The incidence of all the following are increased in large for gestational age newborn EXCEPT

Correct Answer: D

Rationale: In pediatric nursing, understanding the implications of large for gestational age (LGA) newborns is crucial for providing appropriate care. The correct answer, D) developmental retardation, is not typically increased in LGA newborns. LGA infants are born with excessive weight, which can lead to various complications, but developmental retardation is not directly associated with being LGA. Option A) cephalohematoma may be increased in LGA newborns due to the trauma during birth caused by the baby's size. Option B) hypocalcemia and C) hypoglycemia are common in LGA infants due to the metabolic demands placed on their bodies. These conditions often result from the baby's body being unable to regulate blood sugar and calcium levels effectively, leading to potential complications. Educationally, this question highlights the importance of understanding the risks and complications associated with LGA newborns. Nurses need to be able to recognize these potential issues early to provide timely interventions and prevent further complications. By grasping the differences in care needs for LGA infants, nurses can improve outcomes and ensure comprehensive care for these vulnerable patients.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding chest radiograph findings in newborns, especially related to conditions like transient tachypnea of the newborn (TTN), is crucial for accurate diagnosis and management. The correct answer, D) diffuse reticulogranular pattern, is false in the chest radiograph of TTN. This is because a diffuse reticulogranular pattern is typically seen in conditions like respiratory distress syndrome (RDS) and meconium aspiration syndrome, not TTN. A) Prominent pulmonary vascular markings are often seen in TTN due to retained fetal lung fluid, which is a characteristic feature. B) Fluid in the intralobar fissures can be present in TTN due to delayed reabsorption of lung fluid. C) Overaeration is also a common finding in TTN due to increased respiratory effort. Educationally, understanding these radiographic findings helps nurses differentiate between different respiratory conditions in newborns, guiding appropriate interventions and treatments. It emphasizes the importance of thorough assessment and interpretation of diagnostic tests in pediatric nursing practice.

Correct Answer: D

Rationale: The correct answer is D) congenital infections. Jaundice appearing at birth or within the first 24 hours of life is known as neonatal jaundice. It is primarily caused by the accumulation of unconjugated bilirubin due to the immature liver function in newborns. A) Erythroblastosis fetalis is a condition where maternal antibodies attack fetal red blood cells, leading to hemolysis and subsequent jaundice due to increased bilirubin levels. B) Crigler-Najjar syndrome is a rare genetic disorder that impairs the liver's ability to process bilirubin, resulting in severe jaundice. C) Concealed hemorrhage, such as cephalohematoma or subgaleal hemorrhage, can lead to excess bilirubin production due to the breakdown of blood, contributing to jaundice in newborns. Educational context: Understanding the etiology of neonatal jaundice is crucial for pediatric nurses to provide timely interventions and support to infants at risk. Recognizing the different causes of jaundice helps in early detection and appropriate management to prevent complications like kernicterus.

Correct Answer: C

Rationale: In pediatric nursing, understanding the indications for surgical repair of umbilical hernia is crucial for providing safe and effective care to pediatric patients. In this case, the correct answer is option C: "Hernias that appear before the age of 6 months." The rationale behind this is that umbilical hernias that present before the age of 6 months often resolve spontaneously without the need for surgical intervention. This is because during the first few months of life, the umbilical ring typically closes naturally as the abdominal muscles strengthen, leading to the resolution of the hernia. Option A ("If hernia persists to the age of 4-5 years") is incorrect because waiting until this age range without symptoms or complications does not necessarily warrant surgical intervention. Many umbilical hernias will resolve on their own before this age. Option B ("Causes symptoms") is incorrect because the presence of symptoms such as pain or protrusion alone may not always necessitate surgery. Symptomatic hernias may require intervention, but the mere presence of symptoms is not a blanket indication for surgical repair. Option D ("Becomes strangulated") is incorrect because a hernia becoming strangulated is a medical emergency that requires immediate surgical intervention to prevent complications such as tissue necrosis. Waiting for a hernia to become strangulated is not a safe or recommended approach to management. Educationally, it is important for healthcare providers to be knowledgeable about the natural history of umbilical hernias in pediatric patients to avoid unnecessary interventions. Monitoring the hernia's size, appearance, and any associated symptoms is crucial in determining the appropriate course of action, whether it be surgical repair or conservative management. This understanding ensures safe and evidence-based care for pediatric patients with umbilical hernias.

Correct Answer: B

Rationale: In a cohort of 6,215 VLBW infants, gram-positive agents were associated with 70% of cases of late-onset sepsis. The correct answer is B) 70%. Rationale: Gram-positive agents, such as Staphylococcus epidermidis and Streptococcus species, are commonly implicated in late-onset sepsis in VLBW infants due to their vulnerability to infections. These organisms can easily colonize the skin and mucous membranes, leading to bloodstream infections. The statistic of 70% indicates the significant role of gram-positive agents in causing sepsis in this population. Option A) 90% is incorrect because it overestimates the percentage of cases associated with gram-positive agents. While they are common culprits, they do not account for such a high majority of cases. Option C) 50% is incorrect as it underestimates the prevalence of gram-positive agents in late-onset sepsis in VLBW infants. The actual percentage is higher than this. Option D) 30% is incorrect as it also underestimates the role of gram-positive agents in causing late-onset sepsis. The correct percentage is higher than 30%. Educational Context: Understanding the microbial etiology of late-onset sepsis in VLBW infants is crucial for nurses and healthcare providers working in neonatal care settings. Recognizing the common pathogens involved, such as gram-positive agents, helps in prompt diagnosis and appropriate treatment to improve outcomes for these vulnerable infants. This knowledge underscores the importance of infection control practices and antimicrobial stewardship in preventing and managing sepsis in this population.