A nurse is caring for four newborns. Which of the following newborns should the nurse assess first?
A newborn who has subconjunctival hemorrhage of the left eye
A newborn who has overlapping suture lines
A newborn who has nasal flaring
A newborn who has rust stained urine
The Correct Answer is C
A. Subconjunctival hemorrhage is common after vaginal delivery and usually harmless.
B. Overlapping suture lines are normal in newborns due to molding during birth.
C. Nasal flaring is a sign of respiratory distress and requires immediate assessment.
D. Rust-stained urine can be due to urate crystals and is usually benign in newborns.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. While bilirubin levels are important, the immediate concern for a large-for-gestational-age (LGA) newborn is hypoglycemia.
B. LGA newborns are at increased risk for hypoglycemia, so monitoring blood glucose levels is essential.
C. Arterial blood gases are not routinely indicated unless respiratory distress is present.
D. WBC count is not specifically related to LGA status.
Correct Answer is B
Explanation
A. A transvaginal fetal Doppler is not commonly used for continuous monitoring and is typically reserved for early pregnancy.
B. An external ultrasound transducer is appropriate for continuous fetal monitoring when the membranes are intact. It is noninvasive and safe for use during labor.
C. A DeLee Hillis fetoscope is used for intermittent auscultation, not continuous monitoring.
D. An internal fetal scalp electrode requires ruptured membranes and cervical dilation; it is contraindicated with intact membranes.
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