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.
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason: "My baby will always be smaller than other babies his age." This is an incorrect answer that indicates a misconception or pessimism about SGA newborns. SGA newborns may not always be smaller than other babies their age, as they may catch up in growth and development with appropriate nutrition and care. SGA newborns may have different growth paterns depending on the cause and timing of their growth restriction.
Choice B Reason: "My baby will be okay as long as he has frequent feedings." This is an incorrect answer that indicates an oversimplification or optimism about SGA newborns. SGA newborns may not be okay with just frequent feedings, as they may have other problems or complications that require medical atention and intervention. SGA newborns may have increased nutritional needs and feeding difficulties due to low birth weight, poor suck-swallow coordination, or oral aversion.
Choice C Reason: "My baby will need to stay in the hospital until he weighs 5 pounds." This is an incorrect answer that indicates a misunderstanding or confusion about SGA newborns. SGA newborns may not need to stay in the hospital until they weigh 5 pounds, as they may be discharged earlier or later depending on their condition and readiness for home care. SGA newborns may have different criteria for discharge based on their gestational age, weight gain, feeding tolerance, temperature stability, and absence of complications.
Choice D Reason: "My baby can get cold easily, may have low blood sugar, and may have trouble breathing." This is because this statement by the parents indicates that they understand some of the common problems and complications that SGA newborns may face. SGA newborns are those who weigh less than the 10th percentile for their gestational age, which can be due to intrauterine growth restriction (IUGR) or constitutional factors. SGA newborns may have difficulties with thermoregulation, glucose metabolism, and respiratory function due to inadequate fat stores, glycogen reserves, and surfactant production.
Correct Answer is B
Explanation
Choice A Reason: Vascular spider veins. This is an incorrect answer that refers to a different skin change that occurs during pregnancy, which affects the blood vessels, not the pigment. Vascular spider veins are small red or purple clusters of blood vessels that appear on the skin, especially on the face, neck, chest, or legs. Vascular spider veins are caused by increased blood volume and hormonal changes, which dilate and rupture the capillaries. Vascular spider veins are harmless and usually disappear after delivery.
Choice B Reason: Linea nigra. This is because linea nigra is a term that refers to a darkened vertical line that appears on the abdomen during pregnancy, which runs from the umbilicus to the pubis. Linea nigra is caused by increased production of melanin, which is a pigment that gives color to the skin and hair. Linea nigra is more common and noticeable in women with darker skin tones, and it usually fades after delivery.
Choice C Reason: Melasma. This is an incorrect answer that refers to a different skin change that occurs during pregnancy, which affects the pigment, but not in a linear patern. Melasma is a term that refers to patches of brown or gray-brown discoloration that appear on the face, especially on the forehead, cheeks, nose, or upper lip. Melasma is also caused by increased production of melanin, but it is influenced by sun exposure and genetic factors. Melasma is also known as chloasma or the mask of pregnancy, and it may persist after delivery.
Choice D Reason: Striae gravidarum. This is an incorrect answer that refers to a different skin change that occurs during pregnancy, which affects the connective tissue, not the pigment. Striae gravidarum are stretch marks that appear on the skin, especially on the abdomen, breasts, hips, or thighs. Striae gravidarum are caused by rapid growth and stretching of the skin, which damage the collagen and elastin fibers. Striae gravidarum are initially red or purple, but they fade to white or silver after delivery.

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