The parents of a 2-day-old girl are concerned because her feet and hands are slightly blue. How should the nurse respond?
“This is a vasomotor response caused by cooling or warming."
“This is normal her circulatory system will take a few days to adjust.”
"Let's watch her carefully to make sure she does not have a circulatory problem."
"Your daughter has acrocyanosis; this is causing her blue hands and feet.”
The Correct Answer is D
A. “This is a vasomotor response caused by cooling or warming": While vasomotor responses can cause changes in skin color due to temperature changes, acrocyanosis specifically refers to blue discoloration of the hands and feet due to reduced peripheral circulation, not necessarily due to temperature changes.
B. “This is normal her circulatory system will take a few days to adjust”: While it's true that newborns may have transient circulatory changes as their circulatory system adapts after birth, acrocyanosis specifically refers to a benign condition characterized by persistent blue discoloration of the extremities unrelated to circulatory adjustments.
C. "Let's watch her carefully to make sure she does not have a circulatory problem": While it's important to monitor infants for any signs of circulatory problems, acrocyanosis is typically a
benign and self-limiting condition that does not require intervention unless accompanied by other concerning symptoms.
D. "Your daughter has acrocyanosis; this is causing her blue hands and feet.”: This response provides an accurate explanation for the blue discoloration of the infant's hands and feet. Acrocyanosis is a common and benign condition in newborns characterized by blue discoloration of the extremities due to peripheral vasoconstriction, which gradually resolves over the first few days to weeks of life.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Uses thumb and index fingers in a pincer grasp: The pincer grasp typically develops around 9 to 12 months of age, not at 6 months.
B. Sitting steadily without support: Most infants begin to sit steadily without support between 6 and 8 months of age, so this would be considered a developmental milestone for a 6-month-old.
C. Closed posterior fontanel: The posterior fontanel typically closes by 2 months of age. By 6 months, the posterior fontanel should be closed, so this finding would not be expected.
D. Lateral incisors: By 6 months of age, most infants will have erupted their lower central
incisors. The eruption of the lateral incisors typically occurs around 9 to 13 months of age, so this would be a normal finding for a 6-month-old infant.
Correct Answer is C
Explanation
A. Telling about safety procedures during baths: While bath safety is important, it may not be the most relevant topic for a 9-month-old, who may already have established bathing routines. Additionally, the focus of anticipatory guidance at this age is often broader than just one specific activity.
B. Warning about small objects left on the floor: While important for safety, this advice may be more pertinent when the child is older and more mobile. At 9 months, infants are typically not yet crawling or exploring the environment as extensively.
C. Advising how to create a toddler-safe homE. At 9 months, infants are becoming more mobile and curious, so advising on how to create a safe environment is crucial to prevent accidents and injuries as the child begins to explore their surroundings.
D. Cautioning about putting the baby in a walker: Walkers are generally not recommended due to safety concerns, but this advice may be more relevant when the child is closer to reaching the appropriate age for walker use.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today