A patient with blood group AB, whose husband has blood group O, has recently given birth. What is the main complication or test result to watch for in the newborn concerning ABO incompatibility?

Correct Answer: D

Rationale: In the context of ABO incompatibility between a mother with blood group AB and a father with blood group O, the correct answer is D) jaundice within the first 24 hours of life for the newborn. This is known as ABO hemolytic disease of the newborn. In this condition, the mother's antibodies cross the placenta and attack the infant's red blood cells of an incompatible ABO blood group, leading to hemolysis and subsequent jaundice. Option A) negative Coombs test is incorrect because in ABO incompatibility, the Coombs test is typically positive due to the presence of maternal antibodies on the infant's red blood cells. Option B) bleeding from the nose and ear is not a typical presentation of ABO incompatibility. This symptom is more commonly associated with other conditions like trauma or clotting disorders. Option C) jaundice after the first 24 hours of life is not specific to ABO incompatibility. In this condition, jaundice typically presents within the first 24 hours due to the rapid breakdown of red blood cells. Understanding ABO incompatibility is crucial for nurses caring for newborns to promptly recognize and manage potential complications. Educating nurses on the early signs and symptoms of ABO hemolytic disease can lead to timely interventions and improved outcomes for affected infants.

Correct Answer: D

Rationale: In the context of nursing care for newborns, ensuring infant safety during car travel is crucial. The correct answer, option D, states that infants are safest in a rear-facing, safety-approved infant car seat located in the middle of the back seat of the car. This option is correct because placing the infant in a rear-facing position in the middle of the back seat provides the best protection in the event of a crash. Option A is incorrect because while it mentions using an approved safety seat, it does not specify the optimal rear-facing position in the middle of the back seat. Option B is incorrect as it suggests using a car seat that the infant can grow into, which may not provide the best fit and protection for a newborn. Option C is also incorrect as it allows for the seat to be placed in the car's front seat, which is not recommended due to the potential danger from airbags. Educationally, it is essential to emphasize to nursing students and caregivers the importance of correctly securing infants in rear-facing car seats in the back seat, as this position minimizes the risk of injury in case of a collision. Understanding the rationale behind this practice is crucial for ensuring the safety and well-being of newborns during car travel.

Correct Answer: A

Rationale: In the first year of life, newborns undergo significant growth and developmental changes, necessitating regular health provider visits to monitor their progress, provide vaccinations, and address any emerging health concerns. The correct answer, option A (1 month, 2 months, 4 months, 6 months, 9 months, and 12 months of age), aligns with the recommended schedule by the American Academy of Pediatrics (AAP) for well-child visits. At each of these visits, healthcare providers assess the infant's growth, development, feeding, and overall well-being. Vaccinations are also administered according to the AAP's immunization schedule to protect the child from various diseases. Option B (1 month to 12 months, visiting once each month) is too frequent for routine well-child visits and may lead to unnecessary medical interventions or stress for the child and family. Option C (1 month, 3 months, 6 months, 9 months, and 12 months) and Option D (1 month, 3 months, 6 months, 12 months) both miss key visits recommended for newborns, such as the 2-month and 4-month visits which are crucial for timely vaccinations and developmental screenings. Understanding the recommended schedule for newborn visits is essential for nurses caring for infants to ensure they receive appropriate care and interventions at each stage of their early development. Regular well-child visits also provide an opportunity for health education and support to parents, promoting optimal health outcomes for the newborn.

Correct Answer: A

Rationale: The best response from the nurse is option A) "The results indicate your child may have Turner syndrome." This response is correct because 45, X karyotype is characteristic of Turner syndrome, a genetic condition in which a female is born with only one X chromosome instead of the typical two. By providing this information, the nurse is addressing the parents' query directly and accurately, showing knowledge and sensitivity towards the situation. Option B) "Your results are 45, X; you will have to wait to talk with the geneticist" is incorrect because it does not provide the necessary information to the parents who are seeking clarification. It delays communication and may cause unnecessary anxiety for the parents. Option C) "Your results indicate that your daughter has a serious lifelong disease" is incorrect and misleading as Turner syndrome, although a genetic condition, is not always classified as a "disease." Using such language may unnecessarily alarm the parents. Option D) "I'm not sure; I'll call the provider" is also incorrect as the nurse should be knowledgeable enough to explain the implications of the karyotype results to the parents without needing to consult the provider for basic information. In an educational context, it is crucial for nurses to be well-informed about common genetic conditions such as Turner syndrome to provide accurate and timely information to patients and their families. Effective communication in such situations is essential to support families in understanding and coping with a potential diagnosis.

Correct Answer: A

Rationale: In the scenario of a premature newborn requiring assistance with ventilation and oxygenation, the most appropriate method of respiratory support is A) bag mask positive pressure ventilation (PPV). PPV is commonly used in neonatal resuscitation to provide effective ventilation by delivering breaths to the newborn's lungs. It is crucial for providing adequate oxygenation and preventing complications associated with respiratory distress in newborns. Option B) extracorporeal membrane oxygenation (ECMO) is not typically the first-line intervention for initial respiratory support in a premature newborn. ECMO is considered a more advanced form of life support used in severe cases where conventional ventilation methods have failed. Option C) continuous positive airway pressure (CPAP) is used for infants with mild to moderate respiratory distress but may not provide sufficient support for a newborn requiring PPV at birth and ongoing assistance. Option D) nasal cannula at 1 L is a low-flow oxygen delivery system that is not adequate for providing the level of respiratory support needed for a premature newborn requiring PPV. Educationally, understanding the appropriate respiratory support methods for newborns is crucial for nursing care of neonates. Knowledge of when to utilize PPV, CPAP, or other methods based on the newborn's condition is essential for providing effective and timely interventions to optimize outcomes in neonatal care.