A newborn male is evaluated one minute after birth. He was born at 38 weeks gestation to a 28-year-old gravida 3 via vaginal delivery. The patient’s mother received sporadic prenatal care, and the pregnancy was complicated by gestational diabetes. The amniotic fluid was clear. The patient’s pulse is 70/min, and his breathing is irregular with a slow, weak cry. He whimpers in response to a soft pinch on the thigh, and he has moderate muscle tone with some flexion of his extremities. His body is pink and his extremities are blue. The patient is dried with a warm towel and then placed on his back on a flat warmer bed. His mouth and nose are suctioned with a bulb syringe. Which of the following is the best next step in management?
ASupplemental oxygen via nasal cannula and reassessment of Apgar score at 5 minutes
BChest compressions and bag-mask ventilation
CEndotracheal intubation and mechanical ventilation
DIntravenous epinephrine and reassessment of Apgar score at 5 minutes
EPositive pressure ventilation and reassessment of Apgar score at 5 minutes
A 1-month-old infant is brought to the physician for a well-child examination. His mother reports that she had previously breastfed her son every 2 hours for 15 minutes but is now feeding him every 4 hours for 40 minutes. She says that the infant sweats a lot and is uncomfortable during feeds. He has 6 wet diapers and 2 stools daily. He was born at 36 weeks' gestation. He currently weighs 3500 g (7.7 lb) and is 52 cm (20.4 in) in length. He is awake and alert. His temperature is 37.1°C (98.8°F), pulse is 170/min, respirations are 55/min, and blood pressure is 80/60 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 99%. Cardiopulmonary examination shows a 4/6 continuous murmur along the upper left sternal border. After confirming the diagnosis via echocardiography, which of the following is the most appropriate next step in the management of this patient?
ADigoxin and furosemide
BPercutaneous surgery
CX-ray of the chest
DProstaglandin E1 infusion
EIndomethacin infusion
A first time mother of a healthy, full term, newborn girl is anxious about sudden infant death syndrome. Which of the following pieces of advice can reduce the risk of SIDS?
ASleep supine in a crib with bumpers, head propped up on a pillow, and wrapped in a warm blanket
BSleep supine in a crib with bumpers, head propped up on a pillow, and wrapped in an infant sleeper
CSleep supine in the parent's bed and use a pacifier after 1 month of age
DSleep supine in a crib without bumpers, use a pacifier after 1 month of age, and use a home apnea monitor
ESleep supine in a crib without bumpers, use a pacifier after 1 month of age, and avoid smoking
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