A woman with a long history of smoking is now in the last part of the third trimester of her pregnancy. She is at high risk for which of the following conditions?

Correct Answer: D

Rationale: The correct answer is D) Sudden infant death syndrome (SIDS). During pregnancy, smoking poses significant risks to both the mother and the developing fetus. Maternal smoking increases the risk of SIDS in infants due to the harmful effects of nicotine and other toxins in tobacco smoke. Infants born to mothers who smoke during pregnancy are at a higher risk of SIDS compared to infants born to non-smoking mothers. Premature rupture of membranes (A), placental abruption (B), and placenta previa (C) are not directly associated with maternal smoking during pregnancy. While smoking can have adverse effects on pregnancy outcomes such as preterm birth and placental complications, the specific risk factor for SIDS is strongly linked to maternal smoking. In an educational context, it is crucial for healthcare providers, especially nurses, to understand the impact of maternal smoking on both maternal and infant health outcomes. Educating pregnant women on the risks of smoking and providing support for smoking cessation are essential components of prenatal care to promote a healthy pregnancy and reduce the risk of adverse outcomes like SIDS. Nurses play a key role in advocating for smoking cessation interventions and providing evidence-based information to empower pregnant women to make informed decisions for their health and the health of their baby.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Mistrust. The infant of a substance-abusing mother is at risk for developing a sense of mistrust due to the inconsistent caregiving, neglect, or abuse that may result from the mother's substance abuse. This can lead to the infant having difficulties forming secure attachments and trusting others in the future. Option B) Shame is not the best answer because shame is more closely related to feelings of embarrassment or humiliation about oneself, which may not be directly caused by the mother's substance abuse. Option C) Guilt is also not the best answer as guilt is a feeling of responsibility or remorse for a wrongdoing, which is not typically experienced by infants in this context. Option D) Inferiority is not the best answer as it pertains to feelings of inadequacy or low self-worth, which are not directly linked to the situation of having a substance-abusing mother. In an educational context, understanding the potential psychological impacts of parental substance abuse on infants is crucial for healthcare professionals, especially nurses working in pediatric settings. By recognizing the risk factors and potential outcomes, nurses can provide appropriate support, interventions, and referrals to help mitigate the negative effects on the infant's development and well-being. This knowledge also underscores the importance of holistic and family-centered care in pediatric nursing practice.

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: C

Rationale: The correct answer is C) Dehydration. Phototherapy is a common treatment for neonatal jaundice, where exposure to light helps break down bilirubin in the baby's body. The most common complication of phototherapy in neonates is dehydration. This occurs because the lights used during phototherapy can increase insensible water loss through evaporation from the skin. Neonates are already at higher risk for dehydration due to their small size and higher surface area to volume ratio. Option A) Hypercalcemia is not typically associated with phototherapy in neonates. Hypercalcemia is an excess of calcium in the blood and is more commonly seen in conditions like hyperparathyroidism. Option B) Bronchopulmonary dysplasia is a chronic lung disease that primarily affects premature infants who have been on mechanical ventilation. It is not directly related to phototherapy. Option D) Hypoglycemia is low blood sugar levels, which can occur in neonates for various reasons but is not a common complication of phototherapy specifically. Educationally, it is crucial for nurses and healthcare providers caring for neonates undergoing phototherapy to monitor closely for signs of dehydration, such as decreased urine output, dry mucous membranes, and poor skin turgor. Maintaining adequate hydration is essential to prevent complications and ensure the neonate's well-being during phototherapy.

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.