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The nurse provides care for a neonate born two hours ago. Which occurrence initiates the changes that take place in the neonate's circulatory system after birth?

a) Closure of the ductus venosus
b) Initiation of lung ventilation
c) Closure of the foramen ovale
d) Decrease in pulmonary vascular resistance

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Final answer:

The first breath a newborn takes at birth inflates the lungs and dramatically alters the circulatory system, closing the three shunts that directed oxygenated blood away from the lungs and liver during fetal life.

Step-by-step explanation:

The first breath a newborn takes at birth inflates the lungs and dramatically alters the circulatory system, closing the three shunts that directed oxygenated blood away from the lungs and liver during fetal life. Clamping and cutting the umbilical cord collapses the three umbilical blood vessels. The proximal umbilical arteries remain a part of the circulatory system, whereas the distal umbilical arteries and the umbilical vein become fibrotic. The newborn keeps warm by breaking down brown adipose tissue in the process of nonshivering thermogenesis. The first consumption of breast milk or formula floods the newborn's sterile gastrointestinal tract with beneficial bacteria that eventually establish themselves as the bacterial flora, which aid in digestion.

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