Which factor does not influence bilirubin levels in the infant?

Correct Answer: D

Rationale: The correct answer is D: Birth trauma. Birth trauma does not directly influence bilirubin levels in infants. Prematurity can lead to immature liver function affecting bilirubin metabolism. Maternal diabetes can lead to increased risk of neonatal jaundice. Exclusively breastfeeding can lead to breastfeeding jaundice due to inadequate milk intake. Therefore, birth trauma is the only option that does not directly impact bilirubin levels in infants.

Correct Answer: C

Rationale: The correct answer is C because the newborn has both type A blood (from the mother) and O+ blood (from the father), leading to a higher risk of jaundice due to ABO incompatibility. The presence of nuchal cord x2 and the use of forceps during delivery also increase the risk of newborn jaundice. Choice A is incorrect because the mother's age and use of Pitocin do not inherently increase the risk of jaundice. Choice B is incorrect because the baby being born at home and the timing of the umbilical cord cutting are not directly related to jaundice risk. Choice D is incorrect because the method of delivery and the father's unknown blood type do not specifically indicate a high risk of jaundice compared to the scenario in Choice C.

Correct Answer: D

Rationale: The correct answer is D: Increased respiratory rate. When a newborn experiences respiratory obstruction, they will initially exhibit an increased respiratory rate as their body tries to compensate for the lack of oxygen. This is a natural response to try to increase oxygen intake. Gagging (choice A) and vomiting (choice B) may occur as secondary symptoms if the obstruction persists. Decreased heart rate (choice C) is unlikely to be the first sign, as the body typically prioritizes ensuring oxygen supply to vital organs such as the brain. Therefore, the increased respiratory rate is the most immediate and crucial sign to indicate respiratory obstruction in a newborn.

Correct Answer: A

Rationale: The correct answer is A. An infant with a blood glucose level of 45 mg/dL and a maternal history of gestational diabetes should be assessed first to rule out hypoglycemia, which can be life-threatening in newborns. Hypoglycemia can lead to seizures, brain damage, or even death if not promptly treated. Infants born to mothers with gestational diabetes are at higher risk for hypoglycemia due to their own insulin production in response to high maternal glucose levels. Therefore, immediate assessment and intervention are crucial. Choice B is incorrect because growth parameters within normal ranges do not indicate an immediate need for assessment. Choice C is also incorrect as the mother's age and gestational age do not necessarily indicate an urgent need for assessment. Choice D is incorrect as the presence of a green stain and bruising may indicate meconium aspiration syndrome, but hypoglycemia poses a more immediate threat to the infant's health.

Correct Answer: C

Rationale: The correct answer is C because being in the 90th percentile for weight as an infant does not necessarily mean the weight is appropriate or average (choice A) or that the infant is LGA (choice B). Choice D is incorrect because being in the 90th percentile means the infant's weight is greater than 90% of other infants, not less. Choice C is correct because research shows that infants in the 90th percentile for weight are more likely to be overweight as adults due to potential genetic factors and lifestyle habits developed early in life.