Which preterm infant should receive gavage feedings instead of bottle feedings?

Correct Answer: C

Rationale: The correct answer is C because a sustained respiratory rate of 70 breaths per minute indicates respiratory distress in a preterm infant. Gavage feedings are recommended in such cases to ensure adequate nutrition without causing further stress on the respiratory system. A: Sucking on a pacifier during gavage feedings is not a determining factor in choosing gavage over bottle feedings. B: Gagging when a feeding tube is inserted may not necessarily warrant gavage feedings over bottle feedings. D: The vital signs mentioned in choice D do not specifically indicate a need for gavage feedings; they may require further evaluation but are not a direct indication for gavage feedings.

Correct Answer: D

Rationale: The correct answer is D, blood glucose level of 25 mg/dL. Low blood glucose levels can lead to hypoglycemia, which can impair thermoregulation in infants. Hypoglycemia affects the body's ability to produce heat and maintain body temperature. A high hematocrit level (choice A) or RBC count (choice B) would not directly impact thermoregulation. Similarly, a high WBC count (choice C) is more indicative of an infection rather than a direct effect on thermoregulation. Therefore, the correct concern for thermoregulation in a post-term infant would be a low blood glucose level.

Correct Answer: C

Rationale: The correct answer is C because in asymmetric intrauterine growth restriction, the head appears large compared to the rest of the body due to preferential brain sparing. This is a result of inadequate nutrient supply to the fetus, leading to the brain receiving more nutrients at the expense of the body. Choice A is incorrect because in asymmetric growth restriction, body parts are not proportionate. Choice B is incorrect because extremities being disproportionate is not a characteristic of asymmetric growth restriction. Choice D is incorrect because the asymmetry in growth is primarily related to the head-body disproportion, not one side of the body being smaller.

Correct Answer: B

Rationale: The correct answer is B: clavicle fractures. Macrosomic infants are at increased risk for birth injuries, such as clavicle fractures, due to their larger size during vaginal birth. This evaluation is crucial for early detection and appropriate management. Incorrect choices: A: Hyperglycemia is not typically a direct concern following vaginal birth of a macrosomic infant. C: Hyperthermia is not a common issue in this scenario unless there are other contributing factors. D: An increase in red blood cells is not a primary concern immediately after birth and is not specifically related to macrosomia.

Correct Answer: C

Rationale: The correct answer is C because the infant is exhibiting periodic breathing, a common phenomenon in newborns where they have brief periods of apnea followed by rapid respirations. This is a normal finding in many healthy newborns and does not necessarily indicate a serious medical issue. Continuous monitoring is necessary to ensure the infant's respiratory pattern stabilizes over time. Choice A (RDS) is incorrect because the infant's color and heart rate are unchanged, which are not typical signs of respiratory distress syndrome. Choice B is incorrect because tactile stimulation is not needed for periodic breathing episodes in newborns unless there are additional concerning symptoms present. Choice D is incorrect because CPAP is not typically indicated for periodic breathing episodes in a healthy newborn without other respiratory issues.