A baby, exhibiting no obvious signs of congestive heart failure, has been diagnosed with a small ventricular septal defect. Which of the following information should the nurse explain to the baby's parents?

Correct Answer: B

Rationale: The nurse should explain to the baby's parents that the ventricular septal defect will likely close without therapy. Small ventricular septal defects have a high likelihood of closing on their own as the child grows. Surgical intervention is usually not necessary for small defects, especially when the baby does not exhibit signs of congestive heart failure. It is important for the parents to be aware of the natural course of the defect and to follow up with the healthcare provider for monitoring and management.

Correct Answer: C

Rationale: The major manifestation of nephrotic syndrome is edema. Nephrotic syndrome is a kidney disorder characterized by increased permeability of the glomerular filtration barrier, leading to excessive protein loss in the urine. This results in low levels of protein in the blood, particularly albumin, leading to a decrease in oncotic pressure. The decreased oncotic pressure causes fluid to accumulate in the interstitial spaces, leading to edema formation. Patients with nephrotic syndrome typically present with periorbital edema, pedal edema, and ascites due to the fluid redistribution in the body. Hematuria, hyperalbuminemia, and anemia are not typically the primary manifestations of nephrotic syndrome.

Correct Answer: A

Rationale: Cretinism is a condition caused by congenital hypothyroidism. Common features of cretinism include umbilical hernia, wet skin, and feeding problems. Prolonged jaundice is not typically associated with cretinism. Jaundice is more commonly seen in conditions such as neonatal hepatitis or biliary atresia.

Correct Answer: D

Rationale: The most critical physiologic change required of the newborn is the onset of breathing. Prior to birth, the fetus receives oxygen from the mother's blood through the placenta. However, once the newborn is delivered, it needs to begin breathing on its own to support oxygen exchange and remove carbon dioxide from the body. The respiratory system must transition from a fluid-filled state in the womb to an air-filled state outside the womb. The onset of breathing is essential for the newborn's survival and initiates the process of oxygenation of tissues and removal of carbon dioxide, which are vital for metabolism and overall physiological functioning. While closure of fetal shunts, stabilization of fluid and electrolytes, and body-temperature maintenance are also important changes that occur in the newborn, the onset of breathing is the most critical to ensure proper oxygenation of the body's tissues.

Correct Answer: A

Rationale: Milia are distended sebaceous glands that appear as tiny white papules on the cheeks, chin, and nose in the newborn period. They are commonly found in newborns and usually resolve on their own without treatment. Milia are not harmful and are considered a normal physiological occurrence in newborns. Lanugo refers to fine, downy hair covering newborn infants, Mongolian spots are blue-grey birthmarks usually found on the lower back or buttocks of newborns, and Cutis marmorata is a vascular mottling of the skin in newborns.