A nurse is performing a gestational age assessment on a newborn. ...

[Bernana]

A nurse is performing a gestational age assessment on a newborn. The nurse determines that the newborn is term if which findings are assessed? (Select all that apply.)
 
  a. Posture with fully flexed arms and legs
  b. Arm recoil brisk
  c. Square window at 90 degrees
  d. Scarf sign of elbow crossing over the midline
  e. Popliteal angle less than 90 degrees

Question 2

A nurse is conducting discharge teaching for parents of a newborn. The nurse instructs the parents on which method of care for the umbilical cord? (Select all that apply.)
 
  a. Covering the cord with the diaper
  b. Cleansing the cord with water daily
  c. Keeping the cord area free of urine and stool
  d. Monitoring for signs of infection
  e. Applying bacitracin ointment to the cord daily

[marict]

Answer to Question 1

ANS: A, B, E
A term newborn will have a posture that is fully flexed (arms and legs) and a brisk arm recoil. The popliteal angle in a term infant is less than 90 degrees. The square window should show no angle, the hand should lie flat on the ventral surface of the arm in the term newborn. In a term newborn, the elbow should not cross the midline during assessment of the scarf sign.

Answer to Question 2

ANS: B, C, D
Parents are taught to keep the cord area free of urine and stool, cleanse daily with water if needed, and observe for any signs of infection. The diaper should not cover the cord. The diaper is folded in front below the cord to avoid irritation and wetness on the site. Bacitracin ointment should not be applied because the cord area should be kept dry, not moist.