A nurse is preparing to perform a congenital heart screening procedure on a newborn.
Which equipment should the nurse ensure is readily available for the procedure?

Choice A rationale

Initial hearing screens often yield false-positive results due to residual amniotic fluid, vernix caseosa, or middle ear effusion that can interfere with the sound transmission within the ear canal. The American Academy of Pediatrics recommends rescreening infants who fail the initial test, typically before discharge, to allow time for the ear canal to clear. If the infant fails the repeat screening, a definitive diagnostic evaluation is then necessary.

Choice B rationale

Scheduling an immediate specialist consult is premature after a single failed screening. Most initial failures resolve upon rescreening, which is the standard of care to avoid unnecessary anxiety and medical appointments. A referral is only warranted after the newborn fails the repeat screening to confirm a possible permanent hearing loss with a more comprehensive audiologic assessment within a few weeks.

Choice C rationale

A failed initial hearing screen does not automatically signify a permanent disability or necessitate an immediate social services consult. The focus remains on re-evaluation and appropriate follow-up. While providing comfort is always essential, escalating to social services based on a single failed screen is an overreaction and not the correct clinical intervention at this stage.

Choice D rationale

Initiating speech therapy services is inappropriate because the newborn's ability to hear has not yet been definitively determined. Speech therapy is implemented much later, usually when a confirmed hearing impairment impacts language development, typically after 6 months of age. The current priority is to confirm or rule out hearing loss via rescreening and diagnostic testing. —.

Choice A rationale

Retinopathy of prematurity (ROP) is a complex developmental disorder of the retinal blood vessels caused by premature birth, often linked to factors like hyperoxia or fluctuating oxygen levels, not the prophylactic antibiotic erythromycin. Erythromycin ointment is given to prevent ophthalmia neonatorum, which is caused by Chlamydia or Gonorrhea and is a completely distinct eye condition.

Choice B rationale

This is a correct understanding of ROP management. Treatment for severe ROP, necessary to prevent retinal detachment and blindness, can involve precise laser photocoagulation to destroy the abnormal peripheral blood vessels, or intravitreal injections of vascular endothelial growth factor (VEGF) inhibitors to halt abnormal vessel growth.

Choice C rationale

This is correct. The primary risk factor for ROP is prematurity itself, particularly birth before 31 weeks gestation, because the retinal blood vessels are not yet fully developed and are highly susceptible to injury from the extrauterine environment and associated medical treatments. Lower birth weight also increases risk.

Choice D rationale

This statement shows good understanding. Since ROP can progress rapidly and is often asymptomatic until severe, a key part of management is regular, comprehensive dilated eye exams performed by a pediatric ophthalmologist, following established screening guidelines based on the infant's gestational age and medical history. .