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A nurse is assessing a newborn who was born at 42 weeks of gestation.
Which of the following findings should the nurse expect?

A.

Copious vernix.

B.

Dry, cracked skin.

C.

Increased subcutaneous fat.

D.

Scant scalp hair.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Copious vernix is typically found on preterm newborns, not those born post-term.

 

Choice B rationale

Dry, cracked skin is a common finding in post-term newborns due to prolonged exposure to amniotic fluid.

 

Choice C rationale

Decreased subcutaneous fat is more likely in preterm newborns, while post-term newborns might lose some fat due to nutrient depletion.

 

Choice D rationale

Scant scalp hair is more common in preterm infants, whereas post-term infants usually have more developed hair. .


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View Related questions

Correct Answer is D

Explanation

Choice A rationale

Breast tenderness is considered a presumptive sign of pregnancy, as it can result from hormonal changes, but it is not definitive enough to confirm pregnancy.

Choice B rationale

Fetal heart tones detected by ultrasound are a positive sign of pregnancy. However, it is not a probable sign as it is definitive evidence of an existing pregnancy.

Choice C rationale

Fetal movement, often felt later in pregnancy, is a positive sign. It indicates an existing pregnancy but is not used to initially diagnose pregnancy.

Choice D rationale

A positive urine pregnancy test is a probable sign of pregnancy. It detects the presence of hCG (human chorionic gonadotropin), a hormone produced during pregnancy, and is a widely used indicator of probable pregnancy. .

Correct Answer is C

Explanation

Choice A rationale

Assessing the client's blood pressure can help determine if there is a significant loss of blood and consequent hypotension. However, it is not the immediate first action to manage

heavy bleeding postpartum.

Choice B rationale

Assessing the bladder for distention is crucial as a full bladder can interfere with uterine contraction, potentially leading to increased bleeding. But, it isn't the first priority compared to

addressing the immediate bleeding.

Choice C rationale

Massaging the client's fundus is the priority action in this case. It helps to contract the uterus, thereby reducing bleeding. Uterine atony is the most common cause of postpartum

hemorrhage, and fundal massage is the first intervention to manage it.

Choice D rationale

Preparing to administer a prescription may be necessary, especially if uterotonics are required. However, this is a subsequent step after attempting to control the bleeding through

fundal massage.

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