Certified Pediatric Nurse (CPN)

Which of the following is considered an abnormal assessment finding in a newborn?

1. Closed anterior fontanel

2. Red, flaky skin

3. Crossed-eyed

4. Vernix

The correct answer is: Closed anterior fontanel

A closed anterior fontanel in a newborn can be a sign of an underlying condition, making it an abnormal assessment finding. In newborns, the anterior fontanel typically remains open and slightly bulging to accommodate normal brain growth and development during the first year of life. If it is closed too early, it may indicate a condition known as craniosynostosis, where the skull bones fuse prematurely, potentially leading to problems with skull shape and brain development. In contrast, red, flaky skin is often a common finding in newborns due to conditions like normal desquamation or seborrheic dermatitis, which are generally not concerning unless accompanied by other symptoms. Crossed eyes (strabismus) can be relatively common in newborns and typically resolve as the child's vision develops over the first few months. Vernix, the white, cheese-like substance found on newborn skin, is a normal finding and serves to protect the skin while in utero and prevents it from drying out.