A newborn was prenatally diagnosed with trisomy 13 along with an unrepairable cardiac anomaly. Genetic testing and cardiac imaging after birth have confirmed both findings. What discharge planning should be included for this infant?

Correct Answer: C

Rationale: The correct answer is C: home hospice care. This infant has trisomy 13 with an unrepairable cardiac anomaly, indicating a poor prognosis. Home hospice care focuses on providing comfort and support for the infant and family in such situations, ensuring a peaceful environment and managing symptoms. Choice A (cardiology follow-up) is not appropriate as the cardiac anomaly is unrepairable. Genetic testing for the family (Choice B) is not a priority at this stage. Lactation consultant (Choice D) is not relevant for this situation.

Correct Answer: B

Rationale: The correct answer is B: Meconium aspiration. Meconium aspiration occurs when a newborn inhales meconium-stained amniotic fluid during delivery, leading to inflammation and respiratory distress. Meconium can obstruct the airways and cause chemical pneumonitis, resulting in respiratory compromise. Atelectasis (choice A) is the collapse of part or all of the lung, which can occur secondary to meconium aspiration. Bronchopulmonary dysplasia (choice C) is a chronic lung disease in premature infants. Patent ductus arteriosus (choice D) is a heart condition where a blood vessel doesn't close normally after birth. Meconium aspiration is the most immediate risk for the newborn in this scenario due to its impact on the respiratory system.

Correct Answer: B

Rationale: The correct answer is B: Ballard score. The Ballard score is a tool used to assess neuromuscular and physical maturity in newborns, which correlates with their gestational age. It includes assessment of physical characteristics such as skin texture, lanugo, ear form, breast tissue, and genitalia. This assessment helps healthcare providers determine the newborn's gestational age more accurately. A: Apgar score assesses the newborn's overall health and vitality at one and five minutes after birth. C: Phenylketonuria (PKU) screening is a metabolic test to detect inherited disorders, not related to assessing maturity. D: Length and weight measurements provide important information but do not specifically assess neuromuscular and physical maturity correlating with gestational age.

Correct Answer: C

Rationale: The correct answer is C: Decreased surface tension with increased lung compliance. Surfactant reduces surface tension in the alveoli, preventing alveolar collapse and increasing lung compliance. This improves gas exchange and reduces the work of breathing. A: Increased pulmonary vascular resistance is incorrect as surfactant does not affect vascular resistance. B: Increased cerebral blood flow is incorrect as surfactant primarily impacts the lungs, not cerebral blood flow. D: Increased blood viscosity is incorrect as surfactant does not alter blood viscosity.

Correct Answer: B

Rationale: The correct answer is B: Respiratory distress syndrome. In neonates, the most common cause of patent ductus arteriosus is the respiratory distress syndrome. This is because the hypoxia and acidosis associated with respiratory distress syndrome lead to the persistence of the ductus arteriosus. Oxygen therapy (A) may be needed in neonates with respiratory distress syndrome but is not the direct cause of patent ductus arteriosus. Genetic predisposition (C) is not a primary cause of patent ductus arteriosus in neonates. Necrotizing enterocolitis (D) is a condition affecting the intestines and is not directly related to the development of patent ductus arteriosus.