A newborn is diagnosed with persistent pulmonary hypertension (PPHN). Which of the following interventions is most commonly used to treat PPHN?

Correct Answer: A

Rationale: In pediatric nursing, understanding the management of conditions like persistent pulmonary hypertension (PPHN) is crucial for providing effective care to newborns. The correct intervention for treating PPHN is inhaled nitric oxide (Option A). Nitric oxide is a potent pulmonary vasodilator that helps improve oxygenation by dilating pulmonary blood vessels and reducing pulmonary vascular resistance, thus increasing blood flow to the lungs. This ultimately improves oxygenation and reduces the risk of hypoxemia in newborns with PPHN. Option B, magnesium sulfate, is not commonly used to treat PPHN. Magnesium sulfate is typically used in obstetrics for conditions like preeclampsia or eclampsia to prevent seizures. Option C, surfactant therapy, is used for conditions like respiratory distress syndrome (RDS) in newborns, where there is a deficiency of surfactant in the lungs, leading to atelectasis and poor oxygenation. PPHN, however, is primarily a vascular issue rather than a surfactant deficiency. Option D, continuous positive airway pressure (CPAP), is a supportive therapy used in conditions like respiratory distress syndrome (RDS) or apnea of prematurity to help keep the airways open and improve oxygenation. While CPAP may be part of the overall management of PPHN, it is not the primary intervention for treating PPHN. Educationally, nurses need to understand the specific pharmacological interventions for different respiratory conditions in newborns to provide safe and effective care. Knowing the rationale behind using inhaled nitric oxide for PPHN empowers nurses to advocate for the most appropriate treatment and monitor for desired outcomes in newborns with this condition.

Correct Answer: A

Rationale: The recommended mode of delivery for a fetus with suspected fetal macrosomia is a planned cesarean section (Option A). Fetal macrosomia refers to a fetus that is significantly larger than average for its gestational age, which can pose risks during vaginal delivery such as shoulder dystocia and birth trauma. A planned cesarean section is the preferred method for delivering a macrosomic fetus as it reduces the risk of complications associated with vaginal delivery, such as injuries to both the baby and the mother. It allows for a controlled environment where healthcare providers can anticipate and manage potential challenges that may arise during delivery. Vaginal delivery with forceps (Option B) and vacuum assistance (Option C) are not recommended for a macrosomic fetus due to the increased risk of birth trauma and shoulder dystocia. These methods may not be safe or effective in delivering a larger-than-average baby. Induced vaginal delivery (Option D) is also not the best option for suspected fetal macrosomia as it does not address the potential risks associated with vaginal delivery of a macrosomic fetus. In an educational context, understanding the appropriate mode of delivery for a fetus with suspected fetal macrosomia is crucial for healthcare providers working in obstetrics and neonatal care. This knowledge ensures that the safety of both the mother and the baby is prioritized during the birthing process.

Correct Answer: A

Rationale: Transient tachypnea of the newborn (TTN) is a common respiratory condition in newborns characterized by rapid breathing. The correct answer is A) Cesarean section delivery. During a cesarean section, the newborn may not experience the usual squeezing of the chest that occurs during vaginal delivery, which helps to clear lung fluid. This can lead to retained lung fluid, causing TTN. Option B) Prematurity is often associated with respiratory distress syndrome, not TTN. Option C) Maternal diabetes is more closely linked to macrosomia and hypoglycemia in newborns. Option D) Intrauterine growth restriction may lead to other complications like hypoglycemia or polycythemia, but not typically TTN. In an educational context, understanding the risk factors for TTN is crucial for nurses caring for newborns. By knowing that cesarean section delivery can increase the likelihood of TTN, nurses can monitor newborns more closely for signs and symptoms, leading to early detection and intervention. This knowledge can improve patient outcomes and ensure quality care for newborns experiencing respiratory distress.

Correct Answer: D

Rationale: In this pediatric respiratory assessment nursing exam question, the correct answer is D) Developing plans for the future. This answer indicates a misunderstanding by the parents regarding the characteristics of school-age cognitive development. School-age children typically exhibit concrete operational thinking, which means they can think logically about tangible objects and events. While considering simple problem-solving options (Option C) is in line with this stage of development, developing plans for the future (Option D) reflects a higher level of cognitive ability more commonly seen in adolescence. Collecting baseball cards and marbles (Option A) is a typical school-age interest that aligns with their cognitive abilities. Ordering dolls according to size (Option B) also demonstrates logical thinking and classification skills suitable for this age group. In an educational context, it is important for nurses to ensure that parents have a clear understanding of age-appropriate developmental milestones to support their child's growth and provide appropriate guidance. By recognizing misconceptions like the one in option D, healthcare providers can offer additional teaching to enhance parental knowledge and promote optimal child development.

Correct Answer: B

Rationale: In the case of a neonate born with a single umbilical artery, the most appropriate management is option B) Renal ultrasound. This is because a single umbilical artery is associated with congenital renal abnormalities, such as renal agenesis or dysplasia. A renal ultrasound can help in diagnosing any structural abnormalities in the kidneys or urinary system, allowing for early intervention and management to prevent potential complications. Option A) Cardiac ultrasound is not the most appropriate management for a single umbilical artery as the primary concern in this scenario is renal abnormalities, not cardiac issues. Option C) Close monitoring for developmental delays is not the immediate course of action as the focus should be on identifying and addressing any potential renal issues first. Option D) Folic acid supplementation is not directly related to the management of a single umbilical artery and its associated complications. In an educational context, understanding the link between a single umbilical artery and renal abnormalities is crucial for pediatric nurses. By knowing the appropriate management, nurses can ensure early detection and intervention, ultimately improving the long-term outcomes for neonates with this condition. It underscores the importance of thorough assessments and targeted interventions based on specific findings in neonatal care.