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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.
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Which infant is at greatest risk for developing hypoglycemia after birth?
- A. Severe small for gestational age infant
- B. Appropriate for gestational age infant
- C. Infant of a diabetic mother with maternal glucose control
- D. Cold-stressed term infant
Correct Answer: A
Rationale: The correct answer is A: Severe small for gestational age (SGA) infant, as they have limited glycogen stores and are at higher risk for hypoglycemia. SGA infants often have poor growth in utero, leading to decreased nutrient reserves. This puts them at increased risk for low blood sugar levels after birth.
Incorrect choices:
B: Appropriate for gestational age infants typically have adequate glycogen stores and are at lower risk for hypoglycemia.
C: Infants of diabetic mothers with good maternal glucose control are less likely to have hypoglycemia due to stable blood sugar levels in utero.
D: Cold-stressed term infants may have transient hypoglycemia, but they are not at the greatest risk compared to severe SGA infants.
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.
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.
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.
Which sign will the newborn experiencing respiratory obstruction often exhibit first?
- A. Gagging
- B. Vomiting
- C. Decreased heart rate
- D. Increased respiratory rate
Correct Answer: D
Rationale: The correct answer is D: Increased respiratory rate. When a newborn experiences respiratory obstruction, they will initially exhibit an increased respiratory rate as their body tries to compensate for the lack of oxygen. This is a natural response to try to increase oxygen intake. Gagging (choice A) and vomiting (choice B) may occur as secondary symptoms if the obstruction persists. Decreased heart rate (choice C) is unlikely to be the first sign, as the body typically prioritizes ensuring oxygen supply to vital organs such as the brain. Therefore, the increased respiratory rate is the most immediate and crucial sign to indicate respiratory obstruction in a newborn.