Difficulty: Medium
Average Score: 79%
Simulated
Passage / Scenario
Newborn who is 4 hr old. Large ecchymotic caput succedaneum noted on occiput with molding of the skull. Anterior fontanel level and soft. Newborn's respirations are shallow and irregular. Newborn's skin color is consistent with their genetic background. Acrocyanosis noted. The newborn is active and moves all extremities except for left arm. Left arm remains at side during Moro reflexThe newborn most likely has as evidenced by
Correct answer
A
Rationale
The correct answer is A: A clavicle fracture. Newborns commonly experience clavicle fractures during delivery due to shoulder dystocia or difficult labor. This is evidenced by decreased movement on the affected side, swelling, tenderness, and a palpable bony prominence at the fracture site. Neonatal abstinence syndrome (B) is associated with maternal drug use, not typically a newborn's physical trauma. Developmental dysplasia of the hip (C) presents with hip instability or dislocation, not related to a clavicle fracture. A subgaleal hemorrhage (D) is an accumulation of blood between the periosteum and the skull, usually due to trauma during delivery. Congenital cardiac defects (E) manifest with cardiovascular symptoms, not a clavicle fracture.