A parent reports to the nurse that her child has inflamed conjunctivae of both eyes with purulent drainage and crusting of the eyelids, especially on awakening. These manifestations suggest:

Correct Answer: C

Rationale: The symptoms described by the parent, which include inflamed conjunctivae of both eyes with purulent drainage and crusting of the eyelids, are indicative of bacterial conjunctivitis. Bacterial conjunctivitis is typically associated with these symptoms, along with redness, irritation, and a sensation of a foreign body in the eye. It is common for bacterial conjunctivitis symptoms to be most pronounced upon awakening due to the accumulation of discharge overnight. Treatment for bacterial conjunctivitis often involves antibiotic eye drops.

Correct Answer: B

Rationale: Facial nerve paralysis in a newborn is most commonly caused by birth injury. This can occur during the birthing process due to pressure on the baby's face or head, particularly if forceps or vacuum extraction are used during delivery. The trauma can affect the facial nerve resulting in temporary or permanent paralysis. It is important for the nurse to provide reassurance to the parents that birth injury is a common cause of facial nerve paralysis in newborns, and in many cases, the paralysis resolves on its own over time without further complications.

Correct Answer: C

Rationale: Maintaining a neutral thermal environment is an appropriate nursing intervention to promote adequate oxygenation in a low birth weight newborn. Newborns, especially those with low birth weight, have limited capacity to regulate their body temperature. Keeping the baby warm helps prevent cold stress, which can lead to increased metabolic demands and oxygen consumption. By maintaining a neutral thermal environment, the newborn's energy can be directed towards growth and development, rather than compensating for temperature fluctuations. This intervention helps optimize oxygenation and overall well-being of the low birth weight newborn. The other options (A, B, D) do not directly address the need for adequate oxygenation in a low birth weight newborn.

Correct Answer: D

Rationale: The presentation of a preterm newborn with difficulty breathing, grunting, tachypnea, and nasal flaring is concerning and should not be considered a normal finding. This could indicate respiratory distress, which is common in preterm infants due to immature lung development. It is important for the nurse to recognize these symptoms as they may signify a potential underlying respiratory issue that requires further evaluation and intervention. Prompt assessment and management are crucial in ensuring the best outcomes for the newborn. Therefore, further evaluation by the healthcare team is warranted in this situation to determine the cause of the respiratory distress and provide appropriate treatment.

Correct Answer: D

Rationale: Postterm newborns are infants born after 42 weeks of gestation. Some common clinical manifestations of postterm newborns include parchment-like, wrinkled skin due to prolonged exposure to amniotic fluid, and long fingernails as a result of intrauterine growth beyond the expected term. Excessive lanugo and absence of scalp hair are not typically seen in postterm newborns. Increased subcutaneous fat may be more common in infants born at term or post-term, but it is not a specific clinical manifestation of postterm newborns. Minimal vernix caseosa is also usually present in postterm newborns.