Nursing Elites

1. What assessment finding places a newborn at risk for developing physiologic jaundice?

• A. Cephalohematoma
• B. Mongolian spots
• C. Telangiectatic nevi
• D. Molding

Correct answer: A

Rationale: The correct answer is A, Cephalohematoma. Physiologic jaundice in newborns can occur due to the breakdown of excess red blood cells. A cephalohematoma, a collection of blood caused by ruptured blood vessels between a cranial bone's surface and periosteal membrane, can lead to increased red blood cell breakdown. This increased breakdown can contribute to the development of physiologic jaundice in newborns. Choices B, Mongolian spots, and C, Telangiectatic nevi, are both benign skin conditions and are not directly associated with increased red blood cell breakdown. Choice D, Molding, refers to the shaping of the fetal head during passage through the birth canal and is not related to the development of physiologic jaundice.

2. The caregiver is teaching a new parent about signs of adequate breastfeeding. Which statement by the parent indicates understanding?

• A. My baby should have a bowel movement once a week.
• B. My baby should wet at least six diapers a day.
• C. My baby should feed for 5 minutes on each breast.
• D. My baby should sleep through the night without waking up to feed.

Correct answer: B

Rationale: Wetting at least six diapers a day is a key indicator of adequate breastfeeding as it shows that the baby is properly hydrated and receiving enough milk.

3. Where is the most appropriate location to perform a procedure on a preschooler?

• A. Perform the procedure in the child's hospital bed.
• B. Perform the procedure in the treatment room.
• C. Allow the child to decide when the procedure will be performed.
• D. Ask the parents to help restrain the child so the procedure can be performed.

Correct answer: B

Rationale: When performing a procedure on a preschooler, it is most appropriate to do so in the treatment room. This setting is specifically designed to provide a suitable environment with necessary equipment and resources to ensure the procedure is carried out safely and efficiently. It helps minimize distractions and provides a controlled environment for healthcare providers to focus on the child's needs. Choices A, C, and D are incorrect because performing the procedure in the child's hospital bed may lack the necessary resources and equipment, allowing the child to decide when the procedure will be performed may not be feasible due to medical necessity and urgency, and asking parents to help restrain the child is not ideal as it may not provide a professional and controlled setting for the procedure.

4. The healthcare provider is assessing a newborn for signs of hypoglycemia. Which finding is consistent with hypoglycemia?

• A. Jitteriness
• B. Flushed skin
• C. Quiet alert state
• D. Strong cry

Correct answer: A

Rationale: Jitteriness is a common clinical manifestation of hypoglycemia in newborns. It is important to recognize this sign promptly as it can indicate a potentially serious condition that requires immediate attention and intervention to prevent complications.

5. Management for a woman presenting with a prolapsed umbilical cord includes all of the following, EXCEPT:

• A. lifting the baby's head off the umbilical cord.
• B. placing the mother in a position that elevates her hips.
• C. ensuring that the cord stays moist during transport.
• D. relieving pressure off the cord by gently pulling on it.

Correct answer: D

Rationale: In cases of prolapsed umbilical cord, it is crucial to manage the situation promptly. The correct steps include lifting the baby's head off the umbilical cord to reduce pressure, placing the mother in a position that elevates her hips to relieve pressure on the cord, and ensuring that the cord stays moist. Pulling on the cord is not recommended as it can further compromise fetal circulation and should be avoided. Therefore, relieving pressure off the cord by gently pulling on it is not a recommended management approach in cases of prolapsed umbilical cord.

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