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An hour after delivery, a 4000 gram infant exhibits pallor, jitteriness, a blood sugar level of 40 gm/dL, irritability and periodic apnea. Which maternal condition could be the cause of the newborn's symptoms?
- A. Drug addiction
- B. Pregnancy-induced hypertension
- C. TORCH infection
- D. Gestational diabetes
Correct Answer: D
Rationale: The correct answer is D: Gestational diabetes. Infants born to mothers with gestational diabetes are at risk for hypoglycemia due to excessive production of insulin in response to maternal hyperglycemia. This causes the infant's blood sugar level to drop, leading to symptoms such as pallor, jitteriness, irritability, and apnea. The maternal condition directly affects the newborn's blood sugar levels, explaining the infant's symptoms.
Choice A: Drug addiction does not directly cause hypoglycemia in the newborn.
Choice B: Pregnancy-induced hypertension would not typically result in hypoglycemia in the newborn.
Choice C: TORCH infections are unlikely to cause the specific symptoms described in the newborn.
In summary, only gestational diabetes directly affects the newborn's blood sugar levels, leading to the observed symptoms.
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A nurse is assessing a newborn following a circumcision. Which of the following should the nurse identify as an indication that the newborn is experiencing pain?
- A. Decreased heart rate
- B. Chin quivering
- C. Pinpoint pupils
- D. Slowed respirations
Correct Answer: B
Rationale: The correct answer is B: Chin quivering. This is a common sign of pain in newborns as they may not be able to communicate verbally. It indicates distress and discomfort. Decreased heart rate (A) and pinpoint pupils (C) are not indicative of pain but rather can be signs of other medical conditions. Slowed respirations (D) can be a sign of distress but not specifically pain. Therefore, B is the most relevant and specific indicator of pain in this scenario.
A nurse is monitoring a 6-month-old infant who is diagnosed with pneumonia. The nurse observes an absence of respirations and peripheral cyanosis. After determining unresponsiveness, which of the following is the next nursing action?
- A. Look listen and feel for normal breathing.
- B. Give two rescue breaths.
- C. Position the infant to open the airway.
- D. Immediately call for assistance.
Correct Answer: C
Rationale: The correct answer is C: Position the infant to open the airway. For an unresponsive infant with absent respirations and cyanosis, the priority is to open the airway to facilitate breathing. Positioning the infant with a head tilt-chin lift maneuver helps prevent airway obstruction, allowing for adequate oxygenation. This step should be taken before providing rescue breaths or calling for assistance. Choices A, B, and D are not the immediate priority in this situation. A: Looking, listening, and feeling for normal breathing is not appropriate when the infant is unresponsive with absent respirations. B: Giving rescue breaths is not effective if the airway is obstructed. D: Calling for assistance can be done after ensuring the airway is open.
A postterm infant is delivered by cesarean section because of fetal distress and meconium-stained amniotic fluid. The nursery nurse frequently monitors the baby's respiratory rate, observing for tachypnea. Which is the reason for the nurse's actions? The infant may:
- A. experience respiratory depression from the medications used during delivery
- B. develop meconium aspiration pneumonia
- C. have an elevated temperature
- D. have a pneumothorax related to delivery
Correct Answer: B
Rationale: The correct answer is B: develop meconium aspiration pneumonia. Meconium-stained amniotic fluid can lead to the infant inhaling meconium, which can cause blockage and inflammation in the airways, leading to meconium aspiration pneumonia. This can result in respiratory distress, tachypnea, and potential complications like respiratory failure. The nurse monitors the respiratory rate to detect any signs of respiratory distress early on.
Incorrect choices:
A: Respiratory depression from medications used during delivery is less likely to be the cause of tachypnea in this scenario.
C: Elevated temperature is not directly related to meconium aspiration pneumonia or respiratory distress in this case.
D: A pneumothorax related to delivery is possible but less likely than meconium aspiration pneumonia as the cause of tachypnea in this case.
A women in her first trimester contracts rubella. How is the fetus likely to be affected?
- A. Reproductive and urinary defects
- B. Heart defects and cataracts
- C. Spinal cord and skeletal defects
- D. Polydactyly and club feet
Correct Answer: B
Rationale: The correct answer is B: Heart defects and cataracts. Rubella infection during the first trimester can lead to congenital rubella syndrome, causing heart defects and cataracts in the fetus. Rubella affects organ development during this critical period. Choice A is incorrect as rubella does not typically cause reproductive and urinary defects. Choice C is incorrect because rubella does not usually result in spinal cord and skeletal defects. Choice D is incorrect as polydactyly and club feet are not typical manifestations of rubella infection during pregnancy.
Which site is preferred for giving an IM injection to a newborn?
- A. Ventrogluteal
- B. Vastus lateralis
- C. Rectus femoris
- D. Dorsogluteal
Correct Answer: B
Rationale: The correct answer is B: Vastus lateralis. The vastus lateralis muscle is preferred for IM injections in newborns due to its large muscle mass, minimal risk of injury to major blood vessels and nerves, and easy accessibility. It is also recommended by healthcare guidelines for infants. Ventrogluteal and dorsogluteal sites are not recommended for newborns due to the risk of damaging nerves and blood vessels. The rectus femoris muscle is not typically used for IM injections in newborns as it is less accessible and has a higher risk of injury.