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 C

Explanation

Choice A rationale
Assisting with amnioinfusion is not the first priority. Amnioinfusion is a procedure where a sterile solution is introduced into the uterus to increase the volume of fluid around the fetus. It is typically used in cases of oligohydramnios (low amniotic fluid) or to dilute thick meconium in the amniotic fluid.
Choice B rationale
Inserting a scalp electrode is not the first priority. A scalp electrode is a device used to monitor the fetal heart rate more accurately. It is usually used when external monitoring does not provide a clear reading or when there is a need for continuous detailed monitoring.

Choice C rationale
Changing the woman’s position is the correct action. Late decelerations in the fetal heart rate can be a sign of uteroplacental insufficiency, a condition where the placenta cannot deliver adequate oxygen to the fetus. Changing the woman’s position can improve placental blood flow and potentially improve the oxygen supply to the fetus.
Choice D rationale
Notifying the health care provider is important but not the first priority. The nurse should first attempt interventions such as changing the woman’s position to improve the fetal heart rate.

A. Iron B. Calcium C. Vitamin C D. Folic acid

Correct Answer is D

Explanation

Choice A rationale
Iron is an essential nutrient that helps to transport oxygen in the blood. However, it does not specifically prevent defects in the fetus.
Choice B rationale
Calcium is important for bone health in both the mother and the fetus. It does not specifically prevent defects in the fetus.
Choice C rationale
Vitamin C is an antioxidant that protects tissues from damage and helps the body absorb iron and produce collagen. While it is important for overall health, it does not specifically prevent defects in the fetus.
Choice D rationale
Folic acid is crucial in the early development of a fetus for the formation of the neural tube. It can help prevent major birth defects of the baby’s brain and spine.

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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

While evaluating an external monitor tracing of a woman in active labor, the nurse observes that the FHR begins to decelerate late in the contraction, with the decelerations occurring after the peak of the contraction. What is the nurse’s first priority?

Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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