The practical nurse (PN) is caring for a newborn whose mother has poorly controlled type 1 diabetes mellitus. The PN observes the newborn is grunting with mild sternal retractions. The PN should recognize the newborn is exhibiting signs of which condition?

A. Patent ductus arteriosus: While PDA can cause respiratory distress in newborns, it typically presents later with a continuous heart murmur, bounding pulses, or signs of heart failure, rather than immediate grunting and sternal retractions at birth. B. Hyperinsulinemia: Newborns of mothers with poorly controlled type 1 diabetes are at risk for neonatal hypoglycemia due to hyperinsulinemia. Signs such as grunting, mild sternal retractions, and respiratory distress can result from metabolic instability and require prompt assessment and intervention. C. Hypothyroidism: Congenital hypothyroidism usually presents with subtle signs such as lethargy, hypotonia, and feeding difficulties, not acute respiratory distress immediately after birth. D. Ventricular septal defect: VSD may lead to murmurs or heart failure symptoms, but acute respiratory signs like grunting and sternal retractions are not typically evident at birth unless associated with severe defects.