractured bone. Fracture can occur as a natural mechanism to reduce shoulder width or may result from delivery maneuvers, and it often facilitates passage of the shoulder through the birth canal.

D. Skull: Skull fractures are rare in shoulder dystocia because the head is typically already delivered by the time the dystocia is recognized. Skull fractures are more often associated with instrumental deliveries or cephalopelvic disproportion rather than shoulder entrapment.

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Correct Answer is B

Explanation

A. Provide a sitz bath to a client who has a fourth-degree laceration and is 2 days postpartum: A sitz bath for a client with a fourth-degree laceration should be performed by the nurse or an experienced healthcare professional because it involves specific care to prevent infection and manage the laceration appropriately. It also requires assessment of the healing process, which is beyond the AP's scope of practice.

B. Change the perineal pad of a client who just transferred from labor and delivery: Changing a perineal pad is within the scope of the AP's role. This task involves basic hygiene care that can be safely delegated as it does not require clinical judgment or assessment.

C. Observe an area of redness on the breast of a client who is 1 day postpartum: Observing for signs of infection, such as redness on the breast, requires assessment and clinical judgment, which should be performed by the nurse, as it could be indicative of mastitis or other complications.

D. Monitor vital signs during admission of a client who has gestational hypertension: Monitoring vital signs is a task that can be delegated to the AP; however, given the potential for complications from gestational hypertension (such as preeclampsia), the nurse needs to be closely involved in assessing and managing the client's condition.

A. Dry the infant off and cover the head. B. Clear the respiratory tract. C. Cut the umbilical cord. D. Stimulate the infant to cry.

Correct Answer is B

Explanation

A. Dry the infant off and cover the head: This helps prevent heat loss through evaporation, which is important, but it is not the first action. Establishing a patent airway takes priority over thermal regulation in the immediate moments after birth.

B. Clear the respiratory tract: This is the first and most critical step to ensure that the newborn can breathe effectively. Suctioning the mouth and nose removes mucus or amniotic fluid that may obstruct airflow. Airway patency must be established before any other intervention.

C. Cut the umbilical cord: Cord clamping and cutting should be delayed to allow placental blood transfer and improve the newborn’s iron stores. It is not prioritized over ensuring adequate breathing and oxygenation.

D. Stimulate the infant to cry: While stimulating the infant promotes lung expansion, this should follow airway clearance. Clearing the airway enables effective stimulation and reduces the risk of aspiration.

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Which bone in an infant may be broken during a shoulder dystocia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse on the postpartum unit is caring for a group of clients with an assistive personnel (AP). Which of the following tasks should the nurse plan to delegate to the AP?

Correct Answer is B

Explanation

A nurse is caring for a client who just delivered a newborn. Following the delivery, which nursing action should be done first to care for the newborn?

Correct Answer is B

Explanation

A newborn was not dried completely after birth. This places the infant at risk for which of the following types of heat loss?

A nurse in a pediatric clinic is caring for a client who is postpartum and asks the nurse what to do when her newborn cries persistently. Which of the following strategies should the nurse suggest? (Select all that apply.)

A nurse is preparing to administer prophylactic eye ointment to a newborn to prevent ophthalmia neonatorum. Which of the following medications should the nurse anticipate administering?

A woman gave birth to a 7-pound, 6-ounce infant girl 1 hour ago. The birth was vaginal and the estimated blood loss (EBL) was 1500 ml. When evaluating the woman's vital signs, which finding would be of greatest concern to the nurse?

A nurse is caring for a client who is 12 hr postpartum following a vaginal delivery. Which of the following findings should the nurse expect?

A nurse is caring for a newborn who has macrosomia and whose mother has diabetes mellitus. The nurse should recognize which of the following newborn complications as the priority focus of care?

A nurse is caring for a client who is postpartum who asks the nurse when her breast milk will "come in." Which of the following responses should the nurse make?

Which substance, when abused during pregnancy, is the most significant cause of cognitive impairment and dysfunction in the infant?