During a physical assessment of a newborn, the nurse observes bluish markings across the newborn's lower back. The nurse interprets this finding as:
Select one:

Milia.

Dermal melanosis.

Stork bites.

Birth trauma.

Answer and Explanation

The Correct Answer is B

Choice A Reason: Milia. This is an incorrect answer that describes a diﬀerent skin condition. Milia are tiny white or yellow cysts that appear on the nose, chin, or cheeks of newborns. They are caused by the retention of keratin in the sebaceous glands or hair follicles. They usually disappear within a few weeks without treatment.

Choice B Reason: Dermal melanosis. This is a correct answer that explains the finding of bluish markings across the newborn's lower back. Dermal melanosis. This is because dermal melanosis, also known as Mongolian spots, is a common benign skin condition that aﬀects newborns of Asian, African, or Hispanic descent. It is characterized by bluish-gray or brown patches of pigmentation on the lower back, butocks, or extremities. It is caused by the migration of melanocytes from the neural crest to the dermis during embryonic development. It usually fades by 2 to 4 years of age.

Choice C Reason: Stork bites. This is an incorrect answer that refers to another skin condition. Stork bites, also known as salmon patches or nevus simplex, are ﬂat pink or red marks that appear on the forehead, eyelids, nose, upper lip, or nape of the neck of newborns. They are caused by dilated capillaries in the superficial dermis. They usually fade by 18 months of age.

Choice D Reason: Birth trauma. This is an incorrect answer that implies an injury or damage to the newborn's skin or tissues during labor and delivery. Birth trauma can cause bruises, abrasions, lacerations, fractures, or nerve injuries. It is not related to bluish markings on the lower back.

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Correct Answer is D

Explanation

Choice A Reason: Possible Meconium Aspiration Syndrome (MAS). This is an unlikely condition for this newborn, as MAS occurs when fetal stool (meconium) enters into the lungs before or during birth, causing airway obstruction, inﬂammation, and infection. MAS usually aﬀects term or post-term infants who experience fetal distress or hypoxia in utero.

Choice B Reason: Possible polycythemia. This is an unrelated condition for this newborn, as polycythemia refers to an abnormally high number of red blood cells in the blood, which can increase blood viscosity and impair circulation.

Polycythemia may occur in infants who have delayed cord clamping, intrauterine growth restriction, maternal diabetes, or high altitude exposure.

Choice C Reason: Possible Transient Tachypnea of the Newborn (TTN). This is a less serious condition than RDS, as TTN is a mild respiratory problem that results from delayed clearance of fetal lung ﬂuid after birth. TTN causes rapid breathing, nasal ﬂaring, grunting, and mild cyanosis. It usually resolves within 24 to 48 hours after birth.

Choice D Reason: Possible Respiratory Distress Syndrome (RDS). This is a serious condition that requires immediate intervention and treatment, as RDS can lead to life-threatening complications such as pulmonary hemorrhage, pneumothorax, or bronchopulmonary dysplasia. RDS causes respiratory distress, nasal ﬂaring, retractions, grunting, and central cyanosis. It usually occurs within minutes to hours after birth.

A. Late decelerations. B. Moderate decelerations. C. Variable decelerations. D. Early decelerations.

Correct Answer is C

Explanation

Choice A Reason: Late decelerations. This is an incorrect answer that refers to a diﬀerent type of fetal heart rate patern that indicates uteroplacental insufficiency, which can reduce blood ﬂow and oxygen delivery to the fetus. Late decelerations are characterized by gradual decreases in fetal heart rate that begin after the peak of uterine contractions and return to baseline after the end of contractions. Amnioinfusion is not eﬀective for late decelerations, as it does not address the underlying cause of uteroplacental insufficiency, which may be due to maternal hypertension, diabetes, preeclampsia, or placental abruption.

Choice B Reason: Moderate decelerations. This is an incorrect answer that refers to a non-existent type of fetal heart rate patern, as there is no such term as moderate decelerations. The term moderate refers to the category of fetal heart rate variability, which is a measure of the ﬂuctuations in fetal heart rate around the baseline. Moderate variability indicates normal fetal oxygenation and well-being, while absent or minimal variability indicates fetal hypoxia or distress.

Choice C Reason: Variable decelerations. This is because variable decelerations are a type of fetal heart rate patern that indicates cord compression, which can reduce blood ﬂow and oxygen delivery to the fetus. Variable decelerations are characterized by abrupt decreases in fetal heart rate that vary in onset, depth, and duration, and do not have a consistent relationship with uterine contractions. Amnioinfusion is a procedure that involves infusing saline or lactated Ringer's solution into the amniotic cavity through a transcervical catheter, which can relieve cord compression by increasing the volume of amniotic ﬂuid and cushioning the cord. Amnioinfusion can improve fetal oxygenation and reduce variable decelerations.

Choice D Reason: Early decelerations. This is an incorrect answer that refers to a diﬀerent type of fetal heart rate patern that indicates head compression, which can stimulate the vagus nerve and slow down the fetal heart rate. Early decelerations are characterized by gradual decreases in fetal heart rate that begin with the onset of uterine contractions and return to baseline with the end of contractions. Early decelerations are benign and do not require intervention, as they reﬂect normal fetal head descent and progress of labor. Amnioinfusion is not indicated for early decelerations, as it does not aﬀect head compression or vagal stimulation.

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During a physical assessment of a newborn, the nurse observes bluish markings across the newborn's lower back. The nurse interprets this finding as: Select one:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Correct Answer is C

Explanation

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During a physical assessment of a newborn, the nurse observes bluish markings across the newborn's lower back. The nurse interprets this finding as:
Select one: