What is the most likely cause of respiratory distress syndrome in a term macrosomic newborn whose mother has poorly controlled type 2 diabetes?

Increased deposits of fat in the chest and shoulder area.

Hyperinsulinemia.

Brachial plexus injury.

Increased blood viscosity.

Answer and Explanation

The Correct Answer is B

Choice A rationale
Increased deposits of fat in the chest and shoulder area are not typically associated with respiratory distress syndrome in a term macrosomic newborn whose mother has poorly controlled type 2 diabetes.
Choice B rationale
Hyperinsulinemia is a condition in which there are excess levels of insulin circulating in the blood. In the case of a term macrosomic newborn whose mother has poorly controlled type 2 diabetes, the baby’s pancreas may produce extra insulin in response to the mother’s high blood glucose levels. This excess insulin can delay surfactant production, which is needed for lung maturation, leading to respiratory distress syndrome.
Choice C rationale
Brachial plexus injury is a type of birth injury that can occur due to the baby’s large size and difficulty being born. However, it is not the most likely cause of respiratory distress syndrome in a term macrosomic newborn whose mother has poorly controlled type 2 diabetes.
Choice D rationale

Increased blood viscosity can occur in newborns of mothers with poorly controlled diabetes due to polycythemia (an abnormally high number of red blood cells). However, this is not the most likely cause of respiratory distress syndrome in a term macrosomic newborn.

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Correct Answer is B

Explanation

Choice A rationale
Massaging the fundus is not necessary in this case. The fundus is firm, which indicates that the uterus is well contracted and there is no risk of postpartum hemorrhage. Massaging a well- contracted uterus can lead to uterine involution or even inversion.

Choice B rationale
Having the patient urinate is the correct action. A displaced fundus can be a sign of a full bladder. The bladder can push the uterus to the side and prevent it from contracting properly. By emptying the bladder, the uterus can return to its proper position and continue to contract to prevent bleeding.
Choice C rationale
Inserting a urinary catheter is not the first step. The nurse should first ask the patient to urinate. If the patient is unable to urinate, then a catheter may be necessary.
Choice D rationale
Administering an analgesic is not related to the position of the fundus. Pain management is important in postpartum care, but it is not the reason for a displaced fundus.

A. “I will call my provider if I have discharge from my incision.”. B. “I am likely to have a fever during the first week I am home.”. C. “I will rest in a recliner until my incision is healed.”. D. “I should not have unrelieved pain in my abdomen.”.

Correct Answer is ["A","D"]

Explanation

Choice A rationale
The client understanding the importance of monitoring their incision for signs of infection, such as discharge, indicates effective teaching. It is crucial for the client to report any changes to their healthcare provider promptly.
Choice B rationale
Having a fever during the first week at home is not a normal postoperative symptom and could indicate an infection. Therefore, this statement does not indicate effective teaching.
Choice C rationale

Resting in a recliner until the incision is healed is not necessary. While it’s important for the client to rest and recover after surgery, they should also engage in light physical activity, such as walking, to promote circulation and prevent complications such as blood clots.
Choice D rationale
The client should not have unrelieved pain in their abdomen. Persistent pain could indicate a complication, such as an infection or a hematoma. Therefore, this statement indicates effective teaching.

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What is the most likely cause of respiratory distress syndrome in a term macrosomic newborn whose mother has poorly controlled type 2 diabetes?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient who experienced a vaginal birth 3 hours ago. Upon palpation, the fundus is displaced to the right of midline, is firm, and is two fingerbreadths above the umbilicus. Which actions should the nurse take at this time?

Correct Answer is B

Explanation

A nurse is providing discharge teaching to a client who is 3 days postoperative following a cesarean birth. Which of the following client statements should indicate to the nurse the teaching is effective? (Select all that apply)

Correct Answer is ["A","D"]

Explanation

A nurse is caring for a client who is postpartum and is breastfeeding. The client states that she is concerned about dietary precautions since she has a family history of food allergies. The nurse offers which of the following responses?

A nurse in a prenatal clinic is teaching a client who is in her second trimester and has a new diagnosis of gestational diabetes. Which of the following statements by the client indicates a need for further teaching?

A nurse is performing a physical examination of a client who is 1 day postpartum. Which finding requires immediate attention?

What Apgar score should a nurse document for a newborn with a pink trunk and head, bluish hands and feet, flexed extremities 5 min after delivery, a weak and slow cry, a heart rate of 130/min, and cries in response to suctioning?

A nurse is preparing to administer 250 mg of an antibiotic intramuscularly to a pregnant client for a sexually transmitted infection. The available medication is 3 g/5 mL. How many mL should the nurse administer per dose? (This is a medical math querry no options provided) .

A nurse is caring for a client who experienced a vaginal delivery 12 hr ago. When palpating the client’s abdomen, at which of the following positions should the nurse expect to find the uterine fundus?

A nurse is formulating a care plan for a newborn who is small for gestational age (SGA). Which of the following should be the priority intervention in the newborn’s care plan?

A nurse is teaching a client who is postpartum and has a new prescription for Rh(D) immunoglobulin. Which of the following should be included in the teaching?