A new mother and father are inspecting their baby after the nurse brings the infant to them. The mother wants to know why her baby has bruises on the buttocks area. Which statement should be made by the nurse?

Correct Answer: B

Rationale: The correct answer is B because blue/gray macules, also known as Mongolian spots, are common in certain ethnic groups, especially in babies with darker skin tones. These marks typically appear on the buttocks and lower back and usually fade away by around 3 years of age. This explanation reassures the parents that the marks are not bruises from trauma but rather a normal and harmless skin pigmentation variation. Choices A, C, and D are incorrect because: A: This statement implies a traumatic delivery, which may cause unnecessary worry for the parents. It also deflects responsibility by suggesting involving the physician without providing a clear explanation. C: This statement misidentifies the marks as birthmarks, which are different from Mongolian spots. It also incorrectly suggests they are a permanent impairment, causing unnecessary concern. D: This statement is confrontational and shifts the focus away from addressing the parents' concerns. It does not provide any explanation or reassurance about the baby's condition.

Correct Answer: A

Rationale: The correct answer is A: Ask the mom to hold the infant using skin-to-skin contact. This is because skin-to-skin contact between the mother and newborn is important for bonding, regulating the baby's temperature, promoting breastfeeding, and comforting the baby. It also helps establish trust and promote attachment. Choice B is incorrect because newborns should not be exposed to direct sunlight for long periods due to the risk of sunburn and overheating. Choice C is incorrect because there is no specific benefit to placing the infant near the door, and it does not address the importance of skin-to-skin contact. Choice D is incorrect because obtaining the baby's weight is not the immediate priority when entering the room, especially when the opportunity for skin-to-skin contact is present.

Correct Answer: B

Rationale: The correct answer is B because infants born before 34 to 36 weeks gestational age may not have fully developed surfactant production, which is crucial for alveolar stability and lung expansion. Surfactant reduces surface tension in the alveoli, preventing their collapse. Without sufficient surfactant, preterm infants are at risk of respiratory distress syndrome. Choice A is incorrect because infants born at 32 weeks may still have underdeveloped alveoli and insufficient surfactant production, leading to potential lung expansion issues. Choice C is incorrect because the presence of gestational diabetes does not guarantee sufficient lung maturity in preterm infants. Lung maturity is more closely related to gestational age and surfactant production. Choice D is incorrect because while carrying multiple fetuses can slightly increase surfactant production, it may not be sufficient for preterm infants born before 34 to 36 weeks, necessitating the need for exogenous surfactant administration.

Correct Answer: D

Rationale: The correct answer is D because swaddling helps maintain the infant's body temperature by preventing heat loss. Swaddling creates a cocoon-like environment, reducing exposure to external factors. Choice A is incorrect because a baby scale does not provide warmth. Choice B is incorrect as the preterm infant is in an extended position, which increases heat loss. Choice C is incorrect as the term infant lying next to the door may experience drafts and heat loss.

Correct Answer: A

Rationale: The correct next course of action is to obtain a blood glucose reading (Choice A). Poor muscle tone and low temperature in a newborn can be indicative of hypoglycemia, which is a common issue in infants. By checking the blood glucose level, the healthcare provider can determine if hypoglycemia is the cause of the symptoms. This action allows for prompt intervention if needed. Choices B, C, and D are incorrect as they do not address the potential underlying issue of hypoglycemia. Resuscitation needs (Choice B) should only be considered if the infant's condition deteriorates. Calling for a transfer to the neonatal intensive care unit (Choice C) may not be necessary if the issue can be managed in the nursery. Placing warm blankets (Choice D) may help with temperature regulation but does not address the root cause of the symptoms.