When assessing a newborn with respiratory distress syndrome who received synthetic surfactant, which parameter should the nurse monitor to evaluate the newborn's condition?

Correct Answer: A

Rationale: The correct answer is A: Oxygen saturation. Monitoring oxygen saturation is crucial in evaluating the newborn's respiratory status post-surfactant administration. It helps assess the effectiveness of surfactant therapy in improving oxygenation. Body temperature and serum bilirubin are not directly related to assessing respiratory distress syndrome. Heart rate may be affected by various factors and may not provide specific information on respiratory status.

Correct Answer: A

Rationale: The correct answer is A: This is more commonly seen in newborns who have dark skin. The bluish-brown marking described is likely a Mongolian spot, a common birthmark in darker-skinned infants. It is not related to hyperbilirubinemia (jaundice), forceps marks, or birth trauma. Mongolian spots are benign and typically fade over time. This statement is correct as it addresses the specific characteristic of the marking and its association with dark skin pigmentation in newborns.

Correct Answer: D

Rationale: The correct answer is D (All of the Above). Epidural anesthesia can increase the risk of urinary retention leading to UTIs. Urinary bladder catheterization can introduce pathogens into the urinary tract. Frequent pelvic examinations can disrupt the natural flora and introduce bacteria. Therefore, all the conditions listed can contribute to an increased risk of urinary tract infections. The other choices (A, B, C) are incorrect because each of them individually presents a risk factor for UTIs, and selecting only one or two choices would not encompass the full range of risk factors that the healthcare professional should include in the teaching.

Correct Answer: B

Rationale: The correct answer is B: Weakened uterine contractions. Terbutaline is a tocolytic medication that inhibits uterine contractions. This helps prevent preterm labor. At 28 weeks of gestation, the nurse would expect terbutaline to weaken uterine contractions, rather than increase fetal heart rate (choice A), enhance fetal lung surfactant production (choice C), or lower maternal blood glucose levels (choice D). Weakening of uterine contractions is the expected therapeutic effect of terbutaline in this scenario to delay preterm labor.

Correct Answer: D

Rationale: The correct answer is D: Covering the newborn's head with a cap. This is the highest priority as newborns are at risk for heat loss due to their large head surface area. By covering the newborn's head with a cap, heat loss can be minimized, helping to maintain the baby's body temperature. This is crucial for the newborn's overall well-being and to prevent complications such as hypothermia. Initiating breastfeeding (A) is important for newborn nutrition but can be delayed slightly without immediate harm. Performing the initial bath (B) can also wait as it is not as urgent as maintaining the newborn's temperature. Giving a vitamin K injection (C) is important for blood clotting but can be done after ensuring the baby's temperature is stable.

Correct Answer: D

Rationale: The correct answer is D: Wide skull sutures. Small for gestational age (SGA) newborns may have wide skull sutures due to reduced skull growth in utero. This is because their growth was restricted, leading to smaller head size and delayed closure of skull sutures. A, B, and C are incorrect: A: Moist skin is not a typical finding associated with being small for gestational age. B: Protruding abdomen is more commonly seen in conditions like gastroschisis or omphalocele, not necessarily SGA. C: Gray umbilical cord color is not specifically linked to being small for gestational age.

Correct Answer: C

Rationale: Rationale: C is correct because keeping the nipple full of formula throughout the feeding helps prevent the baby from swallowing air, reducing the risk of gas and colic. A is incorrect because burping should be done mid-feeding. B is incorrect because newborns should be held in an upright position while feeding to prevent choking. D is incorrect because unused formula should be discarded within 1-2 hours, not refrigerated.

Correct Answer: C

Rationale: The correct answer is C: Sore nipple with cracks and fissures. This is indicative of possible breastfeeding issues like improper latch or infection, requiring prompt intervention to prevent complications. Scant, non-odorous white vaginal discharge (A) is normal postpartum lochia. Uterine cramping during breastfeeding (B) is common due to oxytocin release. Decreased response with sexual activity (D) is a common postpartum concern but not an urgent issue at 4 weeks. Addressing sore nipples promptly is crucial for successful breastfeeding and maternal well-being.

Correct Answer: B

Rationale: The correct answer is option B: Palpate the fundus of the uterus. This technique helps the nurse identify the fetal lie by feeling for the position of the baby's head or buttocks at the top of the uterus. By palpating the fundus, the nurse can determine whether the baby is in a vertex (head down) or breech (head up) position. This method is effective in assessing the fetal lie as it provides direct information about the baby's orientation within the uterus. Option A is incorrect because applying palms to the sides of the uterus does not specifically help identify the fetal lie. Option C is incorrect as grasping the lower uterine segment does not provide information on the fetal lie. Option D is incorrect because standing facing the client's feet with fingertips outlining cephalic prominence is not a technique used to determine fetal lie.