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A newborn assessment finding that would support the nursing diagnosis of postmaturity would be
- A. loose skin.
- B. ruddy skin color.
- C. presence of vernix.
- D. absence of lanugo.
Correct Answer: A
Rationale: The correct answer is A: loose skin. Postmaturity in newborns is characterized by dry, cracked, and peeling skin due to prolonged gestation. Loose skin is a classic sign of postmaturity, indicating reduced subcutaneous fat. Ruddy skin color (B) is not specific to postmaturity. Vernix (C) is present in newborns and decreases with gestational age, not directly related to postmaturity. Lanugo (D) is fine hair that covers a fetus and sheds before birth, not a specific indicator of postmaturity.
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The nurse has access to the results of a karyotype sent out for their patient via an electronic medical record. The parents have accessed the results on their MyChart phone application and have asked the nurse what the results 45, X mean. What is the best response from the nurse?
- A. The results indicate your child may have Turner syndrome.
- B. Your results are 45, X; you will have to wait to talk with the geneticist.
- C. Your results indicate that your daughter has a serious lifelong disease.
- D. I’m not sure; I’ll call the provider.
Correct Answer: A
Rationale: The correct answer is A: The results indicate your child may have Turner syndrome. This is the best response because 45, X is the karyotype typically associated with Turner syndrome, a genetic condition where a female is missing part or all of one X chromosome. This response shows the nurse's knowledge of genetics and ability to interpret karyotype results accurately.
Summary of incorrect choices:
B: Your results are 45, X; you will have to wait to talk with the geneticist - This response delays providing crucial information to the parents and does not address their immediate concerns.
C: Your results indicate that your daughter has a serious lifelong disease - This choice is too vague and alarming, lacking specificity about the condition associated with the karyotype results.
D: I’m not sure; I’ll call the provider - This response shows a lack of knowledge on the nurse's part and does not offer any immediate information or reassurance to the parents.
Which causes infants of diabetic mothers to be large for gestational age?
- A. Maternal insulin crosses the placenta and makes the baby large.
- B. Blood flow across the placenta is greater than normal.
- C. Maternal doses of insulin are absorbed by the infant and cause increased body growth.
- D. Maternal glucose crosses the placenta and causes the infant to produce more insulin than usual, resulting in greater body growth.
Correct Answer: D
Rationale: Step 1: Maternal diabetes leads to high blood glucose levels.
Step 2: Maternal glucose crosses the placenta to the fetus.
Step 3: Fetal pancreas produces more insulin in response to high glucose.
Step 4: Excess insulin promotes fetal growth, leading to macrosomia.
Summary:
A: Incorrect - Maternal insulin doesn't cross placenta in significant amounts.
B: Incorrect - Blood flow doesn't directly cause fetal overgrowth.
C: Incorrect - Maternal insulin doesn't directly cause increased growth.
The nurse is providing care for a premature neonate in the NICU nursery. The neonate is diagnosed with bronchopulmonary dysplasia (BPD) and patent ductus arteriosus (PDA). Which specific intervention does the nurse expect for this neonate?
- A. Monitor of hemoglobin and hematocrit levels.
- B. Obtain blood glucose levels.
- C. Maintain fluid restrictions.
- D. Administer enteral feedings.
Correct Answer: C
Rationale: The correct answer is C: Maintain fluid restrictions. For a neonate with BPD and PDA, fluid restrictions are essential to prevent fluid overload and worsening of the conditions. Excessive fluid can exacerbate pulmonary edema in BPD and increase cardiac workload in PDA. Monitoring hemoglobin and hematocrit levels (A) is important but not specific to these conditions. Obtaining blood glucose levels (B) is important for monitoring overall health but not specific to BPD and PDA. Administering enteral feedings (D) may be necessary but does not directly address the primary concern of fluid management in these conditions.
What term best describes an infant born with a birth weight below the 10th percentile for gestational age?
- A. Appropriate for gestational age
- B. Failure to thrive
- C. Small for gestational age
- D. Infant born to mother of gestational diabetes
Correct Answer: C
Rationale: The correct answer is C: Small for gestational age. This term describes an infant born with a birth weight below the 10th percentile for gestational age, indicating intrauterine growth restriction. This term specifically addresses the infant's size in relation to their gestational age, distinguishing it from other choices.
A: Appropriate for gestational age refers to infants whose birth weight falls within the normal range for their gestational age, not below the 10th percentile.
B: Failure to thrive is a broader term encompassing various factors affecting a child's growth and development, not specifically related to birth weight percentile.
D: Infant born to mother of gestational diabetes pertains to a specific maternal condition that may affect the infant's health but does not directly address the infant's birth weight percentile.
Based on the following risk factors, which newborn is least at risk for developing persistent pulmonary hypertension? Select all that apply.
- A. Late or postdates delivery
- B. Born to a mother with gestational diabetes
- C. Appropriate for gestational age
- D. Meconium aspiration
Correct Answer: C
Rationale: The correct answer is C: Appropriate for gestational age. Newborns who are appropriate for gestational age are least at risk for developing persistent pulmonary hypertension because they have not experienced intrauterine growth restriction or other complications that can lead to lung problems. Being born late or postdates (A) can increase the risk of complications, including pulmonary hypertension. Being born to a mother with gestational diabetes (B) can also increase the risk due to potential metabolic issues. Meconium aspiration (D) can lead to respiratory distress and increase the risk of pulmonary hypertension.