1. A preterm infant born at 28 weeks gestation is admitted

to the neonatal intensive care unit (NICU) with respiratory

distress syndrome (RDS). The nurse knows that this

condition is caused by:

a) Infection of the lungs

b) Congenital heart defect

c) Insufficient surfactant production*

d) Meconium aspiration

Rationale: RDS is a common complication of preterm birth

that results from inadequate production of surfactant, a

substance that reduces surface tension and prevents

alveolar collapse in the lungs. Without enough surfactant,

the lungs become stiff and difficult to inflate, leading to

hypoxia and acidosis.

2. A term infant with a birth weight of 4.5 kg is diagnosed

with macrosomia. The nurse should monitor this infant

closely for signs of:

a) Hypoglycemia*

b) Hyperbilirubinemia

c) Polycythemia

d) Hypocalcemia

Rationale: Macrosomia is defined as a birth weight above

the 90th percentile for gestational age. It is often associated

with maternal diabetes, obesity, or excessive weight gain

during pregnancy. Infants with macrosomia are at risk of

hypoglycemia due to increased insulin production in

response to high glucose levels in utero. Hypoglycemia can