A Term Newborn Is Evaluated in the Nursery 1 Hour

question 285

Multiple Choice

A term newborn is evaluated in the nursery 1 hour after a spontaneous vaginal delivery to a 28-year-old primigravida whose pregnancy was uneventful.  The patient's Apgar scores were 9 and 9 at 1 and 5 minutes, respectively.  Vital signs are normal.  Physical examination shows a newborn sleeping comfortably with overlapping coronal sutures.  There is a I/VI systolic murmur at the left upper sternal border that radiates to the axilla.  The lungs are clear bilaterally.  The abdomen is soft, and the liver is palpable 2 cm below the costal margin.  Genitourinary examination shows curvature of an underdeveloped penis.  The urethral meatus is at the ventral surface of the base and flanked by the surrounding scrotal sac.  Gonads are not palpable.  Examination of the back shows a sacral dimple with intact skin.  The patient has normal fingers and toes.  There is cyanosis in the digits.  There is symmetric movement of all 4 extremities, and Moro and suck reflexes are normal.  Which of the following is the best next step in evaluation of this patient?

• A)Echocardiogram
• B)Head ultrasound
• C)Karyotype analysis
• D)Liver ultrasound
• E)Serum alpha-fetoprotein

Assess the impact of national and international laws on strategic business decisions in the context of globalization.

Analyze the enforcement of antitrust laws in the context of multinational enterprises operating across borders.

Understand legal considerations related to nationalization and expropriation of foreign investments and the avenues for redress.

Evaluate the legal aspects of foreign investments and the pros and cons of different modes of entering international markets.

---

Definitions:

Productivity

The measure of the efficiency of a person, machine, factory, system, etc., in converting inputs into useful outputs.

Quality Work

Work or output that meets or exceeds predefined standards of excellence, often characterized by attention to detail, craftsmanship, and customer satisfaction.

Resources Consumed

The materials, time, energy, and other assets used or expended in the process of achieving a task or goal.

Mission Statement

A formal summary of the aims and values of a company, organization, or individual, guiding its strategies, goals, and actions.