Which of the following is the primary cause of neonatal respiratory distress syndrome (RDS)?

Correct Answer: A

Rationale: Neonatal Respiratory Distress Syndrome (RDS) is primarily caused by surfactant deficiency. Surfactant is a substance produced by the alveoli in the lungs that helps keep the air sacs open and prevents them from collapsing. In premature infants, the lungs may not have produced enough surfactant, leading to respiratory distress. This deficiency is the main reason for RDS in neonates. Option B, congenital pneumonia, is not the primary cause of RDS. While pneumonia can cause respiratory distress in neonates, it is not the main etiology of RDS. Option C, persistent pulmonary hypertension, is a condition where the blood vessels in the lungs remain constricted, making it harder for blood to flow through the lungs and pick up oxygen. While it can lead to respiratory distress, it is not the primary cause of RDS. Option D, meconium aspiration, occurs when a newborn inhales meconium (the infant's first stool) into the lungs, which can cause respiratory problems. However, it is not the primary cause of RDS. Understanding the primary causes of neonatal RDS is crucial for pediatric nurses as they care for preterm infants who are at risk for this condition. Proper education on the importance of surfactant in lung function and the risk factors for RDS can help nurses provide optimal care and support for these vulnerable patients.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Hypoglycemia. When a neonate is born to a diabetic mother, they are at increased risk for hypoglycemia due to maternal hyperglycemia during pregnancy. The fetus produces increased levels of insulin in response to high maternal blood glucose levels. After birth, the infant's insulin production continues, but the glucose supply from the mother is suddenly cut off, leading to a drop in blood glucose levels. Option B) Hypercalcemia is incorrect as it does not have a direct correlation with maternal diabetes. Hypercalcemia is an elevated level of calcium in the blood and is not a typical complication in neonates born to diabetic mothers. Option C) Polyuria, which is excessive urination, is not directly associated with neonates born to diabetic mothers. Polyuria is more commonly seen in conditions like diabetes insipidus or renal issues. Option D) Hypertension is also not a typical complication seen in neonates born to diabetic mothers. Hypertension refers to high blood pressure, which is not a primary concern in this specific scenario. In an educational context, understanding the increased risk of hypoglycemia in neonates born to diabetic mothers is crucial for pediatric nurses. By knowing the physiological basis behind this complication, nurses can be vigilant in monitoring blood glucose levels postnatally and intervene promptly if hypoglycemia occurs. This knowledge enables nurses to provide targeted care and support to these vulnerable newborns, promoting better outcomes and overall health.

Correct Answer: A

Rationale: In the context of pediatric nursing and foreign body aspiration, it is crucial to understand the key clinical presentations and management strategies. The correct answer, A) All children with bronchial foreign bodies typically present with classic triad, is false. Not all children with bronchial foreign bodies present with the classic triad of cough, wheeze, and diminished breath sounds. Some may present with atypical symptoms or be asymptomatic. Option B) Negative clinical manifestation does not exclude foreign body aspiration is correct because the absence of symptoms does not rule out the possibility of foreign body aspiration, and a high index of suspicion is necessary. Option C) Laryngeal foreign body presenting with hoarseness or aphonia is also correct because these symptoms are commonly associated with laryngeal foreign bodies affecting the vocal cords. Option D) When foreign body aspiration is suspected, bronchoscopy must be done is incorrect because not all cases require bronchoscopy. The decision for bronchoscopy should be based on a thorough clinical evaluation and consideration of the risks and benefits. Educationally, understanding the various presentations of foreign body aspiration in children and the appropriate management strategies is essential for pediatric nurses. This knowledge helps in timely recognition, intervention, and prevention of complications associated with foreign body aspiration in pediatric patients. Nurses play a critical role in advocating for prompt assessment and intervention in suspected cases of foreign body aspiration to ensure optimal patient outcomes.

Correct Answer: B

Rationale: In pediatric nursing, understanding respiratory distress signs is crucial for accurate assessment and intervention. Expiratory grunting is a protective mechanism seen in infants with pneumonia. This sound is produced when a child attempts to keep small airways open during exhalation to prevent alveolar collapse. Pneumonia is characterized by inflammation and consolidation of lung tissue, leading to impaired gas exchange and respiratory distress. Option A, asthma exacerbation, typically presents with wheezing rather than grunting. Asthma involves bronchoconstriction and airway inflammation, leading to wheezing on expiration. Pleural effusion (Option C) manifests as decreased breath sounds and dullness to percussion, not expiratory grunting. Croup (Option D) is marked by a barking cough and stridor, not expiratory grunting. Educationally, this question highlights the importance of recognizing specific respiratory distress cues in pediatric patients. Understanding these nuances aids in prompt identification of underlying conditions and appropriate management. By grasping these distinctions, nurses can deliver timely and targeted care, thereby optimizing outcomes for children with respiratory issues.

Correct Answer: D

Rationale: In pediatric nursing, understanding the early manifestations of hypoxemia in young infants is crucial for timely intervention. The correct answer is D) Irritability. Young infants, especially those with hypoxemia, often exhibit irritability as an early sign of inadequate oxygenation. This is because the brain is highly sensitive to changes in oxygen levels, leading to irritability due to cerebral hypoxia. Option A) Cyanosis is a late sign of hypoxemia and typically occurs after significant oxygen deprivation. It is characterized by a bluish discoloration of the skin and mucous membranes due to decreased oxygen saturation in the blood. Option B) Glasgow coma score of six is not specific to hypoxemia in infants. It is a tool used to assess the level of consciousness and neurological status in patients with brain injuries or altered mental status. Option C) Irregular breathing can be a sign of respiratory distress, but it is not specific to hypoxemia. It can be seen in various respiratory conditions and is not as reliable an early indicator of hypoxemia as irritability. Educationally, it is important for nursing students to understand the nuances of assessing young infants for signs of hypoxemia. Recognizing subtle cues like irritability can prompt early intervention and prevent further oxygen deprivation, which is critical in pediatric care. This knowledge can help nurses provide timely and effective care to infants in respiratory distress.