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 can lead to systemic inflammatory response syndrome (SIRS) which can result in hypotension. Sepsis is a serious condition in infants that requires prompt recognition and treatment to prevent complications. Option A, pneumothorax, typically presents with respiratory distress rather than hypotension. Option B, necrotizing enterocolitis, may present with abdominal distension and bloody stools but is less likely to cause sudden hypotension. Option D, hypoglycemia, can cause symptoms such as lethargy and poor feeding but is less likely to be the primary cause of sudden hypotension in this scenario. Educationally, it is crucial for pediatric nurses to understand the different conditions that can present in VLBW infants and recognize the signs and symptoms of each. This knowledge helps in early identification, appropriate interventions, and prevention of adverse outcomes in these vulnerable patients. Understanding the specific clinical manifestations of various conditions is essential for providing safe and effective care to neonates in the pediatric setting.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding meconium aspiration syndrome (MAS) is crucial for providing effective care to infants. The correct answer, D, is that MAS usually occurs in preterm or near-term infants. This is because meconium passage in utero typically happens in post-term infants. Therefore, MAS is less common in full-term infants. Option A is incorrect because MAS develops in about 5-10% of meconium-stained infants, not just 5%. Option B is inaccurate as only about 10-15% of infants with MAS require mechanical ventilation, not 30%. Option C states that 3-5% of infants die from MAS, which is true, highlighting the potential severity of the condition. Educationally, this question emphasizes the importance of recognizing MAS risk factors and outcomes. It underscores the need for nurses to provide prompt and appropriate care for infants at risk of MAS, including monitoring and support for respiratory distress. Understanding MAS helps nurses deliver evidence-based care and advocate for the best outcomes for pediatric patients.

Correct Answer: C

Rationale: In pediatric nursing, understanding the causes of jaundice is crucial for early detection and appropriate management. In this scenario, option C, "if serum bilirubin is >12 mg/dL in a full-term infant," is the correct answer. This is because physiological jaundice, which is common in newborns, typically presents with serum bilirubin levels below 12 mg/dL in full-term infants. Option A is incorrect because jaundice appearing in the first 24-36 hours of life could indicate pathological causes and warrants investigation. Option B is incorrect as a rapid rise in serum bilirubin levels suggests an underlying issue that needs to be addressed. Option D is also incorrect as an elevated direct bilirubin fraction suggests possible liver pathology that requires further evaluation. Educationally, this question highlights the importance of recognizing normal physiological changes in newborns versus pathological conditions. It emphasizes the need for healthcare providers to conduct thorough assessments and investigations when jaundice presents in certain contexts to ensure timely and appropriate interventions.

Correct Answer: B

Rationale: In the context of pediatric nursing, understanding the causes of generalized edema in the neonatal period is crucial for providing effective care to infants. In this question, the correct answer is B) Turner syndrome. Turner syndrome is a genetic condition caused by partial or complete absence of one of the X chromosomes in females. While individuals with Turner syndrome may have various health issues, generalized edema is not a common feature of this syndrome. Therefore, B is the correct answer. A) Congenital nephrosis is a condition characterized by protein loss through the kidneys, leading to edema, making it an incorrect option in this scenario. C) Hurler syndrome is a rare genetic disorder that affects metabolism and can lead to various symptoms, including skeletal abnormalities and organ enlargement, but not necessarily generalized edema, making it an incorrect option. D) Hydrops fetalis is a serious fetal condition characterized by abnormal accumulation of fluid in two or more fetal compartments. This condition can present with marked generalized edema, making it an incorrect option in this context. Educationally, this question helps reinforce the importance of recognizing the varied presentations of different conditions in neonates. By understanding the specific features associated with each condition, nurses can provide timely and appropriate care to affected infants.

Correct Answer: A

Rationale: In pediatric nursing, understanding transplacental infections is crucial as they can have significant implications for the fetus. Osteitis, inflammation of the bone, can be a feature of transplacental infections. In this scenario, the correct answer is A) Cytomegalovirus. Cytomegalovirus (CMV) is a common viral infection that can be transmitted from mother to fetus through the placenta. It is known to cause various congenital abnormalities, including osteitis. CMV can affect multiple organs, including bones, leading to skeletal issues in affected infants. Regarding the other options: - B) Herpes simplex virus: While herpes simplex virus can cause serious infections in newborns, it is not typically associated with osteitis. - C) Varicella-zoster virus: Varicella-zoster virus is responsible for chickenpox and shingles, but it is not commonly linked to osteitis. - D) Rubella: Rubella infection during pregnancy can lead to congenital rubella syndrome, which can involve bone abnormalities, but osteitis specifically is not a common feature. Educational context: Understanding the manifestations of transplacental infections in pediatric nursing is essential for early recognition and appropriate management. Nurses need to be aware of the different pathogens that can affect the fetus and the specific signs and symptoms associated with each infection to provide optimal care for both the mother and the newborn. Being able to differentiate between these infections based on their clinical presentations is crucial for effective nursing practice in the care of infants with congenital infections.