Nokea
The nurse is assessing the laboratory report on a 2-day post partum. The woman has had a normal post partum assessment this morning. Which of the following results should the nurse report to the provider?
- A. White blood cells 12,500 cells/mm
- B. Red blood cells 4,500,000 cells/mm
- C. Hematocrit 26%
- D. Hemoglobin 11g/dl
Correct Answer: C
Rationale: A hematocrit of 26% is abnormally low, indicating significant anemia, which requires further evaluation.
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What is the term for a common and harmless skin condition on an infant’s scalp that presents as yellow scaly patches with a red rash?
- A. erythema toxicum
- B. eczema
- C. a skin allergy
- D. cradle cap
Correct Answer: D
Rationale: Cradle cap is a common, harmless condition characterized by yellow scaly patches on the scalp.
What assessment findings indicate abnormal transition in a neonate? Select all that apply.
- A. prolonged apneic episodes
- B. marked pallor
- C. excessive oral secretions
- D. crackles upon auscultation
Correct Answer: C
Rationale: Abnormal transition signs include prolonged apnea, marked pallor, excessive secretions, and crackles.
Edward, a newborn delivered at 41 weeks' gestation, weighs 10 lb 4 oz. Vaginal delivery for this G1P1 mother was assisted with forceps. The nurse is completing her assessment and notes a sharply demarcated swelling over the parietal bones. The occipital and frontal skull bones are not affected. The neck does not appear edematous and is soft to the touch with full mobility. The infant is awake and active and has been breast-feeding well. What is the most probable cause of the swelling?
- A. cephalohematoma
- B. subgaleal hemorrhage
- C. caput succedaneum
- D. skull fracture
Correct Answer: A
Rationale: Cephalohematoma involves localized bleeding beneath the periosteum, typically over a single bone.
In which condition is breastfeeding contraindicated?
- A. Triplet birth
- B. Flat or inverted nipples
- C. Human immunodeficiency virus infection
- D. Inactive, previously treated tuberculosis
Correct Answer: C
Rationale: The correct answer is C: Human immunodeficiency virus infection. Breastfeeding is contraindicated in this condition due to the risk of vertical transmission of the virus to the infant through breast milk. HIV can be present in breast milk, increasing the risk of infection to the baby. This is supported by guidelines from organizations such as WHO.
Choices A, B, and D are incorrect:
A: Triplet birth is not a contraindication for breastfeeding; it may require additional support but is not a direct contraindication.
B: Flat or inverted nipples may pose initial challenges but can be addressed with proper latch techniques or the use of aids like nipple shields.
D: Inactive, previously treated tuberculosis does not contraindicate breastfeeding as long as the mother has completed treatment and is not actively infectious.
What would be a warning sign of ineffective adaptation to extrauterine life if noted when assessing a 24-hour-old breastfed newborn before discharge?
- A. Apical heart rate of 90 beats/min, slightly irregular, when awake and active
- B. Acrocyanosis
- C. Harlequin sign
- D. Weight loss representing 5% of the newborn’s birth weight
Correct Answer: A
Rationale: A low heart rate and irregularity could indicate poor cardiac function or other underlying issues. Acrocyanosis and mild weight loss are normal findings.