Which of the following is a primary cause of persistent pulmonary hypertension (PPHN) in the newborn?

Correct Answer: C

Rationale: Persistent pulmonary hypertension (PPHN) in newborns is a serious condition characterized by elevated pulmonary vascular resistance. The primary cause of PPHN is vasoconstriction of the pulmonary vasculature (Option C). In PPHN, the pulmonary blood vessels remain constricted, leading to increased pressure in the pulmonary circulation and decreased blood flow to the lungs for oxygenation. This results in persistent hypoxemia, which can be life-threatening for the newborn. Option A (Pulmonary vasodilation) is incorrect because in PPHN, there is vasoconstriction rather than vasodilation of the pulmonary blood vessels. Option B (Impaired oxygenation) is a consequence of PPHN rather than a primary cause. Impaired oxygenation occurs due to the mismatch between ventilation and perfusion caused by the vasoconstriction. Option D (Increased pulmonary blood flow) is also incorrect as PPHN involves decreased blood flow to the lungs due to vasoconstriction. Educationally, understanding the pathophysiology of PPHN is crucial for nurses caring for newborns. Recognizing the primary cause of PPHN can guide appropriate interventions to improve oxygenation and support the newborn's respiratory function. Nurses need to monitor closely for signs of respiratory distress and provide timely interventions to manage PPHN effectively.

Correct Answer: D

Rationale: In the context of Erikson's psychosocial development stages, adolescents are in the identity versus role confusion stage. This stage involves exploring personal values, beliefs, and goals to form a coherent sense of self. Role diffusion, the correct answer, occurs when an adolescent is unable to integrate various roles and experiences into a unified sense of self, leading to confusion and uncertainty about their identity and future roles. Option A, shame, is not the correct answer because shame is associated with a sense of personal failure or inadequacy, often stemming from external judgments or societal norms, which is not the focus of this developmental stage. Option B, guilt, is also incorrect as guilt typically arises from specific behaviors or actions that violate one's own moral code, rather than a broader sense of identity confusion. Option C, inferiority, is not the best choice as it aligns more with Erikson's earlier stage of industry versus inferiority, which occurs in middle childhood. This stage focuses on developing competence in skills and tasks, rather than the identity exploration seen in adolescence. Educationally, understanding Erikson's stages of psychosocial development is crucial for nurses working with adolescents to support their holistic development. By grasping the unique challenges and tasks of each stage, nurses can provide appropriate guidance and interventions to help adolescents navigate this critical period of identity formation.

Correct Answer: A

Rationale: The best method for preventing neonatal nosocomial infections is option A) Hand hygiene and isolation protocols. This is the correct answer because proper hand hygiene is one of the most effective ways to prevent the spread of infections in healthcare settings. By washing hands before and after caring for each patient, healthcare providers can reduce the risk of transmitting pathogens between neonates. Isolation protocols, such as placing infected neonates in isolation rooms, also help prevent the spread of infections to other vulnerable infants in the neonatal unit. Option B) Administering antibiotics to all neonates is not the best method for preventing neonatal nosocomial infections because indiscriminate use of antibiotics can lead to antibiotic resistance and disrupt the normal flora in neonates, making them more susceptible to infections in the long run. Option C) Frequent suctioning of neonates' airways is important for maintaining airway patency but is not the primary method for preventing nosocomial infections. Proper hand hygiene and isolation protocols are more effective in preventing the spread of infections. Option D) Using steroids in preterm neonates is a treatment option for certain conditions but is not directly related to preventing nosocomial infections. It is essential to focus on infection control practices to reduce the risk of infections in neonatal units. In an educational context, it is crucial for healthcare providers working with neonates to understand and practice proper infection control measures. Emphasizing the importance of hand hygiene, isolation protocols, and other infection prevention strategies can help reduce the incidence of nosocomial infections in neonatal units, ultimately improving neonatal outcomes and patient safety.

Correct Answer: A

Rationale: In the management of an infant with hypoxic-ischemic encephalopathy (HIE), the most important step is therapeutic hypothermia (Option A). Therapeutic hypothermia has been shown to significantly improve neurological outcomes in neonates with HIE by reducing brain injury and improving overall survival rates. It helps decrease metabolic rate, limit the release of harmful neurotransmitters, and reduce inflammation in the brain following hypoxic injury. Steroid therapy (Option B) is not typically indicated in the management of HIE. While steroids may be used in some neonatal conditions, they do not play a primary role in the treatment of HIE. Inhaled nitric oxide (Option C) is more commonly used in conditions such as persistent pulmonary hypertension of the newborn (PPHN) rather than in HIE. Nitric oxide is a potent pulmonary vasodilator and is used to improve oxygenation in neonates with PPHN. Blood transfusion (Option D) may be necessary in cases where there is severe anemia or blood loss contributing to hypoxia, but it is not the primary management strategy for HIE. Educationally, understanding the rationale behind the management of HIE is crucial for pediatric nursing practice. Therapeutic hypothermia is a well-established intervention supported by research evidence, and knowing when and why to implement it can significantly impact patient outcomes in neonatal care. Nurses must be aware of the appropriate treatments for specific conditions to provide safe and effective care to their pediatric patients.

Correct Answer: B

Rationale: In full-term neonates, the most common cause of respiratory distress is transient tachypnea of the newborn (TTN). TTN occurs due to inadequate absorption of fetal lung fluid after birth, leading to retention of fluid in the lungs and resulting in respiratory distress. This condition typically improves within 24-72 hours without specific treatment. Option A, meconium aspiration, occurs when a newborn inhales meconium-stained amniotic fluid before or during delivery. While this is a serious condition, it is less common than TTN in full-term neonates. Option C, respiratory distress syndrome (RDS), is more commonly seen in preterm neonates due to immature lung development. It is caused by a deficiency of surfactant in the lungs, leading to atelectasis and respiratory distress. Option D, infection, can cause respiratory distress in neonates, but it is not the most common cause in full-term infants. Infections may present with other signs and symptoms in addition to respiratory distress. Understanding the common causes of respiratory distress in neonates is crucial for nurses caring for newborns. Recognizing TTN as a common and usually self-limiting condition helps nurses provide appropriate care and reassurance to both the infant and their parents. It is essential to differentiate between these conditions to ensure timely and effective management of respiratory distress in neonates.