Neonates of mothers with diabetes are at risk for which complication following birth?

Correct Answer: D

Rationale: Neonates of mothers with diabetes are at risk for macrosomia following birth. Macrosomia refers to a condition where the newborn baby is significantly larger than average, typically weighing more than 4,000 grams (8 pounds, 13 ounces) at birth. This risk is primarily due to maternal hyperglycemia, which can lead to excessive fetal growth. The elevated glucose levels in the maternal circulation can cross the placenta and stimulate fetal insulin production, resulting in increased growth and potentially leading to macrosomia. Neonates born with macrosomia are at increased risk for complications during delivery, such as shoulder dystocia, birth injuries, and the need for cesarean delivery.

Correct Answer: D

Rationale: The symptoms described (nuchal rigidity, fever, vomiting, and lethargy) suggest possible meningitis, which is an inflammation of the meninges, the membranes surrounding the brain and spinal cord. One of the key diagnostic tests for meningitis is a lumbar puncture, also known as a spinal tap. During a lumbar puncture, cerebrospinal fluid (CSF) is collected from the space around the spinal cord and analyzed for signs of infection, inflammation, or other abnormalities. This test helps confirm or rule out a diagnosis of meningitis and identify the specific infectious agent causing the illness. Other tests, such as blood cultures, may also be done to further evaluate the infection, but a lumbar puncture is essential for diagnosing meningitis in this case.

Correct Answer: A

Rationale: In diagnosing seizure disorder, the most beneficial diagnostic test is an Electroencephalogram (EEG). An EEG is a non-invasive test that records electrical activity in the brain. It is crucial for detecting abnormal brain wave patterns associated with seizures. Skull radiographs, brain scans, and lumbar punctures are not typically used as primary tests for diagnosing seizure disorders. A brain scan may be helpful in identifying structural abnormalities that could be causing seizures, but an EEG is more specific for detecting abnormal electrical activity associated with seizures.

Correct Answer: B

Rationale: Developmental dysplasia of the hip (DDH) is a condition where the hip joint does not properly form in babies and young children. To assess for DDH, healthcare professionals like Nurse Kevin utilize the Ortolani test. Ortolani's sign is a physical exam maneuver where the healthcare provider will gently manipulate the baby's hips to detect if there is a dislocated hip joint. Specifically, the Ortolani maneuver checks for the presence of a "clunk" as the femoral head relocates into the acetabulum, indicating that the hip joint is dislocated. Therefore, during the assessment of a newborn for DDH, Nurse Kevin would expect to assess for Ortolani's sign as it helps in the diagnosis of developmental dysplasia of the hip.

Correct Answer: C

Rationale: Failure to pass meconium within the first 24 hours after birth is a characteristic sign of Hirschsprung's disease. This condition is a congenital disorder in which there is a lack of ganglion cells in certain portions of the large intestine. As a result, the affected segment of the bowel is unable to relax and pass stool, leading to the accumulation of meconium in the intestine. This condition can present with symptoms such as abdominal distension, constipation, and failure to pass stool. Early diagnosis and treatment are crucial to prevent complications such as bowel perforation.