A nurse is conducting an initial assessment of a newborn delivered with a nuchal cord. What clinical findings should the nurse anticipate?
Facial petechiae
Erythema toxicum
Periauricular papillomas
Telangiectatic nevi
The Correct Answer is A
Choice A rationale
Facial petechiae are small, pinpoint, red or purple spots on the skin that can occur when a newborn has a nuchal cord, or the umbilical cord wrapped around the neck. This is due to the pressure exerted on the baby’s face and neck during delivery.
Choice B rationale
Erythema toxicum is a common rash seen in newborns, characterized by tiny bumps surrounded by red skin. However, it is not specifically associated with a nuchal cord.
Choice C rationale
Periauricular papillomas are small skin tags or pits seen near the ear. They are a common minor anomaly seen in newborns, but they are not associated with a nuchal cord.
Choice D rationale
Telangiectatic nevi, also known as “stork bites,” are common birthmarks seen in newborns, characterized by small, light pink patches, usually on the back of the neck. However, they are not associated with a nuchal cord.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Breast tenderness is a common side effect of clomiphene citrate. This medication stimulates the release of hormones needed for ovulation, which can also cause changes in breast tissue leading to tenderness.
Choice B rationale
Urinary frequency is not a known side effect of clomiphene citrate. However, urinary frequency can be a symptom of pregnancy, which is the intended outcome of using this medication.
Choice C rationale
Chills are not a known side effect of clomiphene citrate. If a patient experiences chills while taking this medication, it may be due to other causes and should be evaluated by a healthcare provider.
Choice D rationale
Tinnitus, or ringing in the ears, is not a known side effect of clomiphene citrate. If a patient experiences tinnitus while taking this medication, it may be due to other causes and should be evaluated by a healthcare provider.
Correct Answer is B
Explanation
Choice A rationale
Frequent urination is a common symptom in early pregnancy due to the increased blood flow to the woman’s kidneys. This is a normal physiological change and does not require immediate attention.
Choice B rationale
Severe vomiting at 8 weeks of gestation could indicate hyperemesis gravidarum, a severe form of nausea and vomiting in pregnancy that can lead to dehydration and weight loss. This
condition requires immediate medical attention as it can have serious health implications for both the mother and the baby.
Choice C rationale
Back pain following intercourse at 36 weeks of gestation could be a sign of labor. However, it is not as urgent as severe vomiting in early pregnancy which can lead to dehydration.
Choice D rationale
Periodic tingling of the fingers at 24 weeks of gestation could be due to physiological changes in pregnancy such as fluid retention causing carpal tunnel syndrome. While this can be uncomfortable, it is not a medical emergency.
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