Final answer:
A premature baby at 26 weeks requires ventilatory support due to a lack of pulmonary surfactant, necessitating respiratory distress syndrome (RDS) treatment.
Step-by-step explanation:
The nurse caring for a neonate born prematurely at 26 weeks understands that the need for ventilatory support is primarily because of a lack of surfactant. At this stage of development, the type II alveolar cells in the lungs have not produced an adequate amount of pulmonary surfactant, which is crucial for reducing the surface tension in the alveoli and allowing for proper lung inflation. Without sufficient surfactant, the neonate's lungs cannot fully inflate, leading to respiratory distress syndrome (RDS) and the requirement of supplemental oxygen and possible mechanical ventilation to support breathing.