A nurse is caring for a newborn who was born to a mother with gestational diabetes. The newborn is large for gestational age.
The nurse should recognize which of the following newborn complications as the priority focus of care?
Monitoring for hypoglycemia.
Monitoring for physiological jaundice.
Monitoring for hyperthermia.
Monitoring for development of rash.
The Correct Answer is A
Choice A rationale
Monitoring for hypoglycemia is critical in newborns born to mothers with gestational diabetes, as they can experience significant drops in blood sugar levels post-birth due to the
sudden discontinuation of the high glucose supply from the mother.
Choice B rationale
Physiological jaundice is common in many newborns but does not represent the most immediate threat. It typically resolves within a few days with appropriate monitoring and care.
Choice C rationale
Hyperthermia can be a concern for newborns, but it is not the primary immediate complication in newborns born to gestational diabetic mothers. Hypoglycemia poses a greater
immediate risk.
Choice D rationale
Development of rash is generally a less critical concern and does not represent an immediate threat to the newborn’s well-being in comparison to hypoglycemia.
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Correct Answer is C
Explanation
Choice A rationale
The absence of creases on the plantar surface is typical of a preterm infant, not a term infant. Term infants usually have some creases.
Choice B rationale
Abundant lanugo is more common in preterm infants, while term infants may have some but not extensive lanugo.
Choice C rationale
A flexed position at rest is expected in a term neonate, as it indicates good muscle tone and neuromuscular development.
Choice D rationale
The pinna of the ear remaining folded is more indicative of a preterm infant, as term infants typically have fully formed and firmer ear cartilage.
Correct Answer is B
Explanation
Choice A rationale
A pincer grasp, using the thumb and index finger to pick up small objects, typically develops around 9 to 12 months of age, not at 4 months.
Choice B rationale
The posterior fontanel typically closes by the age of 2 to 3 months, so a 4-month-old infant would be expected to have a closed posterior fontanel. This finding is consistent with normal development.
Choice C rationale
Lateral incisors, the teeth on either side of the front teeth, typically erupt around 9 to 13 months of age, not at 4 months.
Choice D rationale
Sitting steadily without support generally occurs closer to 6 to 8 months of age, so it would not be expected in a 4-month-old infant.