Neonatal Nurse Practitioner Practice Exam

What should be the initial intervention for a newborn with respiratory distress and a chest x-ray showing bilateral streaky densities?

1. Initiation of antibiotics

2. Sepsis workup

3. Surfactant administration

4. Chest physiotherapy

The correct answer is: Sepsis workup

In the context of a newborn presenting with respiratory distress and a chest x-ray revealing bilateral streaky densities, the most appropriate initial intervention is a sepsis workup. Respiratory distress in neonates can often be a sign of underlying infection, particularly sepsis, which is a critical condition requiring prompt identification and treatment. The bilateral streaky densities on the chest x-ray can indicate a variety of conditions, including infection or fluid-related issues, which makes it essential to rule out sepsis as a potential cause. Conducting a sepsis workup will involve evaluating the newborn's clinical condition, obtaining blood cultures, and possibly performing other laboratory tests to identify any infectious agents. Early diagnosis and management of sepsis are crucial, as it can rapidly progress and significantly impact the newborn's outcome. While other interventions like initiating antibiotics, administering surfactant, or performing chest physiotherapy may also be considered in the management of respiratory distress, they are not the immediate priorities without first addressing the possibility of sepsis. Antibiotics might be initiated after the sepsis workup confirms an infection, surfactant administration is primarily indicated for conditions like neonatal respiratory distress syndrome, and chest physiotherapy is typically used for clearance of secretions rather than addressing the initial cause of