The newborn's mother is concerned about the shape of the baby's head after delivery. She states that the baby looks like a "cone head." What is the most appropriate response by the nurse?

Correct Answer: B

Rationale: The most appropriate response by the nurse is option B) It is molding caused by the pressure during birth and will disappear in a few days. This is the correct answer because newborns often have a misshapen or elongated head after birth due to the pressure exerted on the skull during the passage through the birth canal. This condition, known as molding, is a normal and temporary phenomenon. It typically resolves within a few days as the baby's head returns to a more rounded shape. Option A is incorrect because dismissing the mother's concerns without providing information could lead to increased anxiety and uncertainty. Option C is incorrect as there is no need for a diagnostic scan unless there are other concerning symptoms present. Option D is incorrect as it describes a cephalohematoma, which is a different condition involving blood accumulation under the scalp and does not apply to the described situation of a "cone head" appearance. In an educational context, it is important for nurses to reassure parents about common newborn characteristics and variations to alleviate unnecessary anxiety. Understanding the normal physiological changes that occur in newborns can help parents feel more confident in caring for their baby and promote a positive parent-child relationship. Educating parents on what to expect in the immediate postpartum period can enhance their overall experience and adjustment to parenthood.

Correct Answer: D

Rationale: The correct answer is option D: "I'm sure you have discussed this with your doctor, but let's review the benefits and risks of circumcision." This response is the most appropriate because it acknowledges the parents' previous discussions with their doctor while also promoting an informed decision-making process through an open dialogue about the benefits and risks of circumcision. Option A is incorrect because although some studies suggest a reduced risk of penile cancer with circumcision, the evidence is not strong enough to recommend routine circumcision solely for this reason. Option B is not the best choice as it does not provide the parents with valuable information or guidance to make an informed decision. Option C is incorrect because it misrepresents the current stance of the American Academy of Pediatrics, which recognizes that the decision to circumcise is a personal one and should be made by the parents after receiving accurate and unbiased information. In an educational context, it is crucial for nurses to approach discussions about circumcision with sensitivity, respect, and a focus on providing evidence-based information to empower parents to make informed decisions about their child's health. By engaging in open and non-judgmental conversations, nurses can support parents in navigating the complex decision-making process surrounding circumcision, ultimately promoting the well-being of both the newborn and the family.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Transparent, red skin. A male infant delivered at 28 weeks gestation weighing 2 pounds, 12 ounces would likely exhibit this characteristic due to the immaturity of his skin. Preterm infants have thinner, transparent skin with visible vasculature, giving it a red appearance due to the presence of capillaries close to the surface. Option A) Wide, staring eye is incorrect because newborns, especially preterm infants, often have difficulty focusing their eyes and may exhibit a lack of coordination in eye movements. This is not a specific finding related to prematurity. Option C) An absence of lanugo is incorrect as lanugo, the fine hair that covers a fetus, is typically present on preterm infants and sheds later in development. Option D) A scrotum with descended testicles is incorrect as preterm male infants often have undescended testicles due to immaturity. Testicular descent usually occurs later in gestation or after birth. In an educational context, understanding the physical characteristics of preterm infants is crucial for nurses caring for this vulnerable population. Recognizing these unique features allows for appropriate assessment, monitoring, and intervention to promote optimal health outcomes for preterm infants.

Correct Answer: B

Rationale: In maternal and reproductive health nursing, understanding correct breastfeeding attachment is crucial for promoting successful breastfeeding outcomes. The best indication that correct attachment to the breast has occurred is when the baby's mouth covers most of the areolar surface (Option B). This is because proper latch and attachment ensure effective milk transfer, prevent nipple soreness, and promote adequate stimulation for milk production. Option A (Baby's tongue is securely on top of the nipple) is incorrect because the baby's tongue should be under the nipple, not on top of it, to effectively compress the milk sinuses and extract milk. Option C (Baby makes frequent loud clucking sounds while nursing at each breast) is incorrect as it does not indicate correct attachment but may suggest poor latch or swallowing issues. Option D (Baby sucks each breast vigorously for five minutes before falling asleep) is incorrect as the duration of sucking alone does not determine correct attachment; it is the positioning and mouth coverage that are key. Educationally, nurses should teach mothers the signs of correct attachment, such as observing the baby's mouth covering most of the areola, hearing audible swallowing, and noting comfort and relaxed body language in the baby. Providing hands-on support and guidance to ensure proper latch can significantly impact breastfeeding success and maternal-infant bonding. Regular assessment and reinforcement of correct attachment techniques are essential to support breastfeeding initiation and maintenance.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Respiratory distress. Infants born to mothers with diabetes, especially those with large birth weights like the 9-pound 10 oz. baby in this case, are at higher risk for respiratory distress syndrome due to factors such as delayed lung maturation and surfactant deficiency. Option A) Meconium ileus is incorrect as it is a condition related to cystic fibrosis, not maternal diabetes. Option C) Physiologic jaundice is a common occurrence in newborns and is not specifically associated with maternal diabetes. Option D) Increased intracranial pressure is not typically a direct concern in infants born to mothers with diabetes unless there are other underlying issues present. In an educational context, understanding the potential complications for infants born to mothers with diabetes is crucial for nurses working in maternal and reproductive health. This knowledge allows nurses to provide appropriate care, closely monitor for potential issues such as respiratory distress, and intervene promptly to ensure the well-being of both the mother and the infant.