Sudden onset of hypotension in a very low birthweight (VLBW) infant suggests

Correct Answer: C

Rationale: In a very low birthweight (VLBW) infant, the sudden onset of hypotension suggests bacterial sepsis (option C). This is because bacterial sepsis is a common and serious condition in premature infants, leading to systemic inflammatory response syndrome which can cause hypotension. Option A, pneumothorax, typically presents with respiratory distress, not isolated hypotension. Option B, necrotizing enterocolitis, often presents with abdominal distension, bloody stools, and signs of systemic illness rather than just hypotension. Option D, hypoglycemia, may cause symptoms like jitteriness or poor feeding but is less likely to cause sudden isolated hypotension without other signs. Educationally, understanding the differential diagnosis of a sudden onset of hypotension in a VLBW infant is crucial for pediatric nurses to provide prompt and appropriate care. Recognizing the signs of bacterial sepsis early can lead to timely interventions such as initiating antibiotics or fluid resuscitation, potentially preventing serious complications in these vulnerable infants.

Correct Answer: D

Rationale: Rationale: The correct answer is D) usually occurs in preterm or near-term infants. Meconium aspiration syndrome (MAS) typically affects term or post-term infants, not preterm or near-term infants. This statement is incorrect as MAS is more commonly associated with infants born at or beyond full term. Option A is incorrect because MAS actually develops in approximately 10% of meconium-stained infants, not 5%. Option B is inaccurate as about 15-30% of infants with MAS require mechanical ventilation due to respiratory distress caused by meconium blocking the airways. Option C is sadly true, with a mortality rate of around 3-5% for infants with MAS. Educational Context: Understanding MAS is crucial for pediatric nurses as it is a serious respiratory condition that can lead to significant morbidity and mortality in newborns. Nurses must be able to identify the risk factors, signs, and symptoms of MAS to provide prompt and appropriate care. By knowing the correct information about MAS, nurses can intervene effectively and improve outcomes for these vulnerable patients.

Correct Answer: C

Rationale: In pediatric nursing, understanding the causes of jaundice is crucial for early detection and appropriate management. In this question, option C is the correct answer because a serum bilirubin level of >12 mg/dL in a full-term infant is a normal physiological response within the first few days of life and does not necessarily indicate a pathological condition requiring further investigation. Option A is incorrect because jaundice appearing in the first 24-36 hours of life, known as physiological jaundice, is common and usually resolves without intervention. Option B is incorrect as a rising serum bilirubin level at a rate faster than 5 mg/dL/24 hours may indicate hemolysis or other pathological conditions that warrant further investigation. Option D is incorrect because a direct bilirubin fraction >1 mg/dL at any time may indicate liver pathology and requires further evaluation. Educationally, this question highlights the importance of differentiating between physiological and pathological jaundice in neonates. It reinforces the need for healthcare providers to understand normal variations in bilirubin levels in newborns and to only investigate further when specific criteria suggestive of underlying pathology are met, thus avoiding unnecessary interventions and parental anxiety.

Correct Answer: B

Rationale: In the neonatal period, generalized edema can be associated with various medical conditions. In the context of the question, the correct answer is B) Turner syndrome. Turner syndrome is a genetic disorder that affects females, leading to lymphedema, which can present as generalized edema. A) Congenital nephrosis is incorrect because it is a kidney disorder characterized by protein loss in the urine, leading to edema. C) Hurler syndrome is incorrect as it is a mucopolysaccharidosis disorder causing skeletal deformities and organ enlargement, but not specifically generalized edema. D) Hydrops fetalis is incorrect as it refers to severe edema in a fetus or newborn due to various causes such as heart failure or hemolytic disease, not necessarily a neonatal condition causing generalized edema. Educationally, understanding the differential diagnosis of neonatal edema is crucial for pediatric nurses to provide appropriate care and interventions. Recognizing specific conditions associated with edema helps in early identification, prompt treatment, and improved outcomes for neonates. This knowledge enhances the nurse's ability to assess, plan, and intervene effectively in neonatal care settings.

Correct Answer: A

Rationale: The correct answer is A) Cytomegalovirus. Osteitis, which is inflammation of the bone, can be a feature of congenital cytomegalovirus infection in infants. Cytomegalovirus can be transmitted transplacentally from the mother to the fetus during pregnancy, leading to various manifestations including osteitis. Option B) Herpes simplex virus is incorrect because while it can cause neonatal herpes with central nervous system involvement, it is not typically associated with osteitis. Option C) Varicella-zoster virus is incorrect as it is known to cause chickenpox and shingles, but osteitis is not a common feature of these infections. Option D) Rubella is also incorrect because congenital rubella syndrome can lead to various abnormalities, but osteitis is not typically associated with rubella infection. In an educational context, understanding the manifestations of different transplacental infections is crucial for pediatric nurses to provide comprehensive care to infants. Recognizing the specific features of each infection helps in early diagnosis and appropriate management to improve outcomes for affected infants.