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

Correct Answer: B

Rationale: In pediatric nursing, understanding the significance of maternal serum α-fetoprotein (MSAFP) levels is crucial for identifying potential fetal anomalies. A low MSAFP level is specifically associated with trisomy 21, or Down syndrome. This is because trisomy 21 is characterized by an extra copy of chromosome 21, leading to altered protein production including AFP. Option A, open neural tube defects, is typically associated with elevated MSAFP levels, not low levels. Neural tube defects are linked to inadequate closure of the neural tube during fetal development, leading to increased AFP leakage into the maternal serum. Options C and D, gastroschisis and omphalocele respectively, are abdominal wall defects. These conditions do not show a direct association with MSAFP levels. Gastroschisis involves herniation of abdominal organs through a defect next to the umbilical cord, while omphalocele involves herniation of abdominal organs into the base of the umbilical cord. Educationally, this question highlights the importance of interpreting MSAFP levels in the context of prenatal screening for fetal anomalies. Understanding the specific associations between MSAFP levels and different conditions helps pediatric nurses provide comprehensive care and support to families facing potential diagnoses during pregnancy.

Correct Answer: D

Rationale: In the case of Respiratory Distress Syndrome (RDS) in newborns, the basic defect requiring treatment is inadequate pulmonary exchange of oxygen and carbon dioxide, which is option D. This is because RDS is primarily a condition characterized by surfactant deficiency in the lungs, leading to poor gas exchange. Treatment strategies for RDS focus on improving oxygenation and ventilation to support the infant's respiratory function. Option A, metabolic acidosis, is not the primary defect in RDS. While metabolic acidosis can occur as a result of respiratory distress, it is a secondary effect rather than the underlying cause of RDS. Option B, circulatory insufficiency, is also not the primary defect in RDS. While RDS can lead to complications that affect the circulatory system, such as hypotension, the main issue in RDS is related to respiratory function rather than circulatory problems. Option C, hypothermia, is not the basic defect requiring treatment in RDS. While maintaining appropriate body temperature is important in managing RDS, hypothermia itself is not the primary issue that needs to be addressed in this condition. In an educational context, understanding the underlying pathophysiology of RDS is crucial for nurses caring for newborns with this condition. By recognizing that the main defect is inadequate pulmonary exchange of oxygen and carbon dioxide, nurses can implement appropriate interventions to support respiratory function and improve outcomes for these vulnerable patients. This knowledge allows nurses to provide effective and evidence-based care for infants with RDS, optimizing their chances for recovery.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding congenital diaphragmatic hernia (CDH) and its associated anomalies is crucial for providing comprehensive care to affected infants. In this case, the correct answer is B) CNS lesions, as CNS anomalies are not commonly associated with CDH. Pulmonary hypoplasia is a key feature of CDH due to lung compression in utero, leading to respiratory distress at birth. Esophageal atresia can be present in CDH cases, as the herniation of abdominal contents can affect the development of the esophagus. Cardiovascular lesions are also commonly seen in CDH patients, as the defect can impact cardiac development and function. Educationally, this question serves to reinforce the understanding of common anomalies associated with CDH and the importance of recognizing atypical findings that may suggest additional complications. By differentiating between the expected and unexpected anomalies in CDH cases, nurses can better advocate for appropriate diagnostic and management strategies to optimize patient outcomes.

Correct Answer: D

Rationale: In pediatric nursing, understanding the therapeutic effects of phototherapy is crucial for managing neonatal jaundice effectively. The correct answer, D) in vivo metabolism and excretion of bilirubin, is not a factor that directly influences the therapeutic effect of phototherapy. Phototherapy works by converting unconjugated bilirubin in the skin to water-soluble isomers that can be excreted easily. Therefore, the metabolism and excretion of bilirubin in the body do not determine the efficacy of phototherapy. A) The distance between the lights and the infant is crucial as it determines the intensity of light exposure, which directly impacts the breakdown of bilirubin. B) Skin color plays a role in how quickly bilirubin can be broken down, as darker skin may require longer exposure to achieve the same effect. C) The surface area of exposed skin is important as a larger surface area allows for more efficient absorption of light and thus better treatment outcomes. In an educational context, nurses need to comprehend the principles behind phototherapy to provide safe and effective care to neonates with jaundice. By understanding the factors that influence the therapeutic effect of phototherapy, nurses can make informed decisions regarding treatment protocols and monitor patients effectively to ensure optimal outcomes.

Correct Answer: D

Rationale: In pediatric nursing, understanding the impact of maternal diabetes on infants 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 maternal diabetes poses a higher risk for congenital anomalies in infants due to the effects of hyperglycemia on fetal development. Option A is incorrect as hypoglycemia actually develops in about 25-50% of infants of diabetic mothers due to the sudden drop in glucose levels after birth. Option B is incorrect because while there may be increased weight of the placenta and certain organs, it is not a universal truth for all infant organs. Option C is incorrect as heart failure can occur in 5-10% of infants of diabetic mothers due to the strain on the infant's heart caused by maternal diabetes. Educationally, this question highlights the importance of understanding the specific risks and complications infants of diabetic mothers may face. It emphasizes the need for pediatric nurses to be knowledgeable about how maternal health conditions can impact neonatal outcomes and the importance of vigilant monitoring and care for these infants.