A nurse is assessing a newborn the day after delivery. The nurse notes a raised, bruised area on the left side of the scalp that does not cross the suture line. How should the nurse document this finding?
Molding
Caput succedaneum
Pilonidal dimple
Cephalhematoma
The Correct Answer is D
A. Molding refers to the shaping of the fetal head during labor and delivery to facilitate passage through the birth canal. It typically resolves within a few days and does not involve bruising.
B. Caput succedaneum is localized swelling or edema of the scalp that crosses suture lines and typically resolves within a few days. It is not associated with bruising.
C. Pilonidal dimple refers to a small pit or depression in the skin, typically at the base of the spine, and is not related to the finding described.
D. Cephalhematoma is a collection of blood between the skull bone and its periosteum. It is
confined by suture lines and may take weeks to resolve. It does not cross suture lines and may be associated with bruising due to birth trauma.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Methylergonovine is not indicated for preventing thromboembolic events.
B. Methylergonovine is not indicated for preventing hypertension.
C. Methylergonovine is used to prevent postpartum hemorrhage by causing uterine contractions and reducing bleeding after delivery.
D. Methylergonovine is not indicated for preventing postpartum infection.
Correct Answer is ["B","D","E"]
Explanation
A. Supplementing with formula after breastfeeding due to perceived weight loss may indicate a misunderstanding of normal newborn feeding patterns and could potentially interfere with establishing a sufficient milk supply. Breastfeeding on demand and ensuring proper latch and
positioning are essential for successful breastfeeding. This statement suggests a need for further education about newborn feeding and breastfeeding management.
B. Breastfeeding frequency is crucial for establishing and maintaining milk supply. Newborns typically need to breastfeed at least 8 to 12 times per day to ensure they receive enough milk and to stimulate milk production in the mother's breasts. This statement indicates that the client
understands the importance of frequent feeding for successful breastfeeding.
C. While covering sore nipples with breast pads can provide comfort and protect clothing from leakage, using plastic-lined breast pads after every feeding may not be necessary and could
potentially worsen nipple discomfort. Plastic-lined breast pads can trap moisture, which may
contribute to nipple soreness or increase the risk of developing nipple thrush. Education may be needed to clarify appropriate nipple care and management of nipple discomfort during
breastfeeding.
D. Meconium stools, which are dark and sticky, are normal for newborns in the first few days of life. As the baby begins to digest breast milk, their stools transition from meconium to a yellow, seedy consistency. This statement indicates that the client understands what to expect regarding the color and consistency of their baby's stools after transitioning to breastfeeding.
E. This statement demonstrates an understanding of breast engorgement, a common occurrence when milk production increases in the breasts. Breasts may become harder, warmer, and more
tender when milk "comes in" or when lactation is established. Recognizing these signs indicates that the client is aware of normal changes in their body related to breastfeeding.
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