Nokea
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.
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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 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.
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.
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.
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.