Which clinical sign is most concerning immediately following the delivery of a high-risk neonate?
- A. Axillary temperature of 97.8°F
- B. Blood glucose of 35 g/dL
- C. Oxygen saturation of 90%
- D. Blue-tinged hands and feet
Correct Answer: B
Rationale: The correct answer is B: Blood glucose of 35 g/dL. This is the most concerning sign as hypoglycemia in neonates can lead to serious neurological complications. Low blood glucose levels can result in seizures, brain damage, and even death if not promptly addressed. It is crucial to maintain appropriate blood glucose levels in neonates to support their brain development and overall health.
Explanation of other choices:
A: Axillary temperature of 97.8°F - Slightly below normal but not immediately concerning.
C: Oxygen saturation of 90% - Suboptimal but not as critical as severe hypoglycemia.
D: Blue-tinged hands and feet - Could indicate poor circulation, but hypoglycemia is more urgent to address.
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Which laboratory value is important to check on a newborn with excessive bruising following delivery?
- A. White blood cells
- B. Glucose
- C. Bilirubin
- D. Potassium
Correct Answer: C
Rationale: The correct answer is C: Bilirubin. Excessive bruising in a newborn can indicate hemolysis, leading to elevated bilirubin levels and potential jaundice. Checking bilirubin levels is crucial to monitor for hyperbilirubinemia, which can lead to complications like kernicterus. White blood cells (A) are not typically associated with bruising. Glucose (B) levels are important in monitoring for hypoglycemia, not bruising. Potassium (D) levels are not directly related to bruising in a newborn.
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.
An infant delivered prematurely at 28 weeks' gestation weighs 1200 g. Based on this information the infant is classified as
- A. SG
- B. VLBW.
- C. ELBW.
- D. low birth weight at term.
Correct Answer: B
Rationale: The correct answer is B: VLBW (Very Low Birth Weight). This classification is based on the infant weighing less than 1500 g at birth, which applies to this scenario as the infant weighs 1200 g. VLBW infants are at higher risk for complications due to their low weight and prematurity.
A: SG (Small for Gestational Age) is incorrect because it refers to infants who are below the 10th percentile for weight at a specific gestational age, not based solely on weight.
C: ELBW (Extremely Low Birth Weight) is incorrect as it typically refers to infants weighing less than 1000 g at birth, which is lower than the infant in this scenario.
D: Low birth weight at term is incorrect as it does not accurately classify a premature infant like the one in the question.
Which is the most common etiology for pathological jaundice in an infant?
- A. ABO incompatibility
- B. Physiological
- C. Inherited pathology
- D. Birth trauma
Correct Answer: A
Rationale: The correct answer is A: ABO incompatibility. This is the most common etiology for pathological jaundice in an infant because it occurs when the baby's blood type is incompatible with the mother's, leading to the destruction of the baby's red blood cells and subsequent release of bilirubin, causing jaundice. Physiological jaundice (B) is common but typically resolves on its own without treatment. Inherited pathologies (C) such as genetic conditions may cause jaundice, but they are less common than ABO incompatibility. Birth trauma (D) can lead to jaundice in rare cases, but it is not the most common etiology.
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.