Based on the following risk factors, which newborn is least at risk for developing persistent pulmonary hypertension? Select all that apply.

Correct Answer: C

Rationale: The correct answer is C: Appropriate for gestational age. Newborns who are appropriate for gestational age are least at risk for developing persistent pulmonary hypertension because they have not experienced intrauterine growth restriction or other complications that can lead to lung problems. Being born late or postdates (A) can increase the risk of complications, including pulmonary hypertension. Being born to a mother with gestational diabetes (B) can also increase the risk due to potential metabolic issues. Meconium aspiration (D) can lead to respiratory distress and increase the risk of pulmonary hypertension.

Correct Answer: D

Rationale: Step 1: Maternal diabetes leads to high blood glucose levels. Step 2: Maternal glucose crosses the placenta to the fetus. Step 3: Fetal pancreas produces more insulin in response to high glucose. Step 4: Excess insulin promotes fetal growth, leading to macrosomia. Summary: A: Incorrect - Maternal insulin doesn't cross placenta in significant amounts. B: Incorrect - Blood flow doesn't directly cause fetal overgrowth. C: Incorrect - Maternal insulin doesn't directly cause increased growth.

Correct Answer: A

Rationale: The correct answer is A: ABO incompatibility. This is the most common etiology for pathological jaundice in an infant because it occurs when the baby's blood type is incompatible with the mother's, leading to the destruction of the baby's red blood cells and subsequent release of bilirubin, causing jaundice. Physiological jaundice (B) is common but typically resolves on its own without treatment. Inherited pathologies (C) such as genetic conditions may cause jaundice, but they are less common than ABO incompatibility. Birth trauma (D) can lead to jaundice in rare cases, but it is not the most common etiology.

Correct Answer: B

Rationale: The correct answer is B: Blood glucose of 35 g/dL. This is the most concerning sign as hypoglycemia in neonates can lead to serious neurological complications. Low blood glucose levels can result in seizures, brain damage, and even death if not promptly addressed. It is crucial to maintain appropriate blood glucose levels in neonates to support their brain development and overall health. Explanation of other choices: A: Axillary temperature of 97.8°F - Slightly below normal but not immediately concerning. C: Oxygen saturation of 90% - Suboptimal but not as critical as severe hypoglycemia. D: Blue-tinged hands and feet - Could indicate poor circulation, but hypoglycemia is more urgent to address.

Correct Answer: A

Rationale: The correct answer is A: Severe small for gestational age (SGA) infant, as they have limited glycogen stores and are at higher risk for hypoglycemia. SGA infants often have poor growth in utero, leading to decreased nutrient reserves. This puts them at increased risk for low blood sugar levels after birth. Incorrect choices: B: Appropriate for gestational age infants typically have adequate glycogen stores and are at lower risk for hypoglycemia. C: Infants of diabetic mothers with good maternal glucose control are less likely to have hypoglycemia due to stable blood sugar levels in utero. D: Cold-stressed term infants may have transient hypoglycemia, but they are not at the greatest risk compared to severe SGA infants.