What complication can result from untreated respiratory distress in the newborn?

Correct Answer: D

Rationale: In newborns, untreated respiratory distress can lead to the reopening of the foramen ovale. The foramen ovale is a normal fetal structure that allows blood to bypass the lungs since the fetus receives oxygen from the placenta. After birth, this opening should ideally close as the newborn starts breathing independently. However, if respiratory distress goes untreated, the pressure in the pulmonary circulation remains high, which can cause the foramen ovale to remain open or even reopen. Option A) Esophageal atresia is a congenital condition where the esophagus is not properly connected to the stomach and is unrelated to respiratory distress in the newborn. Option B) Gastric dilation refers to the stomach becoming distended with air or fluid, often due to feeding issues, and is not directly related to untreated respiratory distress. Option C) Cold stress is a condition where a newborn's body temperature drops significantly, typically due to environmental factors, and is not a direct consequence of untreated respiratory distress. Educational Context: Understanding the consequences of untreated respiratory distress in newborns is crucial for healthcare providers involved in neonatal care. Recognizing the potential outcomes of respiratory distress underscores the importance of swift and appropriate interventions to support respiratory function and prevent complications such as the reopening of the foramen ovale, which can impact the cardiovascular system.

Correct Answer: C

Rationale: In educating a patient who has just learned she is pregnant with dizygotic twins, it is crucial to provide accurate information to promote understanding and alleviate any concerns. Option C, stating that dizygotic pregnancies tend to repeat in families, is correct. This information is important as it helps the patient understand the genetic predisposition to dizygotic twinning. Option A is incorrect because dizygotic twins can be the same or different sexes. Option B is incorrect because dizygotic twins typically have separate placentas, though there can be cases where they share a placenta. Option D is incorrect because dizygotic twins can have separate chorions, which are the outermost fetal membrane layers. Educationally, understanding the different types of twinning is important in maternal monitoring as it can impact pregnancy management and monitoring strategies. Providing accurate information empowers the patient to make informed decisions about her prenatal care and helps in addressing any concerns she may have regarding her pregnancy with dizygotic twins.

Correct Answer: B

Rationale: In the context of maternal monitoring for chromosomal abnormalities in the fetus, the best predictor among the options provided is B) Multiple-marker screening. This screening test involves analyzing maternal serum for various markers such as alpha-fetoprotein, human chorionic gonadotropin, unconjugated estriol, and inhibin-A. These markers can indicate an increased risk of chromosomal abnormalities such as Down syndrome. Multiple-marker screening is preferred over the other options for several reasons. Biophysical profile (option A) is a test used to assess fetal well-being and not specifically designed to predict chromosomal abnormalities in the fetus. The lecithin-to-sphingomyelin ratio (option C) is primarily used to assess fetal lung maturity and not for chromosomal abnormalities. Blood type and crossmatch of maternal and fetal serum (option D) are important for assessing blood compatibility but do not directly predict chromosomal abnormalities. Educationally, understanding the rationale behind choosing multiple-marker screening can help students grasp the importance of specific tests in prenatal care. It highlights the significance of using a combination of markers to assess the risk of chromosomal abnormalities, emphasizing the need for a comprehensive approach in maternal monitoring. This knowledge is crucial for healthcare professionals involved in prenatal care to make informed decisions and provide appropriate support and counseling to expectant parents.

Correct Answer: D

Rationale: Amniocentesis is a procedure where amniotic fluid is extracted from the amniotic sac surrounding the fetus. In the context of a patient hospitalized at 34 weeks of gestation with pregnancy-induced hypertension, the primary purpose of amniocentesis would be to determine fetal lung maturity. This information is crucial in deciding whether early delivery is necessary to prevent complications associated with prematurity. Option A, determining if a metabolic disorder exists, is not the primary reason for performing amniocentesis in this scenario. Metabolic disorders are typically assessed through genetic testing or other diagnostic procedures rather than amniocentesis. Option B, identifying the sex of the fetus, is not a valid reason for performing amniocentesis at 34 weeks of gestation in a patient with pregnancy-induced hypertension. The sex of the fetus does not impact the management of the pregnancy in this case. Option C, identifying abnormal fetal cells, is also not the primary purpose of amniocentesis in this context. While amniocentesis can detect genetic abnormalities, the immediate concern in a patient with pregnancy-induced hypertension at 34 weeks would be assessing fetal lung maturity to guide clinical decision-making. Educationally, understanding the rationale behind the use of specific diagnostic procedures like amniocentesis in different clinical scenarios is crucial for healthcare providers involved in the care of pregnant women. It highlights the importance of timely and accurate assessments to ensure optimal outcomes for both the mother and the fetus.

Correct Answer: C

Rationale: In the context of maternal monitoring and chorionic villus sampling (CVS) in pregnancy, the correct answer is C) RhoGAM if the patient is Rh-negative. RhoGAM is administered to Rh-negative pregnant women to prevent the development of Rh incompatibility, which can lead to hemolytic disease of the newborn. CVS involves obtaining a sample of the placental tissue for genetic testing, which can pose a risk of fetal-maternal hemorrhage. If the mother is Rh-negative and the fetus is Rh-positive, there is a risk of sensitization to Rh antigens, which could affect future pregnancies. Administering RhoGAM helps prevent the mother's immune system from forming antibodies against Rh-positive blood, thus protecting future pregnancies from hemolytic disease. A) Magnesium sulfate is commonly used to prevent seizures in preeclampsia and eclampsia, not routinely administered in the context of CVS. B) Prostaglandin suppository is not indicated for CVS and is more commonly used for cervical ripening or induction of labor. D) Betamethasone is a steroid given to pregnant women at risk of preterm delivery to enhance fetal lung maturation, not typically given in the context of CVS for genetic testing. Understanding the rationale behind the administration of RhoGAM in the context of CVS is crucial for nurses and healthcare providers involved in maternal monitoring to ensure the safety and well-being of both the mother and the fetus.