A nurse is assisting with a newborn hearing test when the parent enters and asks what the nurse is doing.
Which of the following statements should the nurse make?

"This screening test is to see if your baby's brain is fully developed.”.

"This screening test is to see if your baby has a heart defect.”.

"This screening test is to see if your baby has a seizure disorder.”.

"This screening test is to see if your baby can hear various sounds.”.

Answer and Explanation

The Correct Answer is D

Choice A rationale

The hearing screening test is not related to brain development but specifically to the ability to hear sounds. It assesses the infant's auditory pathway from the ear to the brainstem to identify potential hearing loss early on.

Choice B rationale

This test does not assess for heart defects. Heart defects are usually detected through physical examination, pulse oximetry screening, or echocardiography, not through auditory tests.

Choice C rationale

Seizure disorders are diagnosed based on clinical presentation and electroencephalogram (EEG) results. The hearing screening test does not have any connection to identifying seizure disorders.

Choice D rationale

The primary purpose of the newborn hearing screening is to detect if the baby can hear various sounds, enabling early intervention if hearing loss is detected. Early identification and management are essential for speech and language development.

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Correct Answer is A

Explanation

Choice A rationale

Heavy vaginal bleeding at 39 weeks of gestation could be due to placental abruption or placenta previa, which necessitates immediate delivery to prevent maternal and fetal complications. Preparing for cesarean birth is crucial as it allows rapid delivery, reducing the risk of maternal hemorrhage and fetal hypoxia.

Choice B rationale

Performing a cervical examination can exacerbate bleeding in cases of placenta previa or placental abruption, making it unsafe. It can disturb the placenta and lead to further complications, so this option is not recommended.

Choice C rationale

Magnesium sulfate is used to prevent seizures in preeclampsia or eclampsia, not for managing heavy vaginal bleeding. Its use is unrelated to the immediate care of a client with heavy vaginal bleeding due to suspected placental issues.

Choice D rationale

Administering antibiotics is not the immediate priority in the case of heavy vaginal bleeding at 39 weeks of gestation. The focus should be on stabilizing the mother and preparing for delivery.

A. Absent Moro reflex, arm extended at the elbow and positioned against body with decreased grasp on affected side. B. Asymmetry of the face during crying and drooping of the corner of the mouth on affected side. C. Asymmetry of Moro reflex, arm externally rotated, and grasp reflex absent on affected side. D. Asymmetry of Moro reflex, crepitus, no movement, swelling, and tenderness on palpation of affected arm.

Correct Answer is A

Explanation

Choice A rationale

Duchenne-Erb (Erb's) palsy is a type of brachial plexus injury that commonly results in an absent Moro reflex on the affected side, an extended arm at the elbow, and decreased grasp. These symptoms arise from injury to the fifth and sixth cervical nerves, leading to motor deficits.

Choice B rationale

This describes facial nerve palsy, not Erb's palsy. Facial nerve palsy affects the muscles of the face, leading to asymmetry during crying and drooping of the mouth's corner on the affected side.

Choice C rationale

While asymmetry of the Moro reflex is accurate, this choice incorrectly states that the arm is externally rotated and the grasp reflex is absent, which aligns more with a total brachial plexus injury rather than Erb's palsy.

Choice D rationale

Crepitus, no movement, swelling, and tenderness on palpation are indicative of a fracture rather than Erb's palsy. These symptoms suggest bone injury rather than nerve damage.

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A nurse is assisting with a newborn hearing test when the parent enters and asks what the nurse is doing. Which of the following statements should the nurse make?

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Naxlex Comprehensive Predictor Exams

A nurse is assisting with the admission of a client who is at 39 weeks of gestation and has heavy vaginal bleeding. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse is collecting data on a newborn who has experienced Duchenne-Erb (Erb's) palsy. Which of the following manifestations should the nurse expect?

Correct Answer is A

Explanation

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A nurse is assisting with a newborn hearing test when the parent enters and asks what the nurse is doing.
Which of the following statements should the nurse make?