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?

Increased risk of anemia

Hyperinsulinemia

Increased blood viscosity

Brachial plexus injury

Answer and Explanation

The Correct Answer is B

Choice A reason: Increased risk of anemia is not a likely cause of respiratory distress in a term macrosomic newborn, as it can affect any newborn regardless of the maternal diabetes status or the fetal size. Anemia can cause pallor, tachycardia, and poor feeding, but not respiratory distress.

Choice B reason: Hyperinsulinemia is a likely cause of respiratory distress in a term macrosomic newborn, as it results from the fetal exposure to high maternal glucose levels and the subsequent overproduction of insulin. Hyperinsulinemia can impair the synthesis of surfactant, which is a substance that prevents the alveoli from collapsing and facilitates gas exchange. Hyperinsulinemia can also cause hypoglycemia, which can affect the respiratory center and cause apnea.

Choice C reason: Increased blood viscosity is not a likely cause of respiratory distress in a term macrosomic newborn, as it can affect any newborn with polycythemia, which is an abnormally high number of red blood cells. Polycythemia can cause cyanosis, jaundice, and thrombosis, but not respiratory distress.

Choice D reason: Brachial plexus injury is not a likely cause of respiratory distress in a term macrosomic newborn, as it affects the nerves that supply the arm and hand, not the lungs. Brachial plexus injury can occur due to the excessive traction or stretching of the shoulder during delivery, and can cause weakness, paralysis, or sensory loss in the affected arm.

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Correct Answer is B

Explanation

Choice A reason: Missed miscarriage is not the type of abortion that the client is experiencing, because it is characterized by the absence of fetal heart activity and the retention of the products of conception in the uterus. The client would not have heavy bleeding or tissue expulsion.

Choice B reason: Incomplete miscarriage is the type of abortion that the client is experiencing, because it is characterized by the partial expulsion of the products of conception from the uterus, with some tissue remaining inside. The client would have heavy bleeding, open cervical os, and tissue present.

Choice C reason: Inevitable miscarriage is not the type of abortion that the client is experiencing, because it is characterized by the rupture of membranes and dilation of the cervical os, but no expulsion of the products of conception. The client would have moderate bleeding and cramping, but no tissue present.

Choice D reason: Complete miscarriage is not the type of abortion that the client is experiencing, because it is characterized by the complete expulsion of the products of conception from the uterus. The client would have mild bleeding and cramping, and a closed cervical os.

A. The mother applies lotion to the newborn's skin. B. The newborn's stools increase in number. C. A pink rash appears on the newborn's trunk. D. The newborn's eyes are covered with a mask.

Correct Answer is A

Explanation

Choice A reason: The mother applying lotion to the newborn's skin requires intervention by the nurse, because it can interfere with the effectiveness of phototherapy and increase the risk of thermal injury. The nurse should instruct the mother to avoid using any lotions, creams, or oils on the newborn's skin during phototherapy.

Choice B reason: The newborn's stools increasing in number does not require intervention by the nurse, because it is a normal and expected outcome of phototherapy. Phototherapy can increase the breakdown and excretion of bilirubin, which can result in more frequent and loose stools.

Choice C reason: A pink rash appearing on the newborn's trunk does not require intervention by the nurse, because it is a common and harmless side effect of phototherapy. The rash usually disappears within a few days after phototherapy is discontinued.

Choice D reason: The newborn's eyes being covered with a mask does not require intervention by the nurse, because it is a standard and essential precaution for phototherapy. The mask protects the newborn's eyes from the harmful effects of the light, such as corneal damage or retinal injury.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client comes to the emergency room reporting severe abdominal cramping and heavy bleeding at 10 weeks gestation. Cervical examination reveals heavy bleeding, the cervical os is open and tissue is present. Which type of abortion is the client experiencing?

Correct Answer is B

Explanation

A nurse is caring for an infant who is receiving phototherapy. Which of the following findings requires intervention by the nurse?

Correct Answer is A

Explanation

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