章节:Comprehensive Test 3

SC
正确指数:93% 正确的次数:13 错误的次数:1 7951---The nurse observes a darkish blue pigment on the buttocks and back of an infant of African descent. Which action is most appropriate?

Saunders Comprehensive Review for the NCLEX-RN® Examination, 7e (Saunders Comprehensive Review for Nclex-Rn)

1. Ask the obstetrician to assess the child.
2. Assess the child for other areas of cyanosis.
3. Document this observation in the child’s medical record.
4. Advise the mother that the bruising will fade in a few days.

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正确答案:
3. Document this observation in the child’s medical record.
解释 :
The bluish pigment on the buttocks and back of an infant of African descent is a common finding and should be documented as Mongolian spots in the child’s medical record . These spots typically fade by the time the child is 5 or 6 years. Additional assessment by the care provider is not indicated. The marks are not bruises.