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In comparison with the term infant, the preterm infant has
- A. more subcutaneous fat.
- B. well-developed flexor muNscleRs. I G
- C. few blood vessels visible through the skin.
- D. greater surface area in proportion to weight.
Correct Answer: D
Rationale: The correct answer is D: greater surface area in proportion to weight. Preterm infants have a higher surface area to weight ratio due to their smaller size and underdeveloped body systems. This increased surface area makes them more susceptible to heat loss and requires special care to maintain their body temperature.
A: more subcutaneous fat - This is incorrect because preterm infants actually have less subcutaneous fat compared to full-term infants.
B: well-developed flexor muscles - This is incorrect as preterm infants typically have less muscle tone and may exhibit muscle weakness.
C: few blood vessels visible through the skin - This is incorrect as preterm infants often have fragile skin with visible blood vessels due to their underdeveloped skin layers.
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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.
Which diagnosis is most common in a newborn born at 35 + 3 gestational age?
- A. Hyperglycemia
- B. Respiratory distress syndrome
- C. Infection
- D. Altered nutrition, more than body requirements
Correct Answer: B
Rationale: The correct answer is B: Respiratory distress syndrome. At 35 + 3 weeks gestational age, the newborn's lungs may not be fully developed, leading to respiratory distress. This condition is common in premature babies due to surfactant deficiency, resulting in difficulty breathing. Hyperglycemia, infection, and altered nutrition are less likely in this scenario as they are not typically associated with prematurity at this gestational age. Respiratory distress is the most common concern in premature infants and requires prompt medical intervention to support breathing and lung function.
A 3-month-old has pulled out their NG tube at home, and the mother is now speaking with the on-call nurse. What recommendation should the nurse provide her?
- A. drive the infant to the nearest ER
- B. Call 911 and wait for EMS to arrive
- C. attempt to replace the NG tube yourself following discharge training
- D. feed the infant by mouth as there is not an NG tube to use
Correct Answer: C
Rationale: The correct answer is C because the mother was trained on NG tube replacement. This knowledge ensures proper technique and reduces the risk of injury. Driving to the ER or calling 911 may waste time, and feeding by mouth without the NG tube is not safe. Replacing the NG tube at home is the most efficient and appropriate course of action in this scenario.
In caring for the preterm infant, which complication is thought to be a result of high arterial blood oxygen level?
- A. Necrotizing enterocolitis (NEC)
- B. Retinopathy of prematurity (ROP)
- C. Intraventricular hemorrhage (IVH)
- D. Bronchopulmonary dysplasia (BPD)
Correct Answer: C
Rationale: The correct answer is C: Intraventricular hemorrhage (IVH). High arterial blood oxygen levels can lead to IVH in preterm infants due to increased cerebral blood flow and disruption of immature blood vessels in the brain. This can cause bleeding into the brain's ventricles. NEC (A) is more associated with feeding issues, ROP (B) with high oxygen levels, and BPD (D) with prolonged use of mechanical ventilation.
The nurse in NICU is assessing a neonate delivered at 32 weeks gestation. Which pathophysiological manifestation is the nurse’s greatest concern?
- A. Absent or weak reflexes
- B. Presence of a heart murmur
- C. Apnea 20 seconds or longer
- D. Low hemoglobin lab level
Correct Answer: C
Rationale: The correct answer is C: Apnea 20 seconds or longer. In a neonate delivered at 32 weeks gestation, apnea lasting 20 seconds or longer is the greatest concern as it indicates immature respiratory control and potential for respiratory distress or failure. Absent or weak reflexes (A) may be common in premature infants but are not as critical as respiratory issues. A heart murmur (B) may be present due to structural heart defects, but apnea poses a more immediate threat. Low hemoglobin (D) may indicate anemia, which can be managed with appropriate interventions, unlike compromised respiratory function.