While inspecting a newborn's head, the nurse identifies a swelling of the scalp that does not cross the suture line. Which finding should the nurse document?

• A. Molding.
• B. Cephalohematoma.
• C. Caput succedaneum.
• D. Bulging fontanel.

Answer: (B)

A swelling that stays within the boundaries of the skull sutures points to a subperiosteal bleed, because the periosteum sticks to the bone and the sutures act as barriers. This is cephalohematoma. It forms after birth when blood collects beneath the periosteum of a skull bone and is confined by the sutures, so it does not cross them. In contrast, caput succedaneum is diffuse scalp edema from pressure in labor and can extend across sutures, usually resolving in a few days. Molding is temporary shaping of the head from vaginal birth, and a bulging fontanel signals raised intracranial pressure or crying, not a localized scalp swelling.