Low Risk Neonatal Nurse Exam Neonatal Jaundice & Hyperbilirubinemia 2

Question 1

What defines 'physiologic jaundice' in a full-term newborn?

Accepted Answer

Jaundice appearing after 24 hours, peaking around days 3–5, and resolving by 2 weeks of age

Answer

Physiologic jaundice follows a predictable pattern: onset after 24 hours, bilirubin peak around day 3–5, and resolution by 2 weeks in term infants due to normal immaturity of hepatic conjugation.

Question 2

What does a positive direct antiglobulin test (DAT/Coombs) indicate in a jaundiced newborn?

Accepted Answer

Maternal antibodies are attached to the infant's red blood cells, indicating immune-mediated hemolysis

Answer

A positive DAT means maternal IgG antibodies have crossed the placenta and coated the infant's red blood cells, causing immune-mediated hemolytic disease and elevated bilirubin.

Question 3

How does breast milk jaundice differ from breastfeeding (insufficient intake) jaundice?

Accepted Answer

Breastfeeding jaundice occurs in the first week from inadequate intake; breast milk jaundice appears after day 5–7 and may persist several weeks from substances in mature breast milk

Answer

Breastfeeding (starvation) jaundice peaks in the first week from inadequate caloric intake; breast milk jaundice is a distinct entity peaking after day 5–7 from beta-glucuronidase and other factors in mature milk that increase enterohepatic circulation.

Question 4

How is bilirubin normally processed and eliminated in the newborn?

Accepted Answer

Conjugated by glucuronyl transferase in the liver, excreted in bile, and eliminated in stool

Answer

The liver conjugates unconjugated (fat-soluble) bilirubin using glucuronyl transferase to form a water-soluble form excreted in bile and passed in stool; immaturity of this process causes physiologic jaundice.

Question 5

Which essential nursing intervention must be maintained throughout phototherapy treatment?

Accepted Answer

Applying protective eye shields and keeping them in place during all light exposure

Answer

Phototherapy light can cause retinal damage; eye shields must be applied and checked frequently to ensure they remain properly positioned and covering both eyes throughout treatment.

Low Risk Neonatal Nurse Exam Practice Test

Low Risk Neonatal Nurse Exam Practice Test

Low Risk Neonatal Nurse Exam Neonatal Jaundice & Hyperbilirubinemia 2