True umbilical cord knots are seen in approximately 1% of births and are associated with the following conditions EXCEPT

Correct Answer: A

Rationale: In this question, the correct answer is option A) short cord. True umbilical cord knots are indeed seen in approximately 1% of births. A short cord is not typically associated with umbilical cord knots. Option B) small fetal size is incorrect because smaller fetuses may have more room in the womb, increasing the likelihood of cord entanglement and knots. Option C) polyhydramnios is incorrect because excess amniotic fluid can lead to increased fetal movement, which in turn may result in cord twisting and knotting. Option D) fetal demise is incorrect as true umbilical cord knots do not always result in fetal demise; some cases may be asymptomatic or lead to complications like decreased fetal movement. Educationally, this question highlights the importance of understanding the various factors that can impact pregnancy outcomes. It emphasizes the need for healthcare providers, especially pediatric nurses, to be aware of potential complications such as umbilical cord knots and their associations with different prenatal conditions. This knowledge can aid in early detection, monitoring, and appropriate interventions to promote positive maternal and fetal health outcomes.

Correct Answer: D

Rationale: Rationale: The correct answer is D) reduces bronco-pulmonary dysplasia (BPD) rates. Prophylactic and rescue administrations of synthetic and natural surfactants in neonates with respiratory distress syndrome have been shown to provide numerous benefits, including reducing adverse outcomes, reducing neonatal mortality, and decreasing the risk for pneumothorax. However, the evidence supporting a significant reduction in BPD rates with surfactant therapy is not as strong. Reducing adverse outcomes, neonatal mortality, and pneumothorax are well-documented advantages of surfactant administration in premature infants with respiratory distress. These benefits are supported by numerous studies and are key reasons why surfactant therapy is a standard of care in neonatal intensive care units. Educationally, understanding the benefits and limitations of surfactant therapy is crucial for pediatric nurses caring for neonates with respiratory distress syndrome. By recognizing the advantages and potential limitations of surfactant therapy, nurses can provide more informed and effective care to their patients. It is important to stay updated on the latest evidence-based practices to ensure the best outcomes for neonates in their care.

Correct Answer: C

Rationale: In the context of a pediatric nurse exam, understanding the poor prognostic signs of congenital diaphragmatic hernia (CDH) is crucial for providing effective care to infants. Option C, early respiratory distress within 6 hours of life, is the correct answer because it indicates severe respiratory compromise and is associated with a higher mortality rate in infants with CDH. This early onset of respiratory distress is due to the herniation of abdominal contents into the thoracic cavity, leading to lung hypoplasia and pulmonary hypertension. Option A, grunting, and option B, use of accessory muscles, are common signs of respiratory distress in infants but are not specific to CDH. These signs can be seen in various respiratory conditions in neonates and do not specifically indicate CDH. Option D, a scaphoid abdomen, is a physical finding seen in infants with CDH due to the displacement of abdominal contents into the chest, but it is not as specific or as significant of a prognostic indicator as early respiratory distress. Educationally, this question helps reinforce the importance of recognizing early signs of respiratory distress in infants with CDH. Understanding the unique challenges and complications associated with CDH is essential for pediatric nurses to provide timely and appropriate interventions to improve outcomes for these vulnerable patients.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding hemolytic disease of the newborn (erythroblastosis fetalis) is crucial. The correct answer, D) low white blood cell count, is the exception in this scenario. In hemolytic disease of the newborn, there is an increase in the destruction of red blood cells, leading to anemia. As a compensatory mechanism, the bone marrow produces more red blood cells, resulting in polychromasia (option A), an increased reticulocyte count (option B), and a marked increase in nucleated red blood cells (option C) on the blood smear. A low white blood cell count, as stated in option D, is not a typical finding in hemolytic disease of the newborn. White blood cells are primarily involved in the body's immune response and are not directly affected by the hemolysis of red blood cells in this condition. Recognizing these characteristic blood smear findings is essential for nurses caring for infants with hemolytic disease of the newborn to provide appropriate interventions and monitor the infant's response to treatment effectively. Educationally, this question helps reinforce the importance of understanding the pathophysiology of hemolytic disease of the newborn and the interpretation of blood smear results in pediatric nursing practice. By explaining why the correct answer is right and why the other options are incorrect, nurses can enhance their knowledge and critical thinking skills, ultimately improving their ability to provide quality care to pediatric patients.

Correct Answer: C

Rationale: The correct answer is C) Achondroplasia. Chromosomal causes of congenital malformations refer to genetic disorders that result from abnormalities in the structure or number of chromosomes. Achondroplasia is caused by a mutation in the FGFR3 gene on chromosome 4, leading to dwarfism and characteristic skeletal abnormalities. This condition is a classic example of a chromosomal cause of congenital malformation. A) Prader-Willi syndrome is a genetic disorder caused by the loss of specific genes on chromosome 15, resulting in intellectual disability, obesity, and other physical and behavioral issues. While it is a genetic disorder, it is not specifically a chromosomal cause of congenital malformations. B) X-linked hydrocephalus is a condition associated with mutations on the X chromosome that lead to an abnormal buildup of cerebrospinal fluid in the brain. While it is a genetic disorder, it is not a chromosomal cause of congenital malformations. D) Treacher Collins syndrome is a genetic disorder caused by mutations in the TCOF1, POLR1C, or POLR1D genes, not by chromosomal abnormalities. It results in craniofacial deformities such as underdeveloped facial bones and structures. While it is a genetic disorder, it is not a chromosomal cause of congenital malformations. Understanding the distinction between chromosomal causes of congenital malformations and other genetic disorders is crucial for healthcare professionals, especially pediatric nurses, as it helps in accurately diagnosing and managing patients with these conditions. Recognizing the specific genetic basis of a disorder can guide treatment decisions and provide valuable information for families regarding recurrence risks and genetic counseling.