What could this be? How would you go about determining which type of “bump” this is?

Please chunk out your responses as the number system indicates for clarity.

1. You are performing a physical exam on a 2 hour old 39 week gestation AGA female. The history is remarkable for vacuum assisted vaginal delivery. On exam, you note a fluctuant mass over the occiput. What could this be? How would you go about determining which type of “bump” this is?

2. The nurse from the well baby nursery calls you, the NNP, to see a baby who is term and 12 hours old. She says the “baby looks a little funny and has some translucent areas on his scalp”. As the NNP, what genetic condition might you be concerned about? Why?

3. The anterior fontanel is usually larger in infants of what racial background?

4. A truncal rash with small pustules or vesicles with erythematous base best describes ___________________?

5. A pediatrician calls you to “run this by you”. He has just performed a discharge exam on a 48 hour old term male infant who still has appreciable acrocyanosis of the hands and feet. Nothing in the history is remarkable. What advice would you give him? Why?

6. An African-American term neonate is delivered in the ER unexpectedly. You are called to evaluate a “rash” that looks pustular on exam. What do you think is the most likely diagnosis? Why?

7. You are called to the delivery room for a C/S secondary to breech presentation at 36 weeks gestation. Mom is from Vietnam and speaks little English. This is her second baby. The newborn female is vigorous in the delivery room with no obvious distress and you triage her to well-baby nursery. Approximately 6 hours later, the nursery calls you because the baby is jaundiced. Would you do anything at this point? Why or why not? What would you do, if anything? Are there other pieces of information that you’d want to investigate? Why or why not?

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