A nurse is caring for a newborn delivered by vaginal birth with a vacuum assist. The newborn’s mother asks about the swollen area on her son’s head. After palpation to identify that the swelling crosses the suture line, which of the following is an appropriate response by the nurse?

“This is a cephalhematoma, which can occur spontaneously.”

“Caput succedaneum occurs due to compression of blood vessels.”

“This is erythema toxicum, which is a transient condition.”

“Mongolian spots can be found on the skin of many newborns.”

Answer and Explanation

The Correct Answer is B

A.   A cephalhematoma is a collection of blood under the periosteum that does not cross the suture lines and can take weeks to resolve.
B.   Caput succedaneum occurs due to compression of blood vessels during delivery, resulting in edema and bruising of the scalp. It crosses the suture lines and usually resolves within a few days and does not cause any complications.
C. Erythema toxicum is a rash that is unrelated to head swelling.
D.   Mongolian spots are blue-gray patches on the skin, not associated with head swelling.

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Correct Answer is C

Explanation

A. Turning the newborn on his side may be done after suctioning but is not the initial priority.
B. Using a suction catheter with low negative pressure may be appropriate, but a bulb syringe is commonly used for newborns.
C.Suctioning the mouth is a necessary step to ensure effective breathing.
D. Suctioningthe nose first may cause the infant to gasp and potentially draw the secretions present in the mouth into the airway, which could lead to aspiration.

A. “I can store my breast milk in the freezer for 3 months.” B. “I can store my breast milk in the refrigerator for 3 months.” C. “I can store my breast milk in the refrigerator for 3 to 5 days.” D. “I can store my breast milk at room temperature for 4 hours.”

Correct Answer is B

Explanation

A. Breast milk can be stored in the freezer for up to 3 months.
B. Storing breast milk in the refrigerator for 3 months is an incorrect statement because breast milk can only be stored in the refrigerator for up to 8 days, not 3 months.
C. Storing breast milk in the refrigerator for 3 to 5 days is a correct statement.
D. Storing breast milk at room temperature for 4 hours is a correct statement.

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A nurse is caring for a newborn delivered by vaginal birth with a vacuum assist. The newborn’s mother asks about the swollen area on her son’s head. After palpation to identify that the swelling crosses the suture line, which of the following is an appropriate response by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has just delivered a newborn. The nurse notes secretions bubbling out of the newborn’s nose and mouth. Which of the following actions is the nurse’s priority?

Correct Answer is C

Explanation

A nurse is discussing the storage of breast milk with a mother whose infant is preterm and in the special care nursery. Which statement indicates that the mother requires additional teaching?

Correct Answer is B

Explanation

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