A nurse is caring for a newborn who is 30 min old.

Exhibits
After reviewing the findings . which of the following conditions is the infant at risk of

Jaundice

Meconium ileus*

Hypoglycemia

Meconium aspiration syndrome

Answer and Explanation

The Correct Answer is D

Jaundice: Although post-term infants are at increased risk, this newborn does not yet show yellowing of the skin or sclera, which are key indicators of jaundice.

Meconium ileus: This is usually associated with cystic fibrosis and involves obstruction of the intestine by thick meconium not respiratory symptoms. This newborn's findings do not suggest GI obstruction.

Hypoglycemia: Post-term and large-for-gestational-age infants are at risk for hypoglycemia, but there are no signs like jitteriness, lethargy, or poor feeding here to support this diagnosis right now.

Meconium aspiration syndrome: This newborn was born through meconium-stained amniotic fluid and is now showing respiratory distress including rapid, shallow breathing, grunting, and fine crackles. These are hallmark signs of Meconium Aspiration Syndrome (MAS), a serious complication where the infant inhales meconium into the lungs, leading to inflammation and potential airway obstruction.

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Correct Answer is B

Explanation

A. "I will take your baby to the nursery for further examination": This response may unnecessarily alarm the mother and does not address the typical, benign nature of the concern. Newborns can occasionally exhibit crossed eyes, which is often a normal developmental stage.

B. "This occurs because newborns lack muscle control to regulate eye movement": This is the most accurate and comforting response. It explains that eye crossing (strabismus) is common in newborns due to their immature eye muscles, and it usually resolves as the baby grows and gains more muscle control.

C. "I will call your primary care provider to report your concerns": While it's important to address concerns, this response may be premature. Eye crossing in newborns is generally normal, and immediate consultation with the primary care provider isn't necessary unless the condition persists beyond a few months or worsens.

D. "This is a concern, but strabismus is easily treated with patching": This response is not appropriate for a newborn. While strabismus can be treated in older children, it is usually normal in newborns and does not require immediate treatment like patching.

A. Brachial plexus injury B. Increased deposits of fat in the chest and shoulder area C. Hyperinsulinemia D. Increased blood viscosity

Correct Answer is C

Explanation

A. Brachial plexus injury: While macrosomic infants are at risk for brachial plexus injuries due to shoulder dystocia, this condition is associated with motor deficits, not respiratory distress. It does not impair lung function or surfactant production, and thus is not the cause of respiratory distress syndrome (RDS).

B. Increased deposits of fat in the chest and shoulder area: Macrosomic infants may have excess adipose tissue, particularly in the shoulders and chest, which can complicate delivery, but this fat distribution does not impair respiratory function directly or lead to surfactant deficiency, the hallmark of RDS.

C. Hyperinsulinemia: Infants of diabetic mothers (IDMs), especially when maternal diabetes is poorly controlled, often experience hyperinsulinemia, which antagonizes cortisol, a hormone necessary for fetal lung maturation and surfactant synthesis. The lack of adequate surfactant leads to alveolar collapse and respiratory distress syndrome, even in term infants who would normally have mature lungs.

D. Increased blood viscosity: Polycythemia, or increased red blood cell mass, is common in IDMs due to chronic intrauterine hypoxia, but while it can lead to sluggish circulation and hypoxia, it is not a direct cause of RDS. Respiratory symptoms in RDS stem primarily from surfactant deficiency, not thickened blood.

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A nurse is caring for a newborn who is 30 min old. Exhibits After reviewing the findings . which of the following conditions is the infant at risk of

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a new mother who is concerned that her newborn's eyes cross. Which of the following statements is a therapeutic response by the nurse?

Correct Answer is B

Explanation

A nurse is caring for a term macrosomic newborn whose mother has poorly controlled type 2 diabetes. The newborn has respiratory distress syndrome. The nurse should be aware that the most likely cause of the respiratory distress is which of the following?

Correct Answer is C

Explanation

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A nurse is caring for a newborn who is 30 min old.

Exhibits
After reviewing the findings . which of the following conditions is the infant at risk of