Low maternal serum α-fetoprotein (MSAFP) is associated with

Correct Answer: B

Rationale: In pediatric nursing, understanding maternal serum α-fetoprotein (MSAFP) levels is crucial for early detection of certain fetal abnormalities. A low MSAFP level is associated with trisomy 21, also known as Down syndrome. This is because fetuses with trisomy 21 often have lower levels of MSAFP due to impaired placental functioning. Option A, open neural tube defects, are associated with high MSAFP levels, not low. Options C and D, gastroschisis and omphalocele, are related to defects in the abdominal wall and are not typically linked to MSAFP levels. Educationally, knowing the correlation between MSAFP levels and specific fetal abnormalities helps nurses provide anticipatory guidance to families, facilitating early interventions and support. This knowledge also underscores the importance of prenatal screening and the role of healthcare providers in guiding families through potential diagnoses.

Correct Answer: D

Rationale: In the case of Respiratory Distress Syndrome (RDS) in neonates, the basic defect requiring treatment is inadequate pulmonary exchange of oxygen and carbon dioxide, which is correctly identified in option D. RDS, also known as Hyaline Membrane Disease, occurs due to a lack of surfactant in the immature lungs of preterm infants, leading to difficulty in oxygen uptake and carbon dioxide removal. Option A, metabolic acidosis, is incorrect because though it can be a consequence of inadequate oxygen exchange, it is not the primary defect in RDS. Option B, circulatory insufficiency, is also incorrect as the main issue in RDS lies within the lungs, affecting gas exchange, not the overall circulation. Option C, hypothermia, is unrelated to the pathophysiology of RDS. In an educational context, understanding the pathophysiology of RDS is crucial for pediatric nurses as they care for neonates at risk. Recognizing the primary defect guides appropriate interventions such as oxygen therapy, mechanical ventilation, and surfactant replacement therapy, which are vital in managing RDS and improving outcomes for these vulnerable patients.

Correct Answer: B

Rationale: In the context of pediatric nursing practice, understanding congenital diaphragmatic hernia (CDH) and its associated anomalies is crucial for providing comprehensive care to infants affected by this condition. In this question, the correct answer is B) CNS lesions. The correct answer is B because CNS lesions are not typically associated with CDH. CDH primarily affects the respiratory system, leading to pulmonary hypoplasia as a common complication. Cardiovascular lesions are also frequently seen in CDH cases due to the impact on the developing heart and blood vessels. Esophageal atresia can occur concurrently with CDH due to the malformation of the diaphragm. Educationally, it is important to highlight the diverse range of anomalies that can coexist with CDH to prepare nurses to anticipate and manage potential complications in affected infants. By understanding the typical and atypical associations, nurses can contribute to early detection, intervention, and holistic care for infants with CDH, optimizing outcomes and promoting family-centered care.

Correct Answer: D

Rationale: In pediatric nursing, understanding the therapeutic effect of phototherapy is crucial in managing conditions like neonatal jaundice. The correct answer, D) in vivo metabolism and excretion of bilirubin, is not a factor that directly influences the effectiveness of phototherapy. Phototherapy works by converting bilirubin into water-soluble forms that can be excreted easily, regardless of the infant's metabolism and excretion rates. A) The distance between the lights and the infant is crucial as it determines the intensity of the light reaching the infant's skin, impacting the effectiveness of the treatment. B) Skin color plays a role as infants with darker skin may require different light wavelengths or longer exposure times for phototherapy to be effective. C) The surface area of exposed skin is important as a larger area exposed to the light ensures more bilirubin breakdown and elimination. Educationally, knowing these factors helps nurses optimize phototherapy treatment for neonatal jaundice. Understanding why certain factors matter and others do not guides clinical decision-making and promotes safe and effective pediatric nursing practice.

Correct Answer: D

Rationale: In pediatric nursing practice, understanding the implications of maternal diabetes on newborns is crucial. The correct answer, option D, states that the incidence of congenital anomalies is increased threefold in infants of diabetic mothers. This is true, as infants born to diabetic mothers have a higher risk of congenital anomalies due to the impact of maternal hyperglycemia on fetal development. Option A, stating that hypoglycemia develops in about 25-50% of infants, is true and is a common complication due to the abrupt cessation of the continuous glucose supply from the mother at birth. Option B, mentioning increased weight of the placenta and all infant organs, is also true as maternal diabetes can lead to fetal macrosomia, resulting in larger-than-average organs and placenta. Option C, which mentions that heart failure occurs in 5-10% of infants of diabetic mothers, is incorrect. While infants of diabetic mothers are at risk for various complications, heart failure is not a common occurrence in this population. Educationally, understanding these facts is essential for pediatric nurses to provide optimal care for infants of diabetic mothers. By knowing the potential complications, nurses can anticipate and provide appropriate interventions to promote the health and well-being of these newborns. This knowledge underscores the importance of thorough maternal health assessments and close monitoring of infants born to diabetic mothers to mitigate risks and ensure positive outcomes.