Answer to Question 1
ANS: D
Difficulty breathing, with grunting, tachypnea, and nasal flaring are clinical manifestations of respiratory distress syndrome and require further evaluation. This is not a normal finding and requires further evaluation. Cyanosis may be present, but these are significant findings indicative of respiratory distress without cyanosis. The child's condition will most likely worsen for approximately 48 hours without intervention. Improvement may begin at 72 hours.
Answer to Question 2
ANS: A
The successful adaptation to extrauterine breathing requires numerous factors, which most term newborns successfully accomplish. Preterm newborns with respiratory distress are not able to adjust. The most likely central cause is the abnormal development of the surfactant system. The deficient production of surfactant results in unequal inflation of alveoli on inspiration and the collapse of the alveoli on end expiration. The number and state of development of the alveoli is not a central factor in respiratory distress syndrome. The instability of the alveoli related to the lack of surfactant is the causative issue.